The pandemic continues to rage, but there’s some hope on the horizon with vaccination expected to start this month. Limited vaccine supplies, however, are leaving decision-makers the tough choice of where to start immunization. We explore the options in the latest coronavirus news update: Who should get vaccinated first?
In this coronavirus news update article:
An independent team of medical experts that advise the CDC will cast their vote and make a recommendation. During a recent meeting, the team favored essential workers. While the CDC rarely rejects their suggestions, no one has faced a challenge like this before, and there is still a lot of uncertainty surrounding the issue.
In the past, the advisory committee relied on facts and science to inform their choices, but social justice concerns are starting to carry more weight. And the debate surrounding the trade-offs are getting heated.
According to the former Food and Drug Administration commissioner Dr. Scott Gottlieb, vaccinations’ short-term goal will affect the decision. For instance, if the goal is to lower the infection rate, the focus should fall on essential workers. On the other hand, to preserve as many lives as possible, the elderly and those with pre-existing conditions should get vaccinated first.
In the end, however, the decision will be up to local health officials, states, and governors. Historically, they have relied on the CDC’s recommendations to inform their policies, but they are not required to follow these guidelines.
Elderly v.s Essential Workers
If the choice comes down to preventing death or curbing infections, the first two groups considered are the elderly and essential workers.
According to current definitions, 70% of the workforce is essential. But, public health officials and economists argue the category is too broad and should only include only those who come in direct contact with others.
There are roughly 90 million workers that the Department of Homeland Security considers as vital in maintaining infrastructure during the pandemic. However, there won’t be enough doses to reach everyone, adding to the dilemma of who should come first.
For instance, Louisiana’s preliminary plan puts food processing workers ahead of grocery employees, whereas Nevada wants to prioritize public transit workers over food processors.
On the other hand, many states plan on prioritizing some older people who live independently or people with medical conditions over essential workers.
Besides, some health policy experts argue preventing deaths rather than reducing the rate of infection is a realistic choice because the available vaccines won’t make a significant dent in transmission. Thus, the most effective use of limited quantities should go towards saving the lives of the frailest.
Without fact-based reasons to prioritize one group over the other, authorities run the risk of mass protests and upheaval.
The Issue of Ethics
Choosing one group over the other brings the question of ethics to the foreground.
On the one side, ethics favor the high proportion of low-income, low-education, and minority workers among essential workers.
However, some essential workers, for example, many teachers, don’t fall into this category. In other words, if a central aim is to reduce health inequities, prioritizing them would be unethical.
Simultaneously, choosing essential workers over the elderly goes against the framework proposed by the World Health Organisation. The WHO, along with many public health officials, believes reducing death should be the definite priority, and therefore the elderly should be the first choice.
With the debate continuing, many are looking towards mathematicians for the answer to a complex problem. But, according to most models, there is no clear solution.
The model to rollout vaccines must reflect the intricacies of human life and interactions. Mathematicians build formulas using data like age, health risks, habits, housing, and socioeconomic status.
It all comes back to the central goal. To reduce death rates, those who are older should get vaccinated first. But to slow the rate of infection, officials should focus on younger adults.
Several models emphasize the importance of local transmission rates. For example, New York city could contain the virus if 40% of the residents were vaccinated.
While some people argue the models are the best bases for a decision, others feel it removes the human factor from the equation.
Regardless, with vaccination expected to start soon, the debate about who goes and lobbying from outside groups is growing more urgent. And with so many variables, decision-makers face an impossible choice.
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