ACIP vaccine recommendation slide

Long-term care residents and staff, as well as healthcare personnel, are recommended as the first priority for COVID-19 vaccinations, according to an independent advisory panel to the Centers for Disease Control and Prevention.

The Advisory Committee on Immunization Practices voted 13-1 Tuesday in an emergency session on interim guidance on allocation of initial supplies of any COVID-19 vaccines authorized by the U.S. Food and Drug Administration. 

LeadingAge President and CEO Katie Smith Sloan said the committee’s recommendation is “an important step in the right direction — if it’s acted on.”

“The committee’s recommendation recognizes the simple truth that older Americans who’ve suffered most need to be first in line for live-saving vaccines, along with the people who care for them and other critical healthcare workers,” Sloan said. “This is COVID’s darkest hour. But if everyone does their part, we can start properly protecting older Americans who have died in record numbers for almost a year.”

The group voted to place healthcare personnel and long-term care residents and staff in Phase 1a of a vaccine rollout. Since initial supplies of vaccine will be limited, Kathleen Dooling, M.D., MPH, from the National Center for Immunization & Respiratory Diseases, said vaccination will primarily focus on skilled nursing facilities and assisted living facility residents and staff, with an implied priority for skilled nursing facilities, which “care for the most medically vulnerable residents.” Vaccination, she said, will move on to assisted living as vaccine supply dictates, followed by residential and intermediate care facilities, and state veterans homes.

“With the ongoing support of our members and our industry association partners, we have advocated for months for vaccine prioritization for senior living,” said Argentum President and CEO James Balda. “We are extremely pleased to see that ACIP recognized the critical importance of vaccinating vulnerable residents and their heroic caregiving staff.”

Mark Parkinson, president and CEO of the American Health Care Association / National Center for Assisted Living, said now it’s up to governors and state health agencies to ensure long-term care residents and staff are prioritized in the actual rollout of the vaccine.

“Given the asymptomatic and pre-symptomatic spread of this virus, combined with the explosion of community spread across the U.S., we are extremely hopeful this vaccine will literally be a lifesaver for thousands of residents and expedite the reopening of our facilities to family members and loved ones.”  

“We are encouraged that the committee recognizes  the front-line position our industry’s staff members have served during this pandemic and the disproportionate impact of this virus on seniors in our communities,” said American Seniors Housing Association President David Schless.

Robert Atmar, M.D., from the Baylor College of Medicine in Houston, TX, said ACIP could revise vaccination prioritization based on the content of emergency use applications and data on the vaccines approved. He said he had concerns about prioritizing long-term care facility residents due to the lack of testing in that population, but he said he was ultimately persuaded by the “tremendous burden, in terms of mortality and hospitalizations, residents of these facilities bear.”

The FDA’s Vaccine and Related Biological Products Advisory Committee will meet Dec. 10 to discuss Pfizer’s vaccine for emergency use authorization, and on Dec. 17 and 18 to discuss Moderna’s vaccine.

Operation Warp Speed, the administration’s vaccine and therapeutics development initiative, plans to send the first batch of 6.4 million doses of Pfizer’s vaccine to communities nationwide within 24 hours of FDA approval. 

The emergency meeting was held to provide guidance to state governors, who have until Friday to tell the federal government where they want their initial vaccine doses sent. The advisory committee makes recommendations to the CDC, but the decision on how to distribute vaccines ultimately lies with states. 

The CDC advisory group will make recommendations at later meetings for priority groups in the next phases, including essential workers and older adults. 

GAO report

This comes on the heels of a report from the Government Accountability Office, which issued an update Monday indicating that officials in 38 states are concerned they won’t have enough supplies to distribute and administer coronavirus vaccines. About one-third to one-half of states reported shortages of testing supplies, including rapid point-of-care tests. 

The GAO recommended that the Department of Health and Human Services, in coordination with the Federal Emergency Management Agency, clarify how they will address supply shortages and help states plan for future supply needs. HHS and the Department of Homeland Security disagreed with these recommendations in September, and HHS repeated its disagreement in November, according to the report.

“As the end of 2020 approaches, urgent actions are needed to help ensure an effective federal response on a range of public health and economic issues,” the GAO report stated.

Check out our sister publication McKnight’s Long-Term Care News for additional coverage on vaccine prioritization .