As expected, the Advisory Committee on Immunization Practices (ACIP) within the Centers for Disease Control and Prevention (CDC) voted 13-1 on December 1, 2020 to recommend that health care personnel and long-term care facility (LTCF) residents be prioritized for Phase 1a access to the COVID-19 vaccine once such a vaccine has received emergency use authorization (EUA) from the Food and Drug Administration (FDA). The Director of the CDC promptly adopted ACIP’s prioritization recommendation; however, states will have the ultimate authority to determine the priority for vaccinations.
The universe of individuals included in the terms “health care personnel” and “LTCF residents” is very broad. Health care personnel are defined as “paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.” This would encompass virtually everyone working in a health care facility, medical practice, home health or hospice agency, pharmacy, or other health care setting. CDC estimates that there are approximately 21 million individuals in this group. LTCF residents, which CDC estimates to be comprised of three million individuals, are defined as “adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently.” It would apply to residents in a variety of settings including nursing homes, assisted living facilities, and other residential settings. Presumably, however, the definition would exclude those residing in purely residential portions of a Life Plan Community/Continuing Care Retirement Community.
Appearing on C-SPAN on December 2, 2020, Secretary of Health and Human Services, Alex Azar stated that EUA applications for two vaccines—Pfizer and Moderna—have been submitted to FDA. FDA’s vaccine requirement committee will review the Pfizer EUA application on December 10, 2020 and will take up the Moderna EUA application on December 17, 2020, with more to follow. The Secretary estimates that the first doses of vaccine could begin shipping to states in mid-December. In October, the U.S. Department of Health and Human Services entered into agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to LTCF residents and staff in facilities that opt in to the program.
What remains to be seen is whether health care personnel and LTCF residents will embrace the COVID-19 vaccines. Many providers mandate vaccinations for their employees with very narrow exceptions based on accommodations for disabilities or religious objections. Any mandate, however, is not without risk of workers’ compensation or personal injury claims if the vaccine ultimately proves to be problematic. LTCF residents have the right under Federal and/or state law to refuse treatments. Thus, many providers worry that the speed with which the vaccines have been developed and concerns with possible side effects and long-term health implications will cause residents to decline the vaccination. Still, most providers are hopeful that with increased education efforts about the vaccine, LTCF residents who have grown weary of the isolation brought to bear by the pandemic will accept the vaccination in the hopes of being able to see loved ones more frequently and take part in activities and other social events that ultimately make life worth living.