CDC Panel Recommends Who Should Get the COVID-19 Vaccine Next

The Advisory Committee on Immunization Practices (ACIP), an independent committee of medical experts that advises the Center for Disease Control and Prevention (CDC), met virtually Sunday, December 20, to discuss whom to recommend for phase 1b, the next phase on the vaccine’s rollout after healthcare workers and residents in long-term care facilities. Their 13 to 1 vote was what many are calling a compromise among the most vulnerable of two high-risk groups: It prioritizes people ages 75 and up who do not live in long-term care facilities and frontline essential workers next.

“These recommendations are difficult to make, but they are supported by the best epidemiologic data that CDC has at this stage,” Jessica Atwell, PhD, MPH, an infectious disease epidemiologist with the Center for Immunization Research at the Johns Hopkins Bloomberg School of Public Health, tells Verywell. “We know that older adults are more likely to experience adverse outcomes from COVID-19 including hospitalization and death. Protecting them should be a priority.”

The federal advisory panel also voted to prioritize adults ages 65 to 75, people ages 16 to 64 with high-risk medical conditions, and “other essential workers” in Phase 1c. The recommendations were made official and published in the CDC Morbidity and Mortality Weekly Report (MMWR) on Tuesday, December 22.

Who Are the Frontline Essential Workers in Phase 1b?

The ACIP defines frontline essential workers as anyone employed in “sectors essential to the functioning of society and are at substantially higher risk of exposure” to the coronavirus. The group included in phase 1b, estimated at around 49 million people, includes the following professions:

• First Responders (firefighters, police)
• Education (teachers, support staff, daycare)
• Food and Agriculture
• Manufacturing
• Corrections workers
• U.S. Postal service workers
• Public transit workers
• Grocery store workers

Atwell thinks the ACIP definitions of “essential” leaves room for individual states to define the specific members of the 1b and 1c groups. “What is essential in one state may be more or less essential in another,” she says.  

Who Are the Essential Workers in Phase 1c?

The third group in the roll-out—an estimated at 129 million people—includes other essential workers in the following professions:

• Transportation and logistics
• Food service
• Shelter and housing (construction)
• Finance
• IT and communication
• Energy
• Media
• Legal
• Public safety (engineers)
• Water and wastewater

Prioritization Weighs Social Justice Concerns with Scientific Evidence 

“We know that there is a disproportionately high representation of some racial and ethic groups within certain essential worker categories, as well as among groups of Americans with some of the key high-risk conditions,” says Atwell, who has been focusing her COVID-19 response efforts on the Native populations across the U.S. at the Center for American Indian Health.

ACIP intentionally did not provide recommendations for prioritization around race or ethnicity, but Atwell says this is because they ultimately wanted to frame things around profession, underlying conditions, and age. Adults 75 years and older, for example, account for 25% of COVID-19 associated hospitalizations. ACIP’s emergency decision to include the oldest people in the next priority group over essential workers comes after climbing hospitalizations and deaths among that demographic in recent weeks.

“No matter what the ACIP decided, there would be unhappy people because we all want the vaccine,” Amber Schmidtke, PhD an assistant professor of microbiology in the School of Medicine at Mercer University in Georgia, tells Verywell. On her very popular Facebook page, Amber Schmidtke, PhD, she helps her followers make sense of COVID-19 data in Georgia.

Both Atwell and Schmidke are hopeful that with increased vaccine supply and government support, we can vaccinate everyone who wants to be vaccinated as quickly as possible.

The first vaccine to receive emergency use authorization from the U.S. Food and Drug Administration (FDA) was from Pfizer-BioTech; 556,208 doses were administered in the first week to those in phase 1a, according to the CDC.

The ACIP endorsed the use of the Moderna vaccine on Saturday, December 19, which will double the amount of vaccine supplies currently available. 

How Many People are Ahead of You in Line?

The New York Times recently published a calculator in English and Spanish that estimates your “place in line” for a COVID-19 vaccine among the full U.S. population. Its algorithm factors in your age, the county you live in, your occupation, and underlying health conditions while also factoring in the vaccine priority recommendations issued by an ACIP. If your result disappoints you, regularly check it. Your place in line may change over time as vaccine supplies are shipped and received across states and territories.   

“Until it is our turn, we all need to continue to be vigilant and limit our exposures,” says Schmidtke, who works most closely with the Georgia Geospatial Information Office, which maps COVID-19 data. “Our non-pharmaceutical interventions like masks and social distancing are going to have a greater impact than the vaccine anyway until we achieve herd immunity.”

Across the nation, healthcare providers are still advocating for more PPE, supplies, and funding for successful implementation of a vaccination campaign. In addition to the actual vaccine, other essential items such as needles and syringes, alcohol pads, surgical masks, face shields, and vaccine report cards to track patients’ vaccine histories are also required.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.