In mid-December, the CDC’s Advisory Committee on Immunization Practices recommended a phased approach for administering the vaccine that prioritized individuals at highest risk. States have flexibility in the rollout, but most are expected to make only minor changes to the plan.
The national recommendation allocates the first doses to healthcare workers, including pharmacists and pharmacy staff, and residents of long-term care facilities. In the initial week of distribution, healthcare workers began receiving immunizations.
The following week, vaccination of long-term care residents began.
The next phase, likely to start in February, will include first responders and essential workers, such as those in the transportation industry, teachers, grocery store workers, and employees of meat processing plants. Adults with high-risk medical conditions and those over age 65 years will follow, probably in March or April. Some states may move up individuals in congregate living situations like homeless shelters or group homes, prisons and other detention facilities, and students living in dormitories, but generally they are expected to follow older adults.
The first general phase will expand immunizations to young adults and children, who have dominated the spread of COVID-19 since late spring. By late spring or early summer, the vaccine will be open to everyone interested.
The precise dates for availability for each group will depend on when additional vaccines are approved, how quickly manufacturing can ramp up to full production, and how many doses the U.S. government, which is providing all vaccine for free, is able to purchase.
As the rollout proceeds, pharmacists need to pay attention to which groups are eligible in their states and document that patients meet the current requirements. In addition, each vaccine is likely to have specifics that make it more suitable for some groups than others. Pregnant or lactating women should be told that the vaccines from Pfizer/BioNTech and Moderna have not been tested in that population, although they may choose to proceed. None of the vaccines has been tested in pregnant participants during clinical trials, but the two other vaccine types have been safely used previously. COVID-19 is the first use of the mRNA vaccine technology. Initially, the Pfizer/BioNTech vaccine was only authorized for individuals age 16 years and older, but the company expects to release more data on the vaccine’s performance in children as young as age 12 years shortly.
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