Many states have prioritized COVID-19 vaccines for people over 75, then switched to those over 65, but they should not continue to decrease in age, said an advisory committee of the Centers for Disease Control and Prevention on Monday. market.
The approach is inherently unfair to minorities, committee members said, because they have a shorter life expectancy and because people of color are dying of COVID-19 at younger ages than white Americans – even in their 30s. , 40 and 50 years old.
“I am not in favor of any part of an eligibility age group below 65,” he said Dr. José Romero, a specialist in pediatric infectious diseases at the University of Arkansas for Medical Sciences in Little Rock and chairman of the Advisory Committee on Immunization Practices.
The committee disagreed with some states’ plans to require people to provide evidence that they have two medical conditions on a pre-specified list before being vaccinated.
People with two well-controlled medical conditions may have a lower risk of severe COVID-19 than those with an out-of-control condition or a less common illness that was not frequent enough.
For example, although type 2 diabetes is considered a high-risk condition, type 1 is not always, although people with this less common autoimmune version are at the same risk, he noted Dr. Katherine Poehling, professor of pediatrics at Wake Forest School of Medicine in Winston-Salem, North Carolina.
Yes, there will be some people who will lie about their medical conditions, he admitted Dr. Helen Talbot, infectious disease specialist at Vanderbilt University Medical Center in Nashville, Tennessee. “There is always someone who finds a way to cheat.”
But it is better to let in some cheaters than to deny the vaccine to people who really need it, she said.
The other category of people that should be prioritized, said the committee members, are those who care for others who may not be vaccinated.
Dr. Grace Lee, a professor of pediatric infectious diseases at Lucile Packard Children’s Hospital and Stanford University School of Medicine in Stanford, California, cited the parents of children who received stem cell transplants.
“Being able to protect these individuals in the absence of any high-risk medical condition, I think in itself, it is important, in part because we cannot vaccinate children at this time,” she said.
Each state has its own vaccination plan, so there are a series of mixed messages about who should be prioritized in the coming months, as vaccine supplies remain tight, committee members said.
For this reason, committee members said the Johnson & Johnson vaccine, authorized over the weekend, should be added to the general set of vaccines available, rather than targeting any particular group or population.
They re-emphasized their commitment to the equitable distribution of vaccines, even if they are distributed to as many people as possible.
“I am very challenged to ensure that we continue to maintain equity as a focus for the implementation of the COVID-19 vaccination program,” said Lee.
Many vaccine distribution centers are so concerned with vaccinating the right people that they are refusing many, she continued.
“Since our intention is to vaccinate everyone anyway, except in the most egregious situations, whether or not I hit high-risk condition A versus B, I think it is less important than just ensuring that we are providing access,” she said.
About 50 million Americans have received at least one dose of the COVID-19 vaccine. In by the end of this month, Pfizer-BioNTech will have provided a total of 120 million doses of its vaccine, enough to vaccinate 60 million people; Moderna will have provided 100 million doses to vaccinate 50 million people; and J&J will supply 20 million doses of its single injection vaccine. That is enough to cover more than half of the 210 million adults in the United States.
At its second four-hour meeting over two days, the committee considered extending the recommended period between the two doses of the Pfizer-BioNTech or Moderna vaccines.
Some suggested that a postponement would allow more vaccine to be distributed, but committee members said they did not think there was enough data to justify postponing the second dose of any of the vaccines.
There were more conflicting opinions about whether people with symptomatic COVID-19 would need both doses of the two-dose vaccines.
Basic immunology suggests that the disease would act as a primary dose and the first injection as a booster, said Talbot. “I don’t need any more data. We have all studied immunology,” she said.
Others raised questions about whether the risks of vaccination for people who received COVID-19 would outweigh the benefits, particularly of a second injection. CDC officials said there was not enough information to answer that question.
Implementing such a policy would be challenging, because it is unclear how long the protection lasts and how sick a person must be to develop adequate natural protection.
Please contact Karen Weintraub at kweintraub @ usatoday.
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This article was originally published in USA TODAY: Should states prioritize the vaccine by age? Some experts say no