Who gets the vaccine first? Discussion Draft Released with 4 Phases 9-1-20

When we hear about vaccines one of our first questions is “Who will get it first?There are many, many issues. This Discussion Draft will give everyone somewhere to start in trying to decide who gets it. 4 Phases of distribution are proposed. See below.

Update 10-15-20 New report, Framework for Equitable Allocation of a COVID-19 Vaccine, done by the same committee, with lots more detail, dated 10-2-20 Click here to read.

“Discussion Draft of the Preliminary Framework for Equitable Allocation of COVID-19 Vaccine” was released on September 1.

Table of the 4 Phases
Scroll down to read more details


The committee’s final report is expected early this fall, after input from the public and other interested parties.

There are many uncertainties affecting COVID-19 vaccine allocation, such as the number and timing of available vaccine doses, number of available vaccine types, vaccine efficacy and safety, vaccine uptake, and vaccine distribution and administration.

The discussion draft also includes a summary of the application in various scenarios, such as if a vaccine requires two doses rather than one or if some health insurers do not cover full vaccine administration costs.

The report is meant to be a guide for more detailed prioritization plans. That work is being conducted by the Advisory Committee on Immunization Practices, an expert panel that does vaccination guidance for the CDC, and by state, local, and tribal health authorities, who must identify the actual people in their regions who fall into the priority groups.

The report author is the National Academy of Medicine/National Academies of Sciences, Engineering, and Medicine//Committee on Equitable Allocation of Vaccine for the Novel Coronavirus (18 members).

The committee was formed in July at the request of the National Institutes of Health and the CDC to help advise the federal government on how to allocate vaccine. The agencies wanted an outside voice; the National Academies are independent, non-governmental expert organizations that advise the federal government about policies.

Criteria include:

– Risk of acquiring infection: Higher priority given to individuals who have a greater probability of being in settings where COVID-19 is circulating and exposure to a sufficient dose of the virus.

– Risk of severe morbidity and mortality: Higher priority given to individuals who have a greater probability of severe disease or death if they acquire infection.

– Risk of negative societal impact: Higher priority given to individuals with societal function and upon whom other people’s lives and livelihood depend directly and would be imperiled if they fell ill. It does not consider their wealth or income, or how readily an individual could be replaced in a work setting, given labor market conditions.

– Risk of transmitting disease to others: Higher priority given to individuals who have a higher probability of transmitting the disease to others.

The 4 Phases:

Phase 1 is for Healthcare workers, first responders, and adults with pre-existing conditions that put them at risk for severe symptoms of COVID-19.

Phase 2 is for teachers, school staff, critical risk workers, prisoners, those in homeless shelters and group homes, and older adults not included in phase 1.

Phase 3 is for children, young adults, and workers in industries with exposure to the virus.

Phase 4 includes everyone else.

Phase 2 includes all older adults not included in Phase 1. “While the risk of illness and death begins to rise substantially starting around age 50, it is most prevalent above age 70.” I am 77 with diabetes. I assume this could/would qualify me.

Phase 3 includes Workers in industries essential to the functioning of society and at increased risk of exposure not included in Phase 2. 

My Questions:

– The age of “Older adults” is not well defined and may change to older than 50.

– What workers and industries are in which phase, such as grocery store or restaurant workers. 

Click Here for lots more information: the announcement, committee members, video recordings if available, FAQs,topics discussed, etc. The information is understandable and easy to locate on the web pages.

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