‘It’s not premature to plan’: Deciding who gets the coronavirus vaccine first

Illustration by Peter Hamlin.;

The new coronavirus’ disproportionate toll on the elderly could put them at the front of the line [for a vaccine] —except they often have the weakest response to vaccines. Conversely, groups such as prisoners, meat packers, soldiers, and grocery store workers are often young and healthy—yet their profession or environment dramatically increases risks of getting infected. And then there is the thorny question of whether to favor specific ethnic groups hard-hit by the virus.

Even if the optimists are right and a COVID-19 vaccine is approved for widespread use as early as this fall, it is likely to be in short supply at first… A subgroup of CDC’s Advisory Committee on Immunization Practices (ACIP) borrowed from a plan made for scarce pandemic influenza vaccines and developed a rough, five-tier scheme for the United States. The top tier includes 12 million people referred to as “critical health care and other workers.”

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Tiers two and three would include 110 million people who also work in health care and other essential jobs, or are in these groups: 65 and older, living in long-term care facilities, or those with medical conditions known to increase the risk of developing severe COVID-19.


“If you waited until you had perfect data about this issue, you would never act,” [CDC’s Tom Frieden] says. “It’s not premature to plan for this.”

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Infographic: Deaths from COVID-19 are far higher than reported estimates

Infographic: Deaths from COVID-19 are far higher than reported estimates

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