MINNEAPOLIS — Two vaccines from Moderna and Pfizer are currently in phase III and have applied for the Food and Drug Administration's (FDA) Emergency Use Authorization. This is great news, however, the supply of those vaccines isn't infinite.
On Dec. 1, the Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) voted 13-1 to give the vaccines to healthcare workers as well as residents of long-term care facilities first. That is, once the vaccine is approved by the FDA and recommended by ACIP.
This, as far as we could tell, was the first time a committee had to make a decision like this, regarding a limited supply of vaccines.
"Who gets a novel vaccine for a novel virus, during a real-time live pandemic," Joel Wu confirmed. Wu is an adjunct professor of clinical ethics at the University of Minnesota. He added that a rollout like this cannot be done without a game plan.
"You want to give the vaccine out to the community in a way that results in the most lives saved and also in a way that's most fair to everybody in the community," he said.
Right now, that game plan is to vaccinate the healthcare workers first.
"There are a couple of aspects to that," Wu said, referring to the logic behind the decision. "The first is the idea of the multiplier effect. If we make sure that the healthcare workers are there to do their job, it actually allows more people to be healthy."
It makes sense to protect the people protecting us, and we cannot do without. The decision to include long-term care facility residents in the same tier also makes sense, according to Wu.
"It's actually the case with a lot of these folks with the right interventions, they have a pretty reasonable opportunity to fully recover," Wu explained. "From a societal standpoint, our obligation here is to treat everybody equally."
In terms of maximizing benefits and minimizing harm, which is one of the ethical pillars that the committee is going by, vaccinating healthy, non-at-risk individuals when there's a limited supply – is ineffective.
"In a way, for the people who are least likely to get sick and are the least likely to suffer or become severely ill or die from the sickness, if we allocate the resources to them, then in another way that resource could have been wasted," Wu said. "With scarce resources, we want to maximize the benefit and minimize the harm to the community as a whole."
History is being made, one committee decision at a time. Wu said the excitement around the vaccine and its rollout schedule are understandable, but emphasized that with it, comes a grim reminder of the lives lost already.
"This is what happens if we don't have a vaccine, so the excitement of the vaccine reminds us that this is what happens if people potentially don't participate in the common good of the public health enterprise," he said. "It's both to benefit individuals but it's to benefit everybody in the community. So I think the excitement is a function of the risk but I think it's a reminder of how effective public health can be and science can be if we participate."
On Dec. 10, and FDA advisory committee will meet to discuss emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 vaccine in individuals 16 years of age and older. On Dec. 17, another committee will meet to discuss the EUA for Moderna's vaccine in people 18 and older.