The Centers for Disease Control and Prevention has instructed public health officials in all 50 U.S. states and five large cities to get ready to provide a viable COVID-19 vaccine to health care workers, in addition to other high-risk groups, according to an initial report from The New York Times.
The Times also said the vaccine could be ready as soon as late October or early November 2020.
CDC instructs states to prepare to distribute COVID-19 vaccine
The new guidance from the CDC is the latest hint of a rapidly-accelerating race to curate a vaccine and reverse the course of the COVID-19 pandemic that's killed more than 184,000 Americans. The guiding documents came the same day President Trump said a vaccine might be available before the end of 2020, in a speech to the Republican National Convention.
There were three separate documents sent to public health officials in every U.S. state and territory, in addition to Chicago, New York, Houston, Philadelphia, and San Antonio on August 27. Together, they outlined different scenarios for distributing two as-yet-unidentified vaccine candidates — each one requiring two doses spaced weeks apart in hospitals, mobile clinics, and other facilities that provide easy access to initial recipients of the vaccine.
UPDATE September 2, 3:36 PM EDT: Public health experts urge all governmental levels prepare for COVID-19 vaccine
In the last week, both Stephen Hahn — head of the Food and Drug Administration, and Anthony S. Fauci — the nation's lead infectious disease expert — have hinted about the possibility of vaccine availability for specific groups of people before clinical trials are finished, given the test data turns out to be positive.
Public health experts think agencies at all governmental levels should fully-commit to preparing for what will surely become a vast and painstaking effort to vaccinate hundreds of millions of Americans. However, the likelihood of a November rollout for the vaccine has also raised concern about the Trump administration pushing the distribution of the vaccine too quickly — or exaggerating a candidate vaccine's effectiveness — before election day hits on Nov. 3, reports the Times.
UPDATE September 2, 3:45 PM EDT: Moderna, Pfizer might be behind forthcoming vaccine
The CDC will provide detailed technical specifications for two candidates called "Vaccine A" and "Vaccine B," in addition to shipping, mixing, administration, and storage requirements, added the Times. As of writing the specifications sound like products developed by Moderna and Pfizer, two pharmaceutical companies that have gone the furthest in late-stage clinical trials.
On Aug. 20, Pfizer declared it was "on track" in its pursuit of government review, with a projected completion date "as early as October 2020."
"This timeline of the initial deployment at the end of October is deeply worrisome for the politicization of public health and the potential safety ramifications," said infection prevention epidemiologist Saskia Popescu in Arizona, to the Times. "It's hard not to see this as a push for a pre-election vaccine."
UPDATE September 2, 4:00 PM EDT: Vaccine priority goes to 'racial and ethnic minority populations,' national security, essential workers
State guidance in the three documents mentioned above notes that health care professionals, in addition to long-term care employees, will be the first to receive the product, along with other national security employees and essential workers, said the Times.
Those 65 years old or older, including people from "racial and ethnic minority populations," Native Americans, and citizens under incarceration — each a community at a disproportionately greater risk for contracting the virus and the severe illness that follows — were also listed as primary recipients of the vaccine, according to the documents.
This is good news because it means "it doesn't just all wind up in high-income, affluent suburbs," said Cedric Dark, a Baylor College of Medicine emergency physician in Texas, to the Times.
UPDATE September 2, 4:12 PM EDT: CDC scenarios assume safety, effectiveness; 'a bit ambitious' to health expert
In its guidance, the CDC said "limited COVID-19 vaccine doses may be available by early November 2020," reports the Times. The new documents were dispatched the same day that CDC Director Robert Redfield sent a letter to governors to prepare vaccine distribution sites by Nov. 1, reports McClatchy.
The CDC also stressed that plans for distributing the vaccine were still hypothetical, saying: "The COVID-19 vaccine landscape is evolving and uncertain, and these scenarios may evolve as more information is available."
The CDC's scenarios assume that two vaccines might prove sufficiently safe and effective for emergency authorization from the FDA before the end of October. But they also say that 2 million doses of Vaccine A — which seems to match Pfizer's — would be ready within this time frame. The agency's scenarios also said Vaccine B — which could be Moderna's — would number at 1 million doses, with tens of millions of each ready for distribution by end of 2020.
While it's possible some promising early data might develop before the end of October, health experts are still skeptical. "The timeline that's reported seems a bit ambitious to me," said Dark. "October's like 30 days away."
UPDATE September 2, 4:35 PM EDT: Researchers strongly advise cautious optimism for forthcoming COVID-19 vaccine distribution
Typically, vaccine trials can take years to prove effective. But that doesn't mean it's impossible for valid conclusions to come far earlier, so land as "there is an overwhelming effect" where vaccinated people show widespread recovery and robust protection from the disease, said Vaccine Researcher and Immunologist Padmini Pillai of MIT, to the Times.
However, early trial data might not hold up as the months move on. Researchers need time to thoroughly test large and diverse populations to grasp how well the vaccine works (or doesn't) in varying groups — including vulnerable communities as identified in the CDC's guidelines, who would be at the front of the line to receive a coronavirus vaccine.
If anything goes wrong, "all of this together could diminish public trust in the vaccine," said Pillai to the Times.
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