Should first vaccines go to most vulnerable or those most at risk of spreading virus?

Should first vaccines go to most vulnerable or those most at risk of spreading virus?
Posted at 11:19 AM, Aug 20, 2020

When a vaccine is approved, who will get it? How will it get to them?

Johns Hopkins has a plan to make front line workers and those most vulnerable first in line. Other experts say that may not be the best approach.

“It may be better to immunize people who are at high risk of transmitting the virus both because of jobs, living situations and other circumstances,” said Dr. Ezekiel Emanuel while speaking with the head of the Journal of the American Medical Association. “And that I think we have to leave an open mind and look at some detailed modeling about what the best way is to reduce the premature mortality.”

Emanuel says transmission between health care workers and patients is basically zero where he is. He says effective PPE use is the reason.

The groups Johns Hopkins said should get a vaccine first could be as big as 90 million people.

Emanuel says there won't be enough doses out of the gate to get all of any initial groups.

“You don’t actually distribute it evenly among countries,” he said. “You concentrate on countries that at the moment when you have the vaccine have severe hot spots and where the vaccine is going to make the biggest difference in terms of reducing premature death.”

Johns Hopkins experts say a vaccine's effectiveness is measured on preventing disease. That doesn't mean it prevents infection and transmission. We won’t know how effective it will be until after it’s in use.

“A disease transmission strategy makes a lot of sense, but we need a lot more information before we can know who to prioritize,” said Dr. Eric Toner, a senior scholar at the Johns Hopkins Center for Health Security. “It’s quite possible we will go to a strategy like that.”

The World Health Organization said younger people in their 20s, 30s and 40s are increasingly driving spread.

The first vaccines will likely be two doses. Experts say that means double the syringes, needles, vials and other supplies, along with getting people to come back for a second dose.