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CDC Immunization Committee Chair On Coronavirus Vaccination Logistics

MARY LOUISE KELLY, HOST:

In the COVID-19 pandemic, there are causes for alarm but also causes for hope. On the alarm side, The U.S. documented more than 100,000 coronavirus infections just yesterday. That is a new record. On the hope side of the ledger, scientists are working around the clock on treatments and eventually a vaccine. So a couple of huge questions on this - who would get a vaccine first, and how will it be rolled out? Well, among the doctors and public health experts focused on answering those questions are those who sit on a committee advising the Centers for Disease Control and Prevention. Dr. Jose Romero chairs this group. It's called the Advisory Committee on Immunization Practices. And Dr. Romero joins me now.

Hi there.

JOSE ROMERO: Hello. How are you?

KELLY: I am well. Thank you. So let's start with that basic question. Is there consensus on the committee on this question? Who should get a vaccine first?

ROMERO: I think there is overall universal agreement the first tier or first phase of the vaccine should be administered to health care providers, and that's health care providers writ large. And by that, I mean it's not just the doctors and nurses that are interacting with these patients but also the support personnel that help deal with them - so respiratory technologists, emergency responders. And then we begin to talk about other individuals at high risk for disease. So as of yet, the groups receiving this has not been finalized because we haven't had a final vote on that.

KELLY: As we know, the virus has hit some groups of Americans harder than others - older people, communities of color, Black and Latinx people. Is there any discussion - will your recommendations look at whether to prioritize vaccine delivery to those groups?

ROMERO: Yes, they are being considered for subsequent phases of, inclusively, the what we would call 1B phase or 1B tier. And we look at data and modeling regarding the impact of these vaccines in order to make those decisions. So we are clearly looking at those groups, in the particular individuals 65 and older, whether they should be in that top tier or not.

KELLY: I do want to ask about pressure - any possible pressure you feel under because these are, of course, public health decisions, but there's politics involved. Have you felt any pressure from the administration to come up with a particular set of recommendations, save for who should get the vaccine first?

ROMERO: No, not at all. I can emphatically say that I've had no contact with the administration or with pharmaceutical companies regarding influencing my decision on how to go with this.

KELLY: Oh.

ROMERO: And from what I've heard talking to my colleagues on the committee, neither have they.

KELLY: Pressure from anyone at all to move sooner than you might feel comfortable with?

ROMERO: No, not at all.

KELLY: OK. So to the basic question on so many people's minds, when might there be a vaccine that is safe, effective and widely available? I know those factors are not all within your control, but what is your best guess?

ROMERO: I would say that at the earliest, it would be next month, December.

KELLY: Including the widely available part of that question?

ROMERO: No.

KELLY: No. OK.

ROMERO: So, again - you know, that's a very good point. So let me make sure that this is clear. So there will be limited amounts. We anticipate having some vaccine for the high-risk individuals - those individuals and health care providers - it looks like as it is now sometime in December or early January, and then more and more vaccine will be rolled out. On top of that, I think it's important also to understand that it's not just one vaccine. At this time, there are four vaccines in phase 3 - that is the highest phase of clinical trials - and another about to enter.

KELLY: So multiple paths to a hopefully successful, effective vaccine. And worth noting that the first vaccine available might not be the best one.

ROMERO: That's correct. I mean, it may not be, and we will see as we go through. I think this issue of the vaccine, at least for the ACIP, is going to be going into next year and possibly the year after because as these vaccines become more available, we'll understand how well they work. We'll understand if there are any safety signals that are not being detected initially.

KELLY: That is Dr. Jose Romero. He is chair of the ACIP. That's the Advisory Committee on Immunization Practices. It's the committee of doctors and public health officials that advise the CDC on how to distribute a coronavirus vaccine.

Dr. Romero, thank you for your time.

ROMERO: Thank you. Transcript provided by NPR, Copyright NPR.

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