Framework for Equitable Allocation of COVID-19 Vaccine

Kahn, Benjamin; Brown, Lisa M.; Foege, William H.; Gayle, Helene

doi:10.17226/25917

Cited by 117 publications

(82 citation statements)

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“…For instance, cold-chain workers who have been particularly affected by COVID-19 and are often linked to workplace transmission could thus be vaccinated before other personnel within Tier 2 [70]. Other examples are represented by individuals aged ≥ 80 years or older with underlying conditions, who may be vaccinated before other personnel within Tier 3 or by individuals of < 60 years of age with ≥ 2 underlying conditions who may represent a subprioritized category within their Tier [20]. Further studies are warranted to examine the sub-prioritization within each vaccination tier.…”

Section: Discussionmentioning

confidence: 99%

“…As of December 1, 2020, JCVI does not provide precise advice on the prioritization for frontline healthcare and social workers. On the other hand, the Framework for Equitable Allocation of COVID-19 Vaccine of the National Academy of Sciences, Engineering, and Medicine suggests that in the US priority should be given to frontline healthcare workers, and those having significant risk of severe illness or death from COVID-19 (as individuals with two or more underlying health conditions) [20]. Compared to the UK and the US, the epidemiological situation in China is quite different, with an almost entirely susceptible population to SARS-CoV-2 infection and very limited local transmission.…”

Section: Discussionmentioning

confidence: 99%

“…We define population groups to be prioritized by occupation, age, and underlying conditions, taking account (1) the interim framework for COVID-19 vaccine allocation and available guidance on allocating vaccines during an influenza pandemic [e.g. from the WHO, US and the United Kingdom (UK), see summary in Additional file 1: Table S1 [5,18,20]], (2) the objectives of and experience gained from the 2009 H1N1 pandemic vaccination program in China [21], (3) specific high-risk groups for severe COVID-19 outcomes and high-risk groups for exposures, and (4) lessons learned from the response to the COVID-19 outbreak in Wuhan such as the role of critical workers in sustaining essential societal functions [1] (Fig. 1).…”

Section: Priority Population Groups For a Covid-19 Vaccination Programmentioning

confidence: 99%

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Who should be prioritized for COVID-19 vaccination in China? A descriptive study

Yang

Zheng

Shi

et al. 2021

BMC Med

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Background All countries are facing decisions about which population groups to prioritize for access to COVID-19 vaccination after the first vaccine products have been licensed, at which time supply shortages are inevitable. Our objective is to define the key target populations, their size, and priority for a COVID-19 vaccination program in the context of China. Methods On the basis of utilitarian and egalitarian principles, we define and estimate the size of tiered target population groups for a phased introduction of COVID-19 vaccination, considering evolving goals as vaccine supplies increase, detailed information on the risk of illness and transmission, and past experience with vaccination during the 2009 influenza pandemic. Using publicly available data, we estimated the size of target population groups, and the number of days needed to vaccinate 70% of the target population. Sensitivity analyses considered higher vaccine coverages and scaled up vaccine delivery relative to the 2009 pandemic. Results Essential workers, including staff in the healthcare, law enforcement, security, nursing homes, social welfare institutes, community services, energy, food and transportation sectors, and overseas workers/students (49.7 million) could be prioritized for vaccination to maintain essential services in the early phase of a vaccination program. Subsequently, older adults, individuals with underlying health conditions and pregnant women (563.6 million) could be targeted for vaccination to reduce the number of individuals with severe COVID-19 outcomes, including hospitalizations, critical care admissions, and deaths. In later stages, the vaccination program could be further extended to target adults without underlying health conditions and children (784.8 million), in order to reduce symptomatic infections and/or to stop virus transmission. Given 10 million doses administered per day, and a two-dose vaccination schedule, it would take 1 week to vaccinate essential workers but likely up to 7 months to vaccinate 70% of the overall population. Conclusions The proposed framework is general but could assist Chinese policy-makers in the design of a vaccination program. Additionally, this exercise could be generalized to inform other national and regional strategies for use of COVID-19 vaccines, especially in low- and middle-income countries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Priority Population Groups For a Covid-19 Vaccination Programmentioning

confidence: 99%

See 1 more Smart Citation

Who should be prioritized for COVID-19 vaccination in China? A descriptive study

Yang

Zheng

Shi

et al. 2021

BMC Med

View full text Add to dashboard Cite

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“…The National Academy of Medicine released a report on November 18, 2020, detailing a framework for equitable COVID-19 vaccine distribution. 7 Phase 1a of their recommendations focuses on frontline healthcare workers. Nursing home and assisted living facility staff are explicitly described as high priority, given contact with residents with the virus, work in an essential industry, and the risk for transmission to others.…”

Section: Introductionmentioning

confidence: 99%

Willingness of Long‐Term Care Staff to Receive a COVID‐19 Vaccine: A Single State Survey

Unroe

Evans

Weaver

et al. 2021

J American Geriatrics Society

132

157

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Objectives To plan for coronavirus infectious disease 2019 (COVID‐19) vaccine distribution, the Indiana Department of Health surveyed nursing home and assisted living facility staff. Design Cross‐sectional analysis of an anonymous survey sent via text message link to personal cell phones and emails. Setting and Participants Nursing home and assisted living facility staff in Indiana. Measures Staff characteristics including age, gender, race, ethnicity, role in the facility, experience in long‐term care, and geographic location of facility were self‐reported along with prior infection and willingness to receive an approved vaccine as soon as it is available. Responses were weighted to represent staff statewide. Weighted frequencies and logit regression estimated characteristics associated with vaccine willingness. Results There were 8,243 responses to the survey. For nursing home staff (survey delivered via 23,232 working phone numbers), there was a 33% response rate). There were 2,372 (29%) in nurse aide or similar roles and 1,602 nurses providing direct clinical care (19%). Overall, 45% of respondents indicated they would receive an approved COVID‐19 vaccine as soon as available. Of those unwilling to take the vaccine when first available, 44% would consider in the future. Concerns about side effects was the primary reason for vaccine hesitancy (70%). Characteristics associated with increased willingness were age over 60, male, and white race (P < .0001). No statistically significant differences were observed among staff self‐reporting prior SARS‐CoV‐2 infection. Conclusions and Implications The willingness to receive the COVID‐19 vaccine immediately or in the future may be as high as 69%, but varies among subgroups of nursing home staff which has implications for distribution. Educating staff on the vaccine may be critical for increasing uptake. Widespread vaccination holds the promise of protection against serious illness and death and a return of visitors and activities that support improved quality of life. This promise will not be realized without strong uptake of the vaccines.

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“…However, vaccinations-not vaccines-save lives [1]. The National Academy of Science, Engineering, and Medicine (NASEM) released Framework for Equitable Allocation of COVID-19 Vaccine [2]. Framework focused on initial vaccine access for healthcare workers and first responders followed by selected populations considered at greatest risk for contracting the virus or experiencing complications.…”

mentioning

confidence: 99%