Covid-19 Vaccines Should First Go to Health Workers, First Responders, Group Recommends

Certain health workers and first responders should be the first to receive a Covid-19 vaccine when one becomes available, followed by people with health conditions that put them at higher risk of severe Covid-19 disease, a special U.S. committee recommended.

As supplies of vaccines rise, the committee recommended vaccinating groups like teachers, child-care staffers and transit workers. Only later should other groups and finally remaining Americans get vaccinated, the committee said in a report released Friday by the National Academies of Sciences, Engineering and Medicine.

“You cannot reduce transmission when you have very few doses. That’s the time to prioritize directly the high-risk groups,” Saad Omer, a committee member and director of the Yale Institute for Global Health, said in an interview.

The committee also recommended that any vaccine be provided to people without any out-of-pocket costs, and that authorities take steps to overcome public reluctance to get vaccinated.

There is no proven vaccine for Covid-19. Public-health officials say developing one will be critical to bringing the coronavirus pandemic under control.

As government and private money pour into the global race for a Covid-19 vaccine, drugmakers are under great pressure to keep the shot affordable while also keeping investors happy. WSJ explains what this means for the final price tag of the jabs. Illustration: Crystal Tai

Several companies including

Pfizer Inc.


Moderna Inc.

are testing experimental Covid-19 vaccines in large, late-stage clinical trials. Interim results about whether the shots safely protect people from Covid-19 could become available as early as this month, though it may take longer.

If results are positive, the companies plan to seek emergency use authorization from the government, which plans to begin shipping the vaccines within 24 hours of the go-ahead.

Yet supplies will be limited at first, forcing health authorities to prioritize who should get access to shots and when. Moderna, for instance, has said it expects to produce 20 million doses by the end of the year. Federal health officials have said there may not be enough for most Americans until around the spring of 2021.

The U.S. Centers for Disease Control and Prevention and the National Institutes of Health asked the National Academies to form the vaccine committee in July, to come up with the recommendations for how to equitably allocate a vaccine in the U.S. The committee includes physicians and specialists in infectious diseases, public health and vaccines.

Federal health officials have already embraced some of the committee’s recommendations, such as eliminating out-of-pocket costs and addressing the hesitancy of many Americans.

The committee laid out a phased approach to vaccinating the U.S. population. “At the outset and in the months to follow, a Covid-19 vaccine will almost certainly be available only in limited supplies. In this context, scarce vaccines will need to be allocated in ways that reduce” transmission of the virus and the risks to those most vulnerable to serious Covid-19 cases, the report said.

The committee recommended a first phase, 1a, of vaccination that would cover about 5% of the population and include front-line health workers such as those in hospitals and nursing homes, workers who provide transportation and other services to health-care facilities, and first responders.


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“First responders are needed to maintain the sort of well-being of society,” Dr. Omer said regarding police, firefighters and emergency medical technicians.

The group has a critical role in maintaining health-care system functions, and a high risk of exposure to patients with Covid-19 symptoms, and higher risk of in turn transmitting the virus to others, the report said.

The next phase, 1b, would cover 10% of the population and include people with health conditions that put them at higher risk of severe Covid-19 disease or death, and people age 65 and older who live in settings such as nursing homes, long-term care facilities, homeless shelters and prisons.

This group also faces the risk of transmission due to living conditions that limit their opportunity to practice social-distancing measures, the report said.

Daily reported Covid-19 deaths in the U.S.

Notes: For all 50 states and D.C., U.S. territories and cruises. Last updated

Source: Johns Hopkins Center for Systems Science and Engineering

Daily reported Covid-19 cases in the U.S.

Note: For all 50 states and D.C., U.S. territories and cruises. Last updated

Source: Johns Hopkins Center for Systems Science and Engineering

Another 30% to 35% would be vaccinated in phase 2, including teachers and school staff for grades kindergarten through 12, child-care workers and workers in high-risk settings who can’t avoid risk of exposure to the virus, such as in food supply and public transit.

Young adults, children and workers in colleges and hotels would be among the 40% to 45% of the population to be vaccinated in phase 3. The final phase would include all Americans not included in the earlier phases.

The report also recommended the U.S. participate in an international effort to procure vaccines for global use—an initiative the Trump administration has declined to join because of the involvement of the World Health Organization and China.

Write to Peter Loftus at and Jared S. Hopkins at

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