US panel tackles race, poverty in virus vaccine priorities

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Photo credit In this undated photo provided by Johnson & Johnson in September 2020, a woman receives an injection during phase 3 testing for the Janssen Pharmaceutical-Johnson & Johnson vaccine in the United States. On Friday, Oct. 2, 2020, a U.S. advisory panel made recommendations for who should be first in line to get COVID-19 vaccine, including a plea for special efforts by states and cities to get the shots to low-income minority groups. (Johnson & Johnson via AP)

A U.S. advisory panel made recommendations Friday for who should be first in line to get COVID-19 vaccine, including a plea for special efforts by states and cities to get the shots to low-income minority groups.

As expected, the panel recommended health care workers and first responders get first priority when vaccine supplies are limited. The shots should be provided free to all, the panel said. And throughout the vaccine campaign, efforts also should focus on disadvantaged areas to remedy racial health disparities.

“Inequity has been a hallmark of this pandemic, both locally and globally,” said the report from the National Academies of Sciences, Engineering and Medicine, noting “an awakening to the power of racism, poverty, and bias in amplifying the health and economic pain and hardship imposed by this pandemic.”

The coronavirus outbreak has hit Black, Hispanic and Native Americans disproportionately in hospitalizations and deaths. Reasons are complex, but the disparities are thought to stem from minorities working in jobs on the front lines, having medical conditions associated with severe disease, higher rates of poverty and poor access to health care.

The report's authors saw their work as “one way to address these wrongs,” they wrote.

“Everybody knows from the news how deadly this has been for minorities," panel co-chair William Foege of Emory Rollins School of Public Health said Friday. "We said it’s racism that is the root cause of this problem.”

Federal health officials will have the final say on distributing the 300 million vaccine doses the government is buying under the Trump administration's Operation Warp Speed. In practice, state and local health departments ultimately will have control over where they set up vaccination clinics.

The National Academies document lays out successive waves of vaccine distribution as manufacturing ramps up:

--When supplies are scarce, the first doses should go to high-risk health care workers in hospitals, nursing homes and those providing home care. First responders also would be in this group.

--Next, older residents of nursing homes and other crowded facilities and people of all ages with health conditions that put them at significant danger. The report said it remains unclear which health conditions should be included. It lists cancer, chronic kidney disease and obesity among possibilities.

—In following waves, teachers, child care workers, workers in essential industries — specific job categories might vary by state, and people living in homeless shelters, group homes, prisons and other facilities.

—Once supplies increase, healthy children, young adults and everyone else.

Several vaccine candidates are in the final stages of human testing, but none has yet been approved. Initial supplies are expected to be limited. Many health experts predict a vaccine won’t be widely available to all Americans until mid-to-late next year.

The report suggests the Centers for Disease Control and Prevention could hold back 10% of the vaccine supply for “hot spots” identified through a tool called the Social Vulnerability Index, which is based on Census data that incorporates race, poverty, crowded housing and other factors.

State and local health officials could use the same tool. The index was developed by CDC to help identify communities that may need support in emergencies such as hurricanes.