November 3, 2020 -- People who live in areas that have been hit disproportionately by the pandemic, including Black and Hispanic communities, may be among the priority groups who receive a coronavirus vaccine first, according to The New York Times.

The Advisory Committee on Immunization Practices, which monitors vaccines and provides guidelines to doctors and health care workers, is drafting recommendations for the Centers for Disease Control and Prevention, which will announce the final plan in coming months.

“Implementing COVID-19 vaccination presents a number of unique, interrelated challenges,” ACIP group members wrote in a viewpoint article in JAMA.

The independent group has held several public meetings in recent months to develop recommendations, and they met again on Friday to discuss the latest updates. The group will release its full recommendations after reviewing safety and efficacy data of coronavirus vaccines that receive emergency use authorization from the FDA, but in the meantime, the committee is considering the logistical implications for vaccine distribution.

So far, the group has recommended that health care personal receive the first available doses of a vaccine. Following that, essential workers, high-risk people and older adults should receive doses, they wrote in JAMA, which could include the hardest-hit communities in the U.S.

“Racial and ethnic minority groups are disproportionately represented in low-wage essential work including farms, factories, grocery stores and public transportation,” they wrote.

On Friday, the group also talked about various ethical issues, including health inequities that place people at a higher risk of contracting COVID-19.

“Inequities in health have always existed, but at this moment there is an awakening to the power of racism, poverty and bias in amplifying the health and economic pain and hardship imposed by this pandemic,” Helen Gayle, MD, a former infectious disease specialist at the CDC and now president of The Chicago Community Trust, told the newspaper.

Gayle is co-chairing a vaccine distribution advisory committee through the National Academy of Sciences. Her committee released a report in October that recommended taking health inequities into account. If the ACIP follows the framework, about 10% of vaccines would be reserved for hard-hit communities, The New York Times reported.

However, the logistics could be difficult. Several public health advisory groups are developing indexes to determine what a “hard-hit” area is and how to ensure fair, equitable distribution of a vaccine.

“We have a very diverse country with different views on what is fair, and in particular, what is fair to communities long underserved,” Matthew Wynia, MD, an infectious disease doctor and ethicist at the University of Colorado, told the newspaper.

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New York Times, “Will the Hardest-Hit Communities Get the Coronavirus Vaccine?”
JAMA, “Scientific and Ethical Principles Underlying Recommendations From the Advisory Committee on Immunization Practices for COVID-19 Vaccination Implementation.”
CDC, “ACIP Presentation Slides: October 2020 Meeting.”
National Academy of Sciences, “Framework for Equitable Allocation of COVID-19 Vaccine.”

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