Pennsylvania has moved smokers to the top of its list for getting the COVID-19 vaccine.

The Pennsylvania Department of Health has added “persons ages 16-64 with high-risk medical conditions” to phase 1a of its vaccine allocation plan. Smoking is listed as a high-risk condition.

Health care personnel, long-term care facility residents and people 65 years old and older are also included in Pennsylvania’s phase 1a. The state is now in phase 1a of its allocation plan.

The change was first reported by WTAE-4 in Pittsburgh.  

In a statement to The Hill, a spokesperson for the Pennsylvania Department of Health said “Our goals are to prioritize persons, while the vaccine supply remains limited, who receive the vaccine to maximize benefits and minimize harms caused by the virus, promote justice, mitigate health inequities, and promote transparency. The [Centers for Disease Control and Prevention], the [Food and Drug Administration], and numerous studies have demonstrated that smoking disproportionately impacts those with low socioeconomic status.”  

“Pennsylvania remains committed to addressing health disparities in our response to this deadly pandemic,” the spokesperson continued.

“Public health experts agree smoking is associated with increased severity of disease and death in hospitalized COVID-19 patients. To mitigate these increased risks, Pennsylvania has chosen to follow the CDC’s recommendations and include smoking among the list of medical conditions putting individuals at greater risk.” 

The CDC’s Advisory Committee on Immunization Practices currently recommends those aged 16-64 with medical conditions that increase their risks of severe COVID-19 to be included in phase 1c, but states are free to modify their distribution plans to their discretion.

The CDC says that smoking increases one’s risk of severe illness from COVID-19. Smoking weakens the immune system, which lowers the body’s ability to fight off disease.

The move comes as states expand eligibility in a rush to vaccinate more of its residents. CNN reported that New Jersey and Mississippi currently offer the vaccine to smokers, and several other states have smokers next in line. 

Updated 2:18 p.m.