Inmates and others in congregate settings such as homeless shelters, group homes and psychiatric facilities should be included in the next wave of those eligible to receive the coronavirus vaccine, members of an advisory subcommittee recommended Tuesday.
The next stage of distribution and administration, known as Phase 1B, could begin as early as this month and run for about 10 weeks. As many as 800,000 Connecticut residents are expected to be included in that phase.
Subcommittee members endorsed suggestions by the national Advisory Committee on Immunization Practices, which prioritized teachers, correctional staff, postal staff, grocery store employees and other “essential workers” for the next stage of the vaccine rollout. But they stressed that inmates and others who live in congregate settings should also be included in that round.
“Just from a pure epidemiology perspective, we know that crowding people together makes it more likely they’ll transmit,” said Zita Lazzarini, a UConn Health professor and co-chair of the allocation subcommittee of the state’s vaccine advisory panel. “Also, some of our congregate settings like prisons, substance abuse treatment centers and other things – some of them are and some of them may be disproportionately vulnerable populations to begin with.”
People 75 and older will also be included in Phase 1B. The national ACIP recommended that restaurant employees be put in a later phase, known as 1C. But Connecticut’s vaccine subcommittee Tuesday recommended moving those workers, along with people who work at food banks and who deliver meals to the elderly, to Phase 1B. Health inspectors should also be part of the next stage, members said.
The subcommittee is considering priority for others, including people with disabilities, uncompensated caregivers, and people aged 16 to 74 who have underlying medical conditions. It also is weighing how to direct the vaccines to address racial and ethnic health disparities. People of color have been disproportionately impacted by COVID-19 in Connecticut.
“The part we have been talking about that has been the most difficult to tease out is … how to define who is vulnerable … how we would address both racial and ethnic equity better and address other underlying health disparities, often involving people with disabilities,” Lazzarini said. “Should we use a Medicaid lens and a federally qualified health center lens to focus on those [populations]? Or should we be choosing specific co-morbidities or numbers of co-morbidities in order to address those health disparities and inequities?”
The subcommittee is expected to meet again soon to consider additional populations for Phase 1B, though no follow-up meeting has been scheduled. Some members cautioned against adding too many people to the next stage of the rollout, noting that it would then take longer to make the vaccines available to residents who are not 75 or older.
“If we push more and more people into [Phase] 1B, we only prolong the availability of vaccines to a larger number of people further down the line,” said Raymond Sullivan, director of health for the Brookfield Health Department and a subcommittee member. “It’s totally dependent upon the availability of vaccine. A number of health departments were notified this week that they were not going to get a shipment and in point of fact had to cancel appointments. So I think we need to concentrate on those individuals who are most prone to getting the disease right now.”