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CDC advisory panel member explains vote against vaccine priority plan - STAT

CDC advisory panel member explains vote against vaccine priority plan - STAT

CDC advisory panel member explains vote against vaccine priority plan - STAT
Dec 03, 2020 2 mins, 59 secs

When a Centers for Disease Control and Prevention advisory committee voted Tuesday to recommend residents of long-term care facilities should be at the front of the line — with health care providers — for Covid-19 vaccines, the lone dissenting voice came from a researcher who studies vaccines in older adults.

Helen Keipp Talbot — who is known by her middle name — raised serious concerns during the meeting of the Advisory Committee on Immunization Practices about using the vaccines in the frail elderly, noting there are no data yet to suggest the vaccines work in this population.

But none has specifically tested the vaccines in people who are in long-term care.

At an earlier ACIP meeting, Talbot warned that vaccinating this population at the start of the vaccine rollout is risky, because long-term care residents have a high rate of medical events that could be confused as side effects of vaccination and undermine confidence in the vaccines.

STAT spoke to Talbot, an associate professor of infectious diseases at Vanderbilt University, over Zoom, asking why she voted against putting long-term care residents into “Phase 1a” for access to Covid-19 vaccines, which will likely begin to be rolled out in the second half of December.

It was a bit unusual to see ACIP — which is an evidence-based decision-making group — make a recommendation on the assumption the vaccines would work in the frail elderly.

Tell me why you think vaccinating long-term care residents first isn’t the right approach.

We need to quit assuming that these vaccines work and actually design them and test them in this population and use them appropriately?

If I know it works in a healthy health care worker, I’d rather get all the health care workers vaccinated, so that when they are around the frail elderly, they don’t get the frail elderly sick?

We don’t have enough vaccine yet for all health care workers.

Do you have any safety concerns about use of the vaccine in long-term care residents.

And the chances of something like a stroke or even death happening in the 30, 60, or whatever days after vaccination is so much higher among long-term care residents ….

In the general population, the way you tease out whether a health event seen after vaccination is caused by it or merely linked to it temporally — it happened around the same time — is by knowing the baseline rates of these kind of events so you can say: This is within the range of the number of strokes we’d expect to see in this population over this amount of time.

Are those rates of events not known for long-term care residents.

Those in long term care facilities are not out and about getting exposed to the virus?

The workers in those facilities, when vaccinated, would create a much safer enviroment.

After health care workers, it seems to me, who to vaccinate is crystal clear if you look at age demographics for deaths from the virus >80 years old ~20%+ (rough) mortality rate, 70-79 ~12%, 60-69 ~7% and so on; under 30 it is almost nil.

I would like my 36 yo daughter who is a health care worker and exposed to Covid every day to be vaccinated.

I would like my 36 yo daughter who is a health care worker with an infant to get vaccinated ASAP

I work with this population and Ms Talbot is correct in her thinking

Independent living, assisted living is different as those folks usually aren’t as frail as the long term care resident

And the health care worker getting vaccinated so as to NOT bring it in is maybe the priority here

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