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Who Should Be First In Line To Get Coronavirus Vaccine?


More good news about COVID-19 vaccines today - the biotech company Moderna says its vaccine is nearly 95% effective at preventing the disease. Last week Pfizer announced similar news, meaning twin vaccines are now seeking emergency authorization. With the whole world waiting, there's a debate over who should be first in line to get those shots. Dr. Helene Gayle is co-chair of a national academies committee which has studied that issue. They published their recommendations last month.

Dr. Gayle, welcome to ALL THINGS CONSIDERED.

HELENE GAYLE: Hi. Good to be here.

SHAPIRO: Your committee's report is one of several that decision-makers are consulting, and the framework you're suggesting has four phases of vaccine distribution. How did you decide which group of people should be in each phase, who should be in the front of the line versus the back of the line?

GAYLE: In order to determine the different phases, what we took was a risk categorization. So we looked at the risk of acquiring or transmitting the infection, the risk of getting serious illness or death if you are infected and then the risk of negative consequences on the society. And so we looked at those four different risks and did a risk hierarchy with those who had the most risk in the first categories and decreasing risk in the later phases.

SHAPIRO: Can you give us just a snapshot of who's in each of the groups?

GAYLE: Well, in the first group, we have high-risk health workers and first responders, also people of any age who have the diseases that put them at greatest risk for severe illness or death and then older adults living in congregate and overcrowded settings. In the second phase, we have teachers. We have other critical workers in high-risk settings, people who are in other congregate living settings like homeless shelters, prisons, detention centers, et cetera, and then any older adult who wasn't included in the first phase. The third phase - young adults, workers in industries that have some risk but not as high-risk as others. And then the fourth phase is everybody residing in the United States who did not get access in the previous phases.

SHAPIRO: Even though Black and Latino people have been disproportionately affected by this disease, this framework doesn't explicitly call for prioritizing communities by race as the vaccine is distributed. Why is that?

GAYLE: Well, what we really looked at - and again, with the risk profiles that we looked at, given the fact that Black and Latino populations and other communities of color have been at highest risk, given that we're using risk as the determinant, we believe that that's one way in which we can account for it because we wanted to make the point and recognize that it's not one's race, but it's the impact of racism. It's the fact that people are often at risk because of low-income jobs or because of crowded households and other kind of social and economic factors that are linked to race but are not racial in and of themselves.

SHAPIRO: It sounds like you're saying you are prioritizing people of color, just in an indirect way.

GAYLE: We're prioritizing people of color by what puts them at risk. It isn't their race. It's racism.

SHAPIRO: Given that Black people are disproportionately affected by the disease and, according to surveys, even more unlikely to want a vaccine than the American public in general, do you think there are specific, targeted ways to reach that community? And can you give us an example of what that would look like?

GAYLE: Well, one of the things that we recommended was that there be campaigns that explicitly focus on communities at greatest risk, communities of color that include the organizations and the people who are trusted by those communities. So, you know, that could be different faith institutions. It could be spokespersons or entertainers that relate to the Black community. So, you know, we really want to make sure that the communities that have been most disproportionately impacted by this don't get left out of what could make a big difference in their life by having access to the vaccine and being willing to take it.

SHAPIRO: That's Dr. Helene Gayle, president and CEO of the Chicago Community Trust and co-chair of the National Academies report on equitable allocation for a COVID-19 vaccine.

Thanks a lot.

GAYLE: All right. Bye-bye. Transcript provided by NPR, Copyright NPR.

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