(1) people of all ages with comorbid and underlying conditions that put them at significantly higher risk; and, (2) older adults living in congregate or overcrowded settings.
CDC currently lists the following comorbid conditions as associated with increased risk of severe COVID-19 disease: cancer, chronic kidney disease, chronic obstructive pulmonary disease (COPD), immunocompromised state from solid organ transplant, obesity (body mass index [BMI] ≥30), serious heart conditions (e.g., heart failure, coronary artery disease, cardiomyopathies), sickle cell disease, and type 2 diabetes mellitus.
Recognizing the limited initial vaccine supply, Phase 1b proposes setting a priority on individuals with two or more of these conditions, recognizing that these priorities can be refined as better evidence emerges.
Phase 2
This category includes administrators, environmental services staff, maintenance workers, and school bus drivers, all of whom are essential to education and face disease exposure.
Vaccinating these individuals supports their vital societal role in providing children’s education and development, while reducing their role in transmission between schools and the community and protecting their own health risks from exposure in these settings.
Includes critical workers in high-risk settings—a group of individuals whose occupations are in essential industries and who cannot avoid a high risk of exposure to COVID-19. They include workers in the food supply system, public transit, and other vital services.
Includes people of all ages with comorbid and underlying conditions that put them at moderately higher risk, which the committee defined as having one of the previously mentioned conditions and potentially some rare diseases as well.
Includes people in homeless shelters or group homes, and staff who work in those settings.
Phase 3
Includes young adults, children, and workers in industries that are both important to the functioning of society and pose moderately high risk of exposure.
Phase 4
Includes everyone residing in the United States who did not have access to the vaccine in prior phases.
Conclusion:
This NAM report provides a very thorough and specific set of goals, actions and criteria to facilitate the opportunities for the African American community, and other communities of color, to employ proven safe and effective COVID-19 vaccines in mitigating the disastrous impact of this pandemic.
You are encouraged to use this as a “checklist” as you participate in the design of vaccine dissemination programs in your community and as you monitor and track the implementation of these programs by local officials.
You can access the full report at: www.nap.edu/vaccineframework.
To access the report, click:
https://www.nap.edu/catalog/25917/framework-for-equitable-allocation-ofcovid-19-vaccine
by Reed Tuckson, MD