Priority healthcare professionals and senior residences in the United States

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Healthcare professionals and nursing home residents should be given priority for COVID-19 vaccination in the United States, an advisory committee recommended Tuesday.

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These two populations represent around 24 million people in the United States, which is the approximate number of people who can be vaccinated in December according to authorities’ forecasts, if the two vaccines are currently being evaluated by the Agency. drugs (FDA), developed by Pfizer / BioNTech and Moderna, were indeed authorized and produced in the quantities promised.

Experts from the Centers for Disease Prevention and Control (CDC) delivered their long-awaited opinion after a public meeting followed by a vote.

“I voted to maximize benefits, minimize risks, promote justice and mitigate existing health inequalities,” said committee chair José Romero.

But this recommendation, which concerns the very first phase known as “1a”, will not be compulsory.

Donald Trump’s federal government will recommend an order of priority that will not necessarily be that of the CDC.

And at the risk of creating confusion in the country, it will ultimately be each of the 50 states and territories that will set the list of priority groups in its jurisdiction, even if most should adhere to the recommendations of the health authorities.

Three weeks

US officials had already said they planned to distribute 40 million doses in all by the end of the year. Each vaccine will be given in two doses spaced three or four weeks apart depending on the laboratory.

So, from an operational standpoint, most states believe they will be able to vaccinate all of their health professionals “in three weeks” or less, said Nancy Messonnier, director of the CDC’s vaccination center.

Retirement homes have concentrated 40% of the deaths from the pandemic in the United States, or about 100,000 deaths. They have three million residents.

For professionals in the health sector, the population is estimated at 21 million people in hospitals, retirement homes and other residences for the elderly, clinics, pharmacies, emergency services …

The committee did not vote for the continuation of the operations, but its experts proposed to then give priority to essential workers (education, food, law enforcement, firefighters, public transport … in a phase 1b), then adults with many risk factors and adults over 65 (phase 1c).

Sara Oliver of the CDC explained during Tuesday’s meeting that after December authorities expected to receive between 5 and 10 million doses per week.

Essential workers

The rather high priority given to workers essential to the recovery of the economy seems to be an American characteristic.

The central tension of the debate is the following: vaccination should both protect the most vulnerable and facilitate the rebirth of society.

Another group of American experts, convened by the National Academies of Sciences, proposed to rapidly vaccinate teachers and other “critical” workers, those who are the cogs essential to a return to normalcy, and whose vaccination would have an effect. multiplier.

It is often precarious workers, from Hispanic and black minorities who have been disproportionately affected by the pandemic.

In France, the Haute Autorité de la santé has recommended starting with residents and certain at-risk employees of retirement homes, followed by the elderly and health personnel, then those over 50, then people whose profession favors a infection and vulnerable and vulnerable people, and finally the rest of the population.

Only one member of the committee voted Tuesday against the recommendations adopted in the United States, after raising the question of the side effects of vaccines on the elderly.

Detailed data from Phase 3 clinical trials, that is, thousands of volunteers, have not yet been published, although the manufacturers have indicated that no serious side effects have been linked to their vaccines.

Historically, almost all side effects appear within six weeks of vaccination, and trials have accumulated two months of safety data.

But monitoring will continue after authorization: many existing and new pharmacovigilance systems will monitor, week by week, the appearance of serious side effects in people vaccinated, detailed CDC officials.

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