Friday , January 15 2021

Who will be vaccinated first in the United States?

The list of priority populations in the United States for vaccination against COVID-19 has not been officially fixed, but already expert opinions diverge there compared to the choices of other countries like France, in particular on workers essential.

There will be no single rule in the United States: at the risk of creating confusion, as during the vaccination campaign against the H1N1 flu in 2009, the federal government will make recommendations and leave each state free to decide. mode of distribution and its order of priority, between elderly people, caregivers, supermarket employees …

Recognized groups of experts have already delivered opinions, sometimes divergent, revealing the central tension of the debate: vaccination should both protect the most vulnerable and facilitate the rebirth of society.

It is on this subject – how to restart the economy as quickly as possible – that the United States could distinguish itself.

The High Authority for Health in France recommended starting with residents and certain at-risk employees of retirement homes, followed by the elderly and health workers, then those over 50, then people whose profession promotes infection. and vulnerable and insecure people, and finally the rest of the population.

An approach close to that suggested by the World Health Organization and chosen by many rich countries, Saad Omer, director of the Institute for Global Health at Yale University, told AFP.

In the United States, in a more than 200 page report, the National Academies of Science, Engineering and Medicine put caregivers “on the front lines” of the pandemic first, and paramedics and police officers. and firefighters who are highly exposed to the virus.

People who have two or more pathologies (cancer, obesity, type 2 diabetes, etc.), whatever their age, would follow, and the 2 million people in retirement homes.

Cogs of the country

The American experts then base themselves not on age but on profession and privilege the “critical” workers who make America turn: first the teachers, and the workers who serve to feed the Americans, from the slaughterhouses to the supermarkets, who drive buses and trains, sell drugs, maintain order, or deliver mail and parcels.

It is also often precarious workers, from Hispanic and black minorities who have been disproportionately hit by the pandemic, an injustice that the experts explicitly want to redress.

After these tens of millions of workers could be vaccinated people with only one pathology, the homeless, prisoners and those over 65 without comorbidity … Then young adults and especially students, who are less at risk but have shown how much they spread the coronavirus.

This is only a proposal. The Centers for Disease Prevention and Control (CDC) are awaiting the opinion of their own (advisory) expert committee, which will vote on Tuesday.

This committee suggested that it could prioritize caregivers and essential workers, because immunizing them will provide a “multiplier effect”: not only are they essential cogs in the health response and the economy, but they are in contact. with a lot of people.

In practice, these ethical, epidemiological and economic considerations may be ignored in the initial rush on doses.

Concrete problems remain to be solved: if it is easy to target retirement homes and hospitals, how are pharmacists and doctors supposed to confirm that a client is indeed an essential worker, or that he has two conditions? ?

In addition, the Trump administration has said it will not be bound by the advice of its health agency, and that retirement homes will receive Pfizer / BioNTech vaccines as early as mid-December in the event of a regulatory green light, whatever. ‘say the experts. The logistics are even already in place.

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