Health care workers and long-term care residents will likely get the first COVID-19 vaccine doses.

The CDC’s Advisory Committee on Immunization Practices (ACIP) took the first official stance on prioritizing who will get the first doses of any COVID-19 vaccine. For almost four hours the committee discussed in detail who within the priority groups would get access early on when doses are limited. For example, the committee wanted to ensure that people who work directly in providing patient care will be first in line. They also wanted those in nursing facilities to have early access.

In the end, the committee voted 13 to 1 to prioritize health care providers first and then elderly residents of long-term care facilities to receive COVID-19 vaccines. This was not a surprise, and while the vote is not binding, most believe Dr. Robert Redfield, head of the CDC, will accept the recommendation.

The CDC believes there are about 21 million healthcare workers, which includes everyone from hospital workers to emergency medical technicians and home health care personnel.  They also believe there are about 3 million older Americans living in skilled nursing or long-term care facilities.

While it is not assured, both the Pfizer vaccine (to be reviewed by the FDA on December 10^th) and the Moderna vaccine (to be reviewed by the FDA on December 17^th) are expected to be approved on the basis of remarkable data (95% effectiveness in preventing illness) from their phase 3 clinical trials. If both vaccines are approved, the first 40 million or so doses could be available by the end of the year. 

Of interest, Dr. Helen Talbot, associate professor of medicine at Vanderbilt University, was the sole member to vote against the vaccine recommendation. She reported concerns about the lack of safety data on vaccinating elderly residents of long-term care facilities. “I’ve spent my career studying vaccines in older adults, and traditionally we’ve tried vaccines in young, healthy populations then hoped it worked in frail, older adults,” she said during the meeting. 

On another continent, the European Medicines Agency EMA (European Union FDA) said its officials will “work through Christmas” to review data from Pfizer and Moderna applications to evaluate the vaccines’ safety and effectiveness. The EMA is set to make a judgment on the Pfizer/BioNTech vaccine first, by Dec. 29 at the latest, two weeks before Moderna’s vaccine, which will be reviewed by Jan. 12. This means the two vaccines are likely to be available in the U.S. a few weeks before they are available in Europe.

I have already formally expressed my personal willingness to take either of these two vaccines. I may be only one “elderly” physician, but I have no reluctance about the safety of either vaccine. Compared to traditional vaccines that contain a mix of virus and cell proteins, along with many other components, these two vaccines are pure RNA that makes only the viral spike protein in your own body. RNA breaks down rapidly, so it should not be present long term inside of you. This is as good as a vaccine gets.