COVID-19 Vaccine Distribution by CDC, WHO
Overview
As of Friday, December 11th, the US Food and Drug Administration (FDA) has approved Pfizer’s SARS-CoV-2 vaccine, the first to be approved in the United States. Distribution of the vaccine will follow CDC’s Phase Allocation that takes a logistical, efficient, and ethical approach on who will receive the vaccine first. The beginning of the end is near and this article will clarify how we will reach the end.
What’s the CDC Distribution Plan?
The CDC has an entire COVID-19 Vaccination Program Playbook. In this playbook is a Phased Allocation of the COVID-19 Vaccine which includes stages of distribution based on demographic groups. The CDC takes a scientific approach supported by ethical responsibilities to determine who would benefit most from the vaccine. Although the CDC has posted Phase 1, which includes 3 subgroups, more of the Phased Allocation will be revealed as more COVID-19 vaccines are approved and become available.
Phase 1A: Healthcare Personnel & Long-term Care Facilities
As the Pfizer COVID-19 Vaccine is distributed, the CDC dictates that the first demographics to be vaccinated will be healthcare personnel (HCP) and residents living in long-term care facilities (LTCF). HCP sums to approximately 21 million individuals who work in:
Hospitals
Long-term care facilities
Outpatient Clinics
Home healthcare
Pharmacies
Emergency medical services
Public health
The CDC recognizes that when HCP are diagnosed with COVID-19, it results in absenteeism. This consequence puts tension on the number of available staff and care for other patients, both COVID-19 and non-COVID-19, resulting in higher death counts. With HCP being the first to receive the vaccine, there’s hope that less strain will be put on staff and the death count will stabilize. Moreover, this decision is supported with ethical reasoning. First vaccinated HCP can result in stable healthcare capacity. Second, HCP are consistently living in a high-risk environment and deserve the justice of adequate care. Lastly, HCP includes a broad range of occupations, which is inclusive to low-wage earners and racial and minority groups.
LTCF residents sum to about 3 million in:
Skilled nursing facilities
Assisted living facilities
Other residential care
Throughout the COVID-19 pandemic, LTFCs have been hotbeds for the spread of SARS-CoV-2. Additionally, most patients living in LTFCs are at high risk of developing severe COVID-19. The CDC Reports that LTFC residents account for 6% of the total cases while make-up 40% of the death count. By distributing vaccines to residents, the rate of hospitalization can be dramatically decreased. Therefore, making hospital beds and ventilators available; ultimately, lowering the death rate. Overall, there is an ethical responsibility to provide care to those who are at a high risk of severe COVID-19 and death.
Phase 1B: Essential Workers
As vaccines become more available, the CDC outlines that essential workers must be the next demographic to receive access to the vaccine. Essential workers are made up of approximately 60M individuals in a variety of fields:
Educators
Food & Agriculture
Utilities
Police
Firefighters
Corrections Officers
Transportation
Etc.
The same criteria and reasoning for HCP is extrapolated to essential workers. These individuals are critical for the continuation of society and systems that improve the livelihood of all citizens. While in this position, individuals are at high-risk of developing COVID-19 and it’s the government’s as well as society’s responsibility to provide adequate protection for such workers. Furthermore, essential workers have a range of occupations that include low-wage earners as well as diverse racial and minority groups.
Phase 1C: Adults 65+ and/or with High-Risk Medical Conditions
The final group in the first phase of vaccination is adults over the age of 65 and adults of any age with medical conditions that put them at high-risk for severe COVID-19. Such conditions could be:
Cancer
Chronic kidney disease
Chronic obstructive pulmonary disease
Heart conditions
Immunocompromised states
Diabetes mellitus
Sickle cell disease
More conditions on the CDC Website
Again, the criteria and reasoning for LTCF residents is extrapolated to these individuals. Beyond the risk of spreading throughout a facility, elderly individuals and those with medical conditions, indeed, are at a high risk of developing severe COVID-19 and death. Therefore, in order to limit hospitalization and maintain low hospital numbers, the total death rate will decrease.
Phases 2 & 3
Phases 2 and 3 predict that there will be sufficient numbers of COVID-19 vaccines that meet the demand at that time. Currently, it appears that Phase 2 includes plans to offer vaccinations to critical populations not met in Phase 1. Phase 3 has plans to make all COVID-19 vaccines widely available for any person who wants a vaccination. During Phase 1, there will be high demand with low supply of COVID-19 vaccines. The length of Phase 1 is expected to have a longer duration, but make a smooth transition into Phase 2 as more vaccines become available.
When Can I Get Vaccinated?
Although a logistical plan has been laid out, it’s difficult to say when someone will be vaccinated. The timeline is determined by several factors: clinical trials, FDA approval, and vaccine production. First, clinical trials are still being conducted for over a dozen COVID-19 vaccines. Second, the FDA needs to approve each vaccine candidate along with the required amount of data from clinical trials. Lastly, once approved, pharmaceutical companies have production limits based on their resources.
If you are a healthcare professional, an essential worker, a long-term care facility resident, or have a medical condition that puts you at high-risk for severe COVID-19, you can expect to receive a vaccine within the first half of 2021, if not the first three months.
If you do not fall into any of these demographics, you can expect to have access to a COVID-19 vaccine in the latter half of 2021. Dr. Anthony Fauci, along with other physicians, predict that the US can begin relaxing guidelines and restrictions near the end of 2021, assuming a minimum of 70% of the American population get vaccinated.
Plan for Second Dose Reminders
Most COVID-19 vaccines approved or in clinical trials require a second vaccination 3 or 4 weeks after the initial vaccination. The CDC plans to provide cards completed by the vaccination provider that indicate dates and specific type of vaccine that was received in order for efficient communication. These cards are to help remind individuals when they must get a second vaccination and inform providers on what vaccine was received.
Receiving a second dosage is essential to ensuring that immunity is reached based on clinical trials. Although immunity is already present after the first vaccination, after a second vaccination, immunity is increased and prolonged. The CDC encourages local jurisdictions to utilize already present systems used to inform patients of appointments and vaccinations such as SMS messaging, phone calls, and emails. Moreover, if health insurance providers are notified of the pending vaccination claim, they too can notify the patient.
*The CDC clarifies that each vaccination must be from the same manufacturer and cannot be interchanged with another vaccine. If done so, the results are unpredictable as interchanged dosing has not been tested through a clinical trial.
WHO’s Vaccine Distribution Plan
The World Health Organization (WHO), like the CDC, has created documents that dictate which populations should receive vaccinations first along with scientific, logistical, and ethical rationale. The WHO’s plan is to logistically determine the global distribution of vaccines with assistance in which demographics should receive the vaccinations first, yet it’s up to individual governments to determine who receives the vaccines within the country.
Roadmap for Prioritizing Population Groups
Overall, the WHO has designed a vaccination rollout in two phases. In Phase 1, vaccinations will be distributed based on population size. The Strategic Advisory Group of Experts offer criteria, similar to the CDC, of how these vaccines should be distributed: HCP, essential workers, and others at high risk of severe COVID-19. If followed accordingly, this can reduce the global death count of COVID-19. In Phase 2, vaccines will be distributed to individuals who are less at risk of being infected or severe COVID-19 symptoms.