Should Nursing Home Residents Be Prioritized For Getting The COVID-19 Vaccine?

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Several COVID-19 vaccines are being studied in trials around the country. Once the Food and Drug Administration authorizes a vaccine for use, health leaders must decide which groups of people get to receive the vaccine first.

Chandan Khanna/AFP via Getty Images

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Chandan Khanna/AFP via Getty Images

Shots — Health News
Advisers To CDC Debate How COVID-19 Vaccine Should Be Rolled Out

Health care workers have long been considered to be first in line because they are exposed directly to COVID-19 through their work, and because protecting them and their patients from the virus would help reduce the spread of coronavirus and keep the health system running.

What’s been more controversial is whether to add nursing home residents and other long-term care facility residents to the initial priority group. (Staffers at these facilities are considered health care workers.) At a public meeting last week, members of the committee agreed that the death toll in this population, a subgroup of the over-65 category, has been severe. Staff and residents at long-term care facilities represent just 6% of confirmed coronavirus cases, but account for nearly 40% of COVID-19 deaths.

Still, some committee members raised concerns about giving newly authorized COVID-19 vaccines to nursing home residents. «This population is not a population that’s been studied in the vaccine trials, said Dr. Robert Atmar, a professor of infectious diseases at Baylor College of Medicine, during last week’s meeting.

Older people who are participating in vaccine trials are generally in good health, while nursing home residents are often frail. «Coming back to the science of it, we really are not able to assess the balance of benefits and harms, he said.

Another committee member worried that introducing COVID-19 vaccines first to nursing home residents could erode public confidence in the safety of the vaccines. Given the high mortality rate in long-term care facilities, it’s likely that some nursing home patients who receive COVID-19 vaccines could die shortly after, from other causes, said Dr. Helen «Keipp Talbot, an associate professor of medicine at Vanderbilt University Medical Center.

«I think you’re going to have a very striking backlash of, ‘My grandmother got the vaccine and she passed away.’ They’re not likely to be related, but that will become remembered, she said.

Before a COVID-19 vaccine is recommended for use among nursing home residents, Talbot suggested running a limited clinical trial in this population to gather data that would show the vaccine is safe for this group.

Tuesday’s vote comes in advance of a COVID-19 vaccine getting authorized by the Food and Drug Administration. The CDC committee previously said it would wait for authorization before making vaccine recommendations. But in recent weeks, it has undergone pressure from the federal government to move faster.

«We are not dependent on any delay from ACIP in terms of helping to advise states, Alex Azar, secretary of health and human services, said at a Nov. 24 press briefing, discussing his intent to move quickly with the vaccine distribution process.

The committee’s guidance will first be reviewed by CDC Director Robert Redfield before being officially issued. Then states will use the guidance as they place orders for COVID-19 vaccine doses. Their first orders are due to the federal government Friday.