The first doses of the COVID-19 vaccine should be given to health care workers who might be exposed to the coronavirus and residents of long-term care facilities where people tend to be elderly and have underlying conditions that put them at high risk of dying, an influential panel of the Centers for Disease Control and Prevention panel said Tuesday.
The Advisory Committee on Immunization Practices said roughly 20 million health care workers who could have “direct or indirect exposure” to the coronavirus and 3 million adults in nursing homes and assisted-living facilities should be grouped into “phase 1a” distribution.
Staff at long-term care facilities, where 40% of U.S. deaths from COVID-19 have been reported, are considered health care workers eligible for initial doses under the recommendations approved in a 13-1 vote.
Committee Chairman Jose Romero said he voted yes because the recommendations maximize benefits, minimize harm and “promote justice.” Helen Keipp K. Talbot cast the lone “no” vote after raising concerns about a lack of available data on how the vaccines would affect older people.
Governors will have the final say on who gets the initial doses, though experts say states typically follow recommendations from the CDC panel of doctors and experts.
Two drugmakers, Pfizer and Moderna, have asked the Food and Drug Administration to authorize their messenger-RNA vaccines for emergency use. Each of the vaccine candidates was over 90% effective in human trials and, assuming the applications are well-received, the first doses could be shipped before Christmas.
The Trump administration expects to send 6.4 million doses in the first shipment and have enough to vaccinate 20 million people before the end of the year, with production expected to ramp up in the new year. Both vaccines require two doses.
The initial-phase population detailed by the advisory committee adds up to 23 million people within the U.S. population of roughly 330 million.
State leaders and health care systems might have to subprioritize people within the initial-phase groups. If supply is too limited to vaccinate all health care workers at once, the committee said, then states should prioritize those in direct contact with patients or infectious materials.
Staff and residents of long-term facilities typically will be vaccinated at the same time, though state leaders might have to adjust to “supply and local context.”
Future meetings of the CDC’s advisory committee will determine who should be next in line as factories churn out more vials. Nonmedical essential workers likely will be next in line, followed by seniors and Americans with high-risk medical conditions.
Moncef Slaoui, the chief science adviser for President Trump’s Operation Warp Speed initiative, said he expects enough doses to be available for every American who wants the vaccine by June, although it is up to everyday people to come forward and roll up their sleeves.
“Vaccines are only useful if they are used,” Mr. Slaoui said in an interview with “Washington Post Live.” “If they stay on the shelf, they are useless.”
The advisory committee said people must wear face masks and take other precautions while the vaccination campaign continues and the population builds herd immunity. The vaccines might not be fully protective in everyone, and experts say 60% to 70% of the population will need to be inoculated to bring the pandemic under control.
Vice President Mike Pence is scheduled to travel to Tennessee on Thursday to highlight the vaccine program at a roundtable event. House Speaker Nancy Pelosi, California Democrat, said the vaccine rollout is a part of bipartisan talks about a stimulus bill in Congress.
“On COVID relief, we acknowledged the recent positive developments on vaccine development and the belief that it is essential to significantly fund distribution efforts to get us from vaccine to vaccination. Any COVID proposal must ensure that the vaccine is free and accessible to everyone,” Mrs. Pelosi said Tuesday after speaking with Treasury Secretary Steven T. Mnuchin.
An approved vaccine is desperately needed. COVID-19 is killing more than 1,000 people per day in the U.S.
The seven-day rolling average of reported daily cases has dropped in recent days but remains high, at 160,000. More than 96,000 people were hospitalized for COVID-19 as of Monday, the most since the pandemic began. Fears that health care systems could be overrun have forced governors to resort to curfews or other business restrictions.
New York Mayor Bill de Blasio and his health commission, meanwhile, urged seniors and those with underlying health conditions to stay home if they can because of increased local transmission.
FDA Commissioner Stephen Hahn was summoned to the White House on Tuesday for a meeting with Chief of Staff Mark Meadows about the pace of the vaccine approval process.
The Axios media outlet reported that Mr. Meadows wanted Dr. Hahn to move faster on Pfizer’s application, though regulators are on track to approve emergency use within weeks.
The White House did not offer details about the reported meeting, and Mr. Slaoui said he wasn’t aware of any disagreements.
“I have no reason to believe, from all my interactions, [the FDA] either sped up or slowed down the process,” Mr. Slaoui told The Washington Post. “I have no reason to believe there should be tensions.”
Companies that filed for emergency approval said they tested their vaccines in age groups that tend to populate nursing homes, which were hit early and often by the pandemic.
Pfizer, which worked with German company BioNTech, said 45% of the people in its U.S. trial were 56 to 85 years old, and Moderna said its trial included 7,000 participants older than 65.
But some members of the Advisory Committee on Immunization Practices were concerned that data on long-term care residents was lacking, given that the trials focused on “community-dwelling” seniors.
The committee worked through the details Tuesday of vaccinating residents and following up with them to make sure they don’t feel adverse effects. Centers with high turnover will have to make sure residents can return for the second day of immunization if they move out of the facility in between doses.