Essential workers are likely to move ahead of adults 65 and older and people with high-risk medical conditions when the Centers for Disease Control and Prevention signs off on Covid-19 vaccine priority lists, coming after health care workers and people living in long-term care facilities, a meeting of an expert advisory panel made clear Monday.
The intention is to bring many people of color closer to the front of the vaccine priority line — should they want to be vaccinated — in recognition of the fact that the pandemic has disproportionately hit Black and Latino communities.
There was no formal vote by the members of the Advisory Committee on Immunization Practices, a group of outside experts that makes recommendations to the CDC on use of vaccines.
But when asked how they felt about moving essential workers closer to the front of the line, there was clear support for the proposal.
“These essential workers are out there putting themselves at risk to allow the rest of us to socially distance. And they come from disadvantaged situations, they come from disadvantaged communities,” said Beth Bell, a global health expert from the University of Washington who is on ACIP and chairs its Covid-19 work group studying the vaccines.
Bell acknowledged people of color may not wish to be vaccinated early or even ever; polling suggests these communities distrust Covid vaccines even more than the American population in general. But principles of equity require addressing the risks people deemed essential workers are facing in the pandemic.
“We need to provide them with the opportunity early on in the process,” she said. “This is an important message to be sending.”
Essential workers include people who work in meat packing plants and other food processing facilities, in municipal wastewater management operations, and in transport. It also includes police and firefighters and, in the current iteration of the ACIP’s plan, teachers. The CDC estimates there are roughly 87 million people in jobs designated as essential services.
An agency within the Department of Homeland Security known as the Cybersecurity and Infrastructure Security Agency, or CISA, is responsible for designating which jobs are essential services. At the end of the day, however, state, territorial, and tribal authorities will interpret the recommendations and have leeway in who they deem to be essential.
Though people from racial and ethnic minorities make up 40% of the American population, they account for nearly 60% of Covid cases and 50% of the Covid deaths in this country, according to CDC data. Agency data also show that Black people make up about 38% of essential workers, compared to 27% for both white and Hispanic people. Black people also more commonly work in jobs that expose them to SARS-CoV-2, the virus that causes Covid-19.
“These workers are essential. They’re fundamental to our response to Covid. And they’re at risk because they work in close proximity to others,” said Henry Bernstein, chief of pediatrics at North Shore University Hospital.
Robert Atmar, an infectious diseases professor at Baylor College of Medicine, said he too favored the plan, noting that essential workers have less opportunity to lower their risk of being exposed to SARS-2 than adults over 65.
Final decisions on who should get priority access to Covid vaccines will be made after the Food and Drug Administration authorizes them under its emergency use authorization protocol.
A vaccine developed by Pfizer and BioNTech is expected to receive an EUA shortly after the FDA’s advisory committee, the Vaccine and Related Biological Products Advisory Committee, meets on Dec. 10. Consideration of a vaccine developed by Moderna vaccine will occur at a Dec. 17 VRBPAC meeting.
Once the FDA clears the vaccines for use, the ACIP will meet and issue recommendations on the populations that should be eligible to be vaccinated. CDC Director Robert Redfield is expected to sign off on ACIP’s recommendations immediately after they are made, clearing the way for vaccination efforts to begin across the country.