Initial doses of a COVID-19 vaccine should go to front-line health workers, first responders and people at serious risk for infection, according to new draft guidelines released Tuesday by a federal advisory panel.
The draft guidelines were developed by the National Academies of Sciences, Engineering, and Medicine to help U.S. officials plan for an equitable allocation of an eventual vaccine.
The final report will be released later this fall.
The committee recommended a four-phased approach, at least when the initial supply of a vaccine is limited, "guided by evidence to achieve the primary goal of maximizing societal benefit by reducing morbidity and mortality caused by the transmission of novel coronavirus."
The panel said the plan will be incrementally phased in as the vaccine supply increases with the goal of targeting people most at risk for catching the virus as well as for transmitting it.
Committee co-chair Helene Gayle said the panel's task is to make the "tough choices ... for allocating the tightly constrained initial supplies."
The first phase, dubbed the "jumpstart phase," includes front-line health workers and first responders, followed by people with underlying health conditions that put them at risk, as well as older adults in dense living settings, such as assisted living or nursing homes, as well as multi-generational homes.
The group includes about 15 percent of the U.S. population, according to the report, which specifically mentions the need to vaccinate not just assisted living and nursing home residents but also the staff.
"Vaccinating these individuals not only enables them to provide these services, but also reduces the risk that they will spread the infection as they work in hospitals, nursing homes, assisted living facilities, home care, and group homes, or return to their own homes,” the report said.
The second group would cover an estimated 30 to 35 percent of the U.S. population. It would include essential workers "at substantially high risk of exposure," such as teachers and school staff, people in jails, prisons and homeless shelters, people with moderate-risk conditions, as well as older people not included in the first group.
A third phase would include providing the vaccine to young adults and children, as well as workers at increased risk of exposure not included in previous phases.
These include service industry workers and people who work in banks, libraries, hair and nail salons, and exercise facilities.
The fourth phase would include everyone else, which should happen no later than 12-18 months after the initial rollout, the panel said.
Many of the leading vaccine candidates in final trial stages are being developed with substantial government investment. The panel recommended officials should ensure vaccines are available to everyone no matter their social and economic resources, employment, immigration or insurance status.
"In the national interest, Medicare and Medicaid should require free vaccine administration; providers should not charge private plans or consumers; and private insurers and employers should not charge co-pays or deductibles for vaccine administration," the panel recommended.