The arrival of two coronavirus vaccines authorized by the Food and Drug Administration for emergency use this month has prompted fierce debate about who ought to be immunized first.
The latest guidelines from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices put health care workers and older Americans living in nursing homes at the head of the line.
Next are Americans over 75, as well as frontline essential workers.
In the third group are individuals ages 65 to 74, those with high-risk medical conditions between 16 and 64, and the remainder of essential workers.
The guidelines are based on an elaborate ethical calculation designed “to maximize benefits and minimize harms, promote justice, and mitigate health inequities.” But there’s another consideration that seems lacking from this discussion: the economy.
Any vaccination program should prioritize individuals who are critical to getting our economy humming again. So in addition to health care workers, we really should be moving teachers and other essential service workers to the front or near the front of the queue.
Protocols for distributing the COVID-19 vaccines were always going to ruffle feathers. But the Advisory Committee on Immunization Practices seemed to go out of its way to court controversy with an earlier version of its recommendations.
Particularly contentious was the panel’s ham-fisted treatment of race. The earlier guidelines prioritized essential workers above many seniors since “racial and ethnic minority groups [are] disproportionately represented in many essential industries.”
By contrast, older Americans — who are more vulnerable to the virus — are disproportionately White.
The committee has since revised its recommendations so vaccines can benefit some older adults earlier in the process.
Distributing life-saving vaccines based on race is plainly unfair. But a preference for essential workers isn’t without merit.
It could be months — or even close to a year — before most of the country is vaccinated. If the economy remains hamstrung until that time, the consequences could be catastrophic.
Already, a combination of social isolation, joblessness, stress, and uncertainty has taken a toll on the nation’s health.
Nearly one-third of adults reported symptoms of depression and anxiety, according to a CDC study from earlier this year. An alarming 11% of respondents — and more than one-quarter of young adults — had contemplated suicide in the past month, the same study found.
Then there’s the financial strain COVID-19 has placed on Americans. Among those left jobless by the pandemic, half were still unemployed as of September, according to a Pew Research Center poll.
This kind of hardship has persisted for too long. That’s why policymakers must do everything in their power to lift stay-at-home orders swiftly.
One way to achieve this aim is by prioritizing teachers in the vaccination rollout. There’s simply no substitute for in-person education.
But it’s also true that one of the main barriers to earning a living during the pandemic has been the need for parents to stay home with their children. Getting teachers vaccinated would help get kids back in the classroom and parents back to work.
Other essential workers like grocery store workers, pharmacy employees, bus drivers, first responders, and health care workers also deserve priority. In short, whether or not individuals can accelerate the reopening of the economy should play a significant role in determining their place in line for the vaccine.
At the same time, we must deploy highly targeted measures, like localized isolation orders for seniors and the vulnerable in infection hotspots. Vaccinating those who work in nursing homes may be the simplest way to protect the elderly who live there.
If the goal is to protect Americans against the worst consequences of the pandemic, then using vaccines to speed the reopening of the economy deserves serious and immediate consideration.