The National Academies of Science, Engineering and Medicine released a draft proposal to distribute a coronavirus vaccine in the United States on Tuesday and if one is approved for public use.
The vaccine would be distributed in four phases, with healthcare workers and vulnerable Americans such as the elderly and people with underlying health conditions coming first, according to the group. They prepared the proposed guidelines at the request of the National Health Institutes and Centers for Disease Control and Prevention.
The first phase would cover about 15% of the population, the group said.
"Frontline health workers are especially important to contain the pandemic and prevent death and serious illness," the group wrote in a section of the report titled "Justification." "Since the beginning of the pandemic, many employees have worked on the front lines in environments where they have been exposed to the virus, often without adequate PPE."
The second phase would include key workers, teachers, homeless shelters, and people in prisons, prisons and detention centers. All older adults not included in phase one would be vaccinated in phase two.
The group defines prisoners as "anyone who has been deprived of their personal liberty against their will after conviction of a crime".
"Data shows people in state and federal prisons are 5.5 times more likely to get Covid-19 than the general US population," the group wrote.
The third phase would include young adults, children and workers in industries "essential to the functioning of society" and who are at risk of exposure to the virus. According to the group, around 85% to 95% of the country would be vaccinated by the end of the third phase. Phase four would include everyone who has not yet been vaccinated.
As drug makers look for a safe and effective vaccine by the end of the year, infectious disease scientists and experts worry about who will get the vaccine first and how. According to Dr. Anthony Fauci, the country's leading infectious disease expert, the US will initially only have a limited supply of vaccine doses that will not be available for "several months" in 2021.
Many medical experts have said that the vaccine should go to the most vulnerable groups first, including health workers and the elderly, as well as the poor and minority communities disproportionately affected by the virus.
Earlier this month, President Donald Trump told reporters at a White House press conference that a coronavirus vaccine should likely go to the elderly or the most at risk first, although he added that he would rely on a doctor's expertise to make that decision would.
The National Academies noted in their draft that data showed that people of color are disproportionately affected by the virus.
There is no evidence that this is "biologically mediated" but rather reflects the effects of systemic racism leading to higher comorbidity rates that increase the severity of Covid-19 infection, and the socio-economic factors that increase the likelihood of infection increase, "said the group.
The group also said that since vaccines under development have received taxpayers' money, it is important that vaccines are delivered to all individuals regardless of "their social and economic resources, employment, immigration or insurance status".
The U.S. has already invested billions of dollars in six potential vaccines as part of the Trump administration's Operation Warp Speed initiative, including from pharmaceutical companies Pfizer and Moderna, which entered the third phase of studies last month.
"Individuals whose legal status is uncertain should be reassured that their claims to receive a vaccine will not lead to deportation or be used against them in immigration proceedings."
The group also said it was concerned that late-stage studies for vaccines had excluded pregnant women, who are more often at risk of Covid-19-related side effects than non-pregnant women.
The public can provide feedback on the framework during a four-day public comment period starting at 12:00 noon. ET on Tuesday, September 1, and ends at 11:59 p.m. ET on Friday September 4th.