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Want the COVID-19 Vaccine First? Read This, Says Doctor.

We must think collectively to distribute it fairly.

Developing a coronavirus vaccine is not easy, fast or straightforward but distributing it to millions of Americans could prove to be even more complicated. In efforts to solve the problem through global scale vaccination, multiple drug companies and research institutions are racing to develop vaccines and treatments, funded partially by the United States government, but once available, who should get the COVID-19 vaccine first?

Most of us agree on things like protecting our planet from climate change and that healthcare is a right, but getting manufacturers, payers, insurers, private clinics and public health officials to agree on a vaccine delivery plan could be a challenge. A vaccine will be crucial for us to safely start reopening the economy and it is time for us to set in motion a National Vaccination Plan that will allow us to start our journey towards regaining the freedom we lost due to this pandemic. 

When Can We Expect a Vaccine?

Vaccine development usually takes many years and, in some cases, the vaccine never comes to fruition. An example of that is that we have not developed successfully a HIV vaccine, and researchers have been working on it for over 30 years. Thankfully, patients living with HIV have the same life expectancy as non-HIV-positive people, due to advances in prevention and treatment.

The challenge is not only to develop and approve a new vaccine but also to manufacture and distribute globally. The Federal Agency that regulates new medications, The Food and Drug Administration, will have to approve the new vaccine for use and label it as "safe and effective," and the minimum standards set by the FDA for approval, includes the requirement that a vaccine must be at least 50% better than a placebo at preventing COVID-19. 

So when can we expect one? Moderna is promising a vaccine by Q4 2020, and Oxford University's shot will likely be ready Q1 2021.

Who Should Get it First?

An advisory committee of health experts was created to assist the Centers for Disease Control and Prevention on a potential vaccination plan. In these programs, doctors, health and elected officials take into consideration things like what populations would benefit the most by receiving a vaccine and which demographic should get the vaccine first. 

Every community across America has suffered from the novel coronavirus, but the damage BIPOC communities are facing in this pandemic is unseen. People that live in high-dense communities have died more than folks protected by living in the suburbs and working-from-home. There are countless layers of striking disparities that BIPOC communities face on a regular day, and COVID-19 added another heavy weight. Black, Hispanic, and Latino pregnant women are five times more likely than white women to be exposed to the coronavirus, and black families living in gentrified neighborhoods have fallen ill at a grander scale than any other community. Folks that work in jobs requiring in-person contact, and that rely on public transport to mobilize and that live in high dense communities are getting sicker.

Blacks are getting infected with the novel coronavirus three times more than white people and a good portion of that population has other health issues like diabetes, obesity and heart problems. In those communities, the underlying conditions are often the result of disparities in housing, employment, and unequal access to health care, and we cannot ignore that this has to do with racial inequality.

It will likely take a double-digit number of months to close the gap between the first doses coming off the manufacturing lines and a stockpile large enough to vaccinate the U.S. population, but until then, we must understand which population groups would benefit the most by receiving a dose of the vaccine first.

We Must Make it Available Earlier For Those More Likely to Die

For new vaccines, the CDC usually recommends to state and local health departments its protocol for adoption, and much of the excitement behind a new vaccine coming up soon is motivated by the Operation Warp Speed that is accelerating vaccine development with billions of federal dollars.

While there isn't a national vaccination plan publicly available, the debate on which group should receive the first COVID-19 vaccine is active and it is likely that high risk groups will be prioritized. Although this virus has been with us less than a year, we have enough data to demonstrate who is more likely to get severely ill and that we need to protect them first.

It is clear that we must consider making the vaccine available earlier for those who are more likely to die of the disease, prioritizing senior citizens and those living in nursing homes, as well as essential and healthcare workers and those with underlying conditions, such as obesity, diabetes, and health disease.

The prioritization line should take into account the potential exposure to the coronavirus and if infected how likely they will be to recover unhurt.

Black and Latino communities have disproportionately fallen ill to the coronavirus, and often work in jobs that are essential and require in-person interactions, these populations would benefit the most from a priority line for the COVID vaccine. That will help ensure that those communities that are dramatically affected by this health crisis have expedited access to a vaccine once one is available.

We need a National COVID-19 Vaccination plan, and this plan should prioritize lower-income families and underprivileged communities who are most at risk. The path to a world free from the coronavirus will be long, complicated and it will require us all to think more collectively than ever before but we can get there.

And while we think collectively, let's act collectively: Continue to practice social distancing, wash your hands regularly for 20 seconds at a time, avoid all crowds, wear a face mask, and don't miss these 37 Places You're Most Likely to Catch Coronavirus.

Leo Nissola, MD
Leo Nissola, M.D. is an award-winning immunologist and scientist. Follow him on Instagram @DoctorLeo and on Twitter @LeoNissolaMD. Read more about Leo
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