Subcommittee discusses prioritizing groups under Phase 1B of vaccine allocation

Posted at 10:31 AM, Dec 22, 2020

MILWAUKEE — With Pfizer's vaccine making rounds, Moderna's vaccine now authorized for use by the FDA and the CDC issuing new guidance on who should be among the next to receive a COVID-19 vaccine, Wisconsin's State Disaster Medical Advisory Committee's (SDMAC) Vaccine Subcommittee is working to determine how to best offer recommendations on vaccine allocation to the next phase of vaccine recipients.

The subcommittee met Tuesday to continue the process of forming their recommendations.

Phase 1B recipients, according to the CDC's Advisory Committee on Immunization Practices (ACIP), will be made up of front line essential workers such as police, firefighters, teachers and childcare workers, grocery store employees, public transit employees, postal workers, and people 75 years of age and older.

There will likely be more people eligible for a vaccine than doses initially available. That's why the subcommittee must determine how to recommend vaccinating entities prioritize who gets a vaccine first.

"We need to make those hard decisions, given the small [number] of doses, of who gets the next slices of pie," said Tom Harter, a subcommittee member.

As the subcommittee met, risk factors such as age dominated the Tuesday morning meeting.

"If we want to save lives, we have to give the vaccine to people who the virus is killing and the virus is killing older people," said Rob Gundermann, subcommittee member, while suggesting that people 75 years old and above should be sub-prioritized some of the others in phase 1B.

In addition for advocating vaccinating people who are 75 years of age or older, subcommittee co-chair Ann Lewandowski also advocated for people under the age of 75 to be considered for the vaccine based on their risk of exposure given their occupation.

"A focus on death is one thing, and preventing death is always in-focus but, there's more than just death and people are seeing it. Young people are having strokes, they're losing limbs," said Lewandowski.

She continued by saying, "To simply say just because you don't die, or your population is not dying, I think ethically, it is really hard to say we are still going to have you out there exposed and possibly having really severe consequences that are going to follow you and the rest of the country - I mean if people become disabled because of COVID - it will have really significant consequences for our workforce for many, many, many years."

Others suggested race and socioeconomic factors be prioritized, especially in places where those risk factors seem to be having more devastating impacts.

"I think that it is fair that we give preference to these populations, especially in Milwaukee County, it has to be just as important as age," said Silvia Munoz-Price, a subcommittee member.

The Tuesday morning discussion was still preliminary as they continue working to define and sub-prioritize each category under Phase 1B.

The six ethical principles that will be used while determining these recommendations are: promoting common good equity, fairness, reasonableness, unity, and respect for person.

The subcommittee meets again in early January to continue working towards final recommendations that will eventually make their way to vaccinating entitles.

In the meantime, Phase 1A remains the vaccination priority in Wisconsin, which means healthcare workers and those in long-term care continue to receive priority.

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