“Today, state and local public health departments are on life support,” said Jeffrey Duchin, a top official for Seattle and King County, Wash., citing the need to train additional immunization staff and conduct outreach to hard-to-reach communities. Referring to the Trump administration initiative to speed vaccine development, he said: “Operation Warp Speed has delivered two Cadillac vaccines to us, but they come with empty gas tanks.”

Helen Keipp K. Talbot, a Vanderbilt University associate professor of medicine, cited barriers to vaccination for front-line workers, such as those who get milk from the farm to the grocery store for her teenage son to drink. The laborers cannot easily take off work to be immunized or stay home if they have side effects.

“This is critical,” said Talbot, a member of the advisory panel. “We need to be working with the White House to fund our state health departments, to get vaccine out so that everyone can get their milk and eggs.”

With limited supply, states are scrambling to decide which groups get the vaccine next and in what order. States often follow the federal recommendations, but they have the final say in priority groups, which will probably vary widely by state.

If the advisory group recommendation is approved and adopted by CDC Director Robert Redfield, it becomes the official CDC recommendation on immunization. The CDC is also planning to release additional guidance this week to include ways for states to prioritize within groups of essential workers. Workers in areas of high transmission or individuals at increased risk for covid-19 because of age or underlying medical conditions could be offered shots first.

“What the CDC might suggest is the right way may be different than what a given state does because of industry voices, and because what groups might have the ears of governors,” said one public health expert who spoke on the condition of anonymity because he is part of a state vaccine advisory committee.

Companies representing technology, food, aviation and utility industries are lobbying states and the federal government to prioritize their workers.

The recommendations received wide-ranging criticism in public comments, even as medical experts, health officials and vaccine advocates hailed the advisory group’s work.

Some said the prioritization of front-line workers would create dilemmas for public health agencies inclined to provide limited resources to those most at risk of the virus. Claire Hannan, executive director of the Association of Immunization Managers, said states and local jurisdictions needed better “communication strategies and talking points,” especially in vaccinating “essential workers who are young and healthy over adults at high risk due to underlying conditions.”

Another gap was the lack of attention to those caring for dependent parents, which several commenters said created unique needs for Asian, Hispanic and other minority groups. Minh Hoang Tu, a Seattle caregiver attending to her 90-year-old mother with dementia, said the priority groups do not recognize her family’s situation.

“My home functions like a nursing home, but of one resident, and I’m a health-care worker, just unpaid and unlicensed,” she said.

Source: The Washington Post