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AFP, published Tuesday 01 December 2020 at 08:23
The list of priority populations in the United States for vaccination against Covid-19 has not been officially decided, but already the opinions of the experts diverge from the choices of other countries such as France, in particular on essential workers.
There will be no single rule in the United States: at the risk of creating confusion, as during the 2009 H1N1 flu vaccination campaign, the federal government will make recommendations and leave each state free to decide. distribution method and order of priority, among the elderly, assistants, supermarket employees …
Recognized groups of experts have already expressed opinions, sometimes divergent, revealing the central tension of the debate: vaccination should both protect the most vulnerable and facilitate the rebirth of society.
It is on this issue – how to restart the economy as quickly as possible – that the United States could stand out.
The High Authority for Health in France recommended starting with residents and some at-risk employees of nursing homes, followed by the elderly and health workers, then the over 50s, then the people whose profession promotes the infection. and vulnerable and insecure people, and finally the rest of the population.
An approach close to that suggested by the World Health Organization and chosen by many rich countries, Saad Omer, director of the Yale University Institute for Global Health, told AFP.
In the United States, in a report of more than 200 pages, the National Academies of Science, Engineering and Medicine put the first assistants “on the front” of the pandemic, and paramedics, police and firefighters highly exposed to the virus.
People who have two or more medical conditions (cancer, obesity, type 2 diabetes, etc.), whatever their age, will follow the 2 million people in nursing homes.
– Gears of the country –
American experts then rely not on age but on profession and favor the “critical” workers who make America go around: first the teachers, and the workers who serve to feed Americans, from slaughterhouses to supermarkets, who drive buses and trains, sell drugs, keep order, or deliver mail and packages.
Often it is also precarious workers, of Hispanic and black minorities, who have been disproportionately affected by the pandemic, an injustice that experts explicitly want to redress.
After these tens of millions of workers, people with a single disease could be vaccinated, the homeless, inmates and those over 65 without comorbidities … Then young adults and especially students, who are less at risk but have shown how much they spread the coronavirus.
This is just a proposal. The Centers for Disease Prevention and Control (CDC) are awaiting the opinion of their expert (advisory) committee, which will vote on Tuesday.
This committee suggested that it could prioritize essential caregivers and workers, because immunizing them will provide a “multiplier effect”: not only are they essential cogs in the health response and the economy, but they are in touch. with many people.
In practice, these ethical, epidemiological and economic considerations can be ignored in the initial rush to doses.
Concrete problems remain: if it is easy to turn to nursing homes and hospitals, how are pharmacists and doctors supposed to confirm that a customer is indeed an essential worker or that he has two conditions? ?
Additionally, the Trump administration said it will not be bound by its health agency’s advice and that nursing homes will receive Pfizer / BioNTech vaccines as early as mid-December in the event of a regulatory green light, whatever. ‘experts say. The logistics are also already in place.
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