Dooling, et al. (2020) acknowledge that less than one year after the SARS-CoV-2 genome was first sequenced, an application for Emergency Use Authorization for a candidate vaccine has been filed with the Food and Drug Administration (FDA); however, they state, "Even if one or more vaccine candidates receive authorization for emergency use, demand for COVID-19 vaccine is expected to exceed supply during the first months of the national vaccination program."

The Advisory Committee on Immunization Practices (ACIP), which advises the Centers for Disease Control and Prevention (CDC) on population groups and circumstances for vaccine use, convened on Dec. 1, 2020, in advance of the completion of FDA’s review of the Emergency Use Authorization application to provide interim guidance to federal, state, and local jurisdictions on allocation of initial doses of COVID-19 vaccine.

The ACIP recommended that, when a COVID-19 vaccine is authorized by FDA and recommended by ACIP, both healthcare personnel and residents of long-term care facilities (LTCFs) be offered vaccination in the initial phase of the COVID-19 vaccination program (Phase 1a).

As the authors of the report in MMWR state, "In its deliberations, ACIP considered scientific evidence of SARS-CoV-2 epidemiology, vaccination program implementation, and ethical principles. The interim recommendation might be updated over the coming weeks based on additional safety and efficacy data from phase III clinical trials and conditions of FDA Emergency Use Authorization."

CDC director Robert Redfield, MD,  says he supports the ACIP's recommendations and looks forward to future recommendations that, based on vaccine availability, demonstrate that the nation also prioritizes the elderly (>70) who reside in multi-generation households.  This framework, in addition to the ACIP guidance, will ensure a more equitable distribution to those most at risk for hospitalizations and fatalities, he says.

Reference: Dooling K, NMcClung N, et al. The Advisory Committee on Immunization Practices’ Interim Recommendation for Allocating Initial Supplies of COVID-19 Vaccine — United States, 2020. Morbidity and Mortality Weekly Report. Vol. 69. Dec. 3, 2020