On November 23, 2020, new Centers for Disease Control and Prevention (CDC) COVID-19 vaccine recommendations were discussed during an emergency meeting of the Advisory Committee on Immunization Practices (ACIP). As I discussed recently, Pfizer, Moderna, and AstraZeneca all have announced that their vaccines exhibited high effectiveness and safety during phase 3 clinical trials.
This is a brief review of what ACIP and CED are “thinking” regarding COVID-19 vaccine recommendations.

ACIP COVID-19 vaccine recommendations meeting
The meeting opened with remarks from Dr. Robert Redfield, current Director of the CDC. He discussed the CDC’s efforts to improve public acceptance of the new vaccines by attempting to be more transparent with respect to the clinical trial process.
However, the primary focus of the meeting was to discuss how to allocate any COVID-19 vaccine that might receive an emergency use authorization (EUA) from the US Food and Drug Administration (FDA).
At this time there are three vaccine candidates from Pfizer, Moderna, and AstraZeneca that are in phase 3 clinical trials and have reported (but not published in a peer-reviewed journal) interim results. There are several other vaccine candidates in phase 3 trials, but less is known about their results. Some of those candidates are not being studied in the USA or the European Union, so they may not ever be available in the USA.

Similar to what I suggested (and no, I don’t think they care what I suggest), the CDC suggests the following groups should be the initial targets for the COVID-19 vaccine recommendations:
- healthcare personnel
- seniors
- individuals at high risk based on pre-existing conditions.
Thus, ACIP’s “Phase 1a” – the very first doses to be released – COVID-19 vaccine proposed allocation recommendations would include the following specific groups:
- healthcare workers (since they are the ones on the frontlines of treating those with COVID-19)
- seniors living in Long-Term Care Facilities (LTCF)
- staff working in LTCF
As of November 6, 2020, LTCF residents and staff have accounted for nearly 6% of COVID-19 cases. Further, they represent 39% of mortalities in the USA.
The group reported that most pharmacies across the USA have been recruited to administer the COVID-19 vaccines to seniors eventually.
ACIP will have future meetings to flesh out COVID-19 vaccine recommendations as more supply is available.
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