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Front-line workers must be vaccinated first, says report

Workers essential to sustaining the ongoing response to coronavirus disease (Covid-19); people maintaining core societal functions; and those at greatest risk of severe illness and death and their caregivers should be vaccinated first whenever a vaccine is approved but is still in limited supply , according to a new report released in the US on Wednesday.

The report, written by public health experts led by the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, proposes establishing tiers of high-priority candidates who will receiving a vaccine first.

First responders and those at risk are in tier one, with tier two including those providing non-Covid healthcare, people supporting maintenance of important societal functionssuch as police and fire personnel, transportation and delivery workers, food system workers, teachers, and workers involved in the maintenance of electricity, water, information, finance and fuel infrastructure, among others, those who may not be able to access health care if they become ill, and those working in sectors that raises their risk of infection.

Apart from health and frontline workers, people over the age of 65, and those with chronic diseases, the report recommends protecting workers needed to maintain public safety, such as police and fire personnel. It also recommends vaccinating those who can spread infection, such as workers in high public contact jobs like transportation, grocery shops workers, teachers, and childcare workers, school-going children and children living with high-risk adults.

The report, the Interim Framework for Covid-19 Vaccine Allocation and Distribution in the United States, can be applied in every country.

There are 29 candidate vaccines undergoing human clinical trials, with eight vaccines in late stages of clinical evaluation around the world, according to the latest World Health Organisation Draft Landscape of Covid-19 candidate vaccines. Another 138 experimental vaccines are in preclinical evaluation — all adding to hope that one or more of these candidates will be available at scale in 2021.

“The purpose of this report is to offer an additional ethics framework for use in making decisions about allocation of Sars-CoV-2 vaccine during this initial period of scarcity in the United States and make related suggestions about vaccine distribution. Our approach takes into account considerations of medical risk, public health, ethics and equity, economic impact, and logistics,” said authors.

India has not placed global pre-orders for a Covid-19 vaccine yet, but has begun talks with made-in-India vaccine producers on production and procurement.

The National Expert Group on Vaccine Administration will meet the country’s leading vaccine developers and producers for the second time this week for information on their production capacity and plans on pricing.

“No vaccine will be 100% effective, but with scientists working on many experimental vaccines, more than one is likely to be available next year. To ensure their timely availability for our population, including priority populations such as our Covid warriors, the expert group has begun consultations with vaccine manufacturers to plan ahead for the production, pricing and distribution of the vaccine, whenever it is ready,” said Union Health Minister Harsh Vardhan.

There is a lag from the time of vaccine administration to the production of a robust immune response, and many vaccines may need more than one dose to offer protection, say experts. “Even with a highly effective vaccine, it will take at least two weeks after the first dose for some immunity to develop, with full protection appearing around two to four weeks after the second dose. This means it may take six to eight weeks to develop immunity after vaccination, which can be short-lived. We still don’t know,” said a scientist at Indian Council of Medical Research, requesting anonymity. – Hindustan Times