When Can Older Americans Expect to Get a COVID-19 Vaccine?

Shots are expected to be widely available by mid-2021, but some may get them earlier. 

 As COVID-19 vaccines become increasingly available in the U.S. over the coming months, older adults who have been disproportionately affected by the pandemic are expected to be prioritized over the general public. But if you’re 65 or older, you’ll likely need to wait a month or two before you can get vaccines that are in high demand but relatively short supply.


Vaccines developed by Pfizer/BioNTech and Moderna have received emergency use authorization from the U.S. Food and Drug Administration. The vaccines are already being distributed across the country, and as many as 20 million people could get one before the end of the year, according to Army Gen. Gustave Perna, chief operating officer of the federal Operation Warp Speed vaccine initiative.


Still, the initial supply is a drop in the bucket for the 331 million Americans — and 53 million adults over the age of 65 — who may want to be immunized. “Once there’s a vaccine approved for use, there will likely be a period when there is insufficient vaccine to meet demand,” Kathleen Dooling, M.D., an epidemiologist at the Centers for Disease Control and Prevention, said during a CDC advisory panel conference call.


Federal health officials are already creating guidance to help states determine who should receive the vaccines when. The CDC is developing recommendations for which groups should be prioritized, recommending this week that states start by inoculating health care workers and residents of long-term care facilities — where 40 percent of the nation’s more than 277,000 COVID deaths have occurred — when vaccines first become available. But state officials are ultimately responsible for making their own distribution plans, and strategies vary considerably from one state to the next. In Kentucky, for example, nursing home residents and staff are expected to receive vaccines even before some doctors and health care professionals who work in outpatient settings, which is not the norm in most states.


Federal and state officials are typically prioritizing older adults, who are at greater risk than younger people of death or serious complications from COVID-19. The CDC estimates people age 65 and older have accounted for 8 in 10 deaths attributed to the coronavirus in the U.S. But in many states, they’re a lower priority than health care workers, nursing home residents and, in some cases, essential workers like police officers.


In Massachusetts, for example, older adults who don’t live in long-term care facilities and who don’t have significant underlying medical conditions will likely be immunized in the state’s third vaccine wave. “Older Americans are certainly up there. It could be Q1 or Q2” that they’re vaccinated, says Robert Finberg, M.D., an infectious diseases specialist and professor at the University of Massachusetts Medical School and a member of Gov. Charlie Baker’s vaccine advisory panel.


Many state plans suggest older Americans will likely be vaccinated in the first half of next year, so people of a similar age in two different states likely won’t have months of vaccine difference between them. But health experts warn that the piecemeal nature of the vaccines’ rollout will likely create confusion about who can receive a vaccination and when. There’s also concern about initial growing pains as the government attempts to distribute tens of millions of vaccines that, in Pfizer’s and Moderna’s cases, require people to get second doses a few weeks after their first.


“There are complexities involved, and there’s going to be some learning as we go here,” says Megan O’Reilly, vice president for federal health and family issues at AARP, noting that there will be “distinctions and differences across states” over who has initial access to a vaccine.


First in line: 24 million Americans


The CDC estimates that 21 million health care workers and 3 million people in congregate community settings such as nursing homes and assisted living facilities will need to be vaccinated. Older adults who don’t fall into either group will need to wait to see if their state health officials follow the CDC’s guidance.


More than 285,000 health care workers are confirmed to have contracted COVID-19, along with more than 905,000 long-term care residents and staff, according to data from the CDC and the Kaiser Family Foundation. “They recognized that those who have been disproportionately harmed need to be first in line for lifesaving vaccines, along with the people who care for them,” says Katie Smith Sloan, president and CEO of the LeadingAge nonprofit nursing home advocacy group, describing recommendations from the CDC’s Advisory Committee on Immunization Practices.


A CDC advisory panel is recommending states consider placing people at least 75 years of age and “frontline essential workers” — including teachers, police officers, grocery store workers and postal employees —in their second phase of vaccine distribution (1b). The panel then recommends states prioritize adults between ages 65 and 74 and adults over the age of 16 with high-risk medical conditions, such as obesity, diabetes and heart problems.


How quickly will vaccines be shipped out?


The federal government is working with state officials and vaccine manufacturers to ensure doses are sent where they’re needed. The Department of Transportation is helping oversee vaccine shipments on a rolling basis, with states receiving shipments proportional to their population size, according to Perna. So states with larger adult populations are initially expected to receive larger vaccine shipments. “We are not waiting for a cluster of vaccines to be available and then push,” Perna said, explaining that they will be shipped “every week based on availability.”


Moncef Slaoui, a vaccine expert and chief scientific adviser to Operation Warp Speed, has outlined a rough estimate for how many vaccines can be shipped to state and local health officials in the coming months. He expects enough vaccines will be shipped in December to vaccinate 20 million people, with an additional 30 million able to be vaccinated in January. He expects 50 million Americans will be vaccinated in February.


At that point, and assuming separate vaccines from Johnson & Johnson, AstraZeneca and others also receive approval, he thinks roughly 75 million Americans could be vaccinated per month. Based on this timeline, many health officials think vaccines will be available to the general public around April or May of next year. But it may take longer.


Francis Collins, director of the National Institutes of Health, told AARP in a tele-town hall that “by July or so, [most of] our country — assuming everybody is willing to take the vaccine, which is another issue — should be able to get access.”

‘Vaccines are useless if they are not used’


And the assumption that everyone is willing to take the vaccine may be wrong. A recent Harris Poll found that nearly 1 in 4 Americans wouldn’t get a vaccine even if the government paid them to do it. Older adults appear to be more receptive to a vaccine — more than half of people in a separate University of Michigan survey between ages 50 and 80 said they are somewhat or very likely to get a COVID-19 vaccine when it becomes available. But only 1 in 5 said they’d want to be vaccinated right away. Nearly half said they’d rather wait until other people have safely received the vaccine. “Vaccines are useless,” Slaoui says, “if they are not used to vaccinate people.”


Some state officials, including Gov. Andrew Cuomo (D) of New York, are considering outreach programs to educate people and make them more comfortable getting a vaccine. But state budgets are strapped after almost a year of pandemic fallout. Many states may need financial help just to distribute their vaccines — let alone fund education and outreach programs.


“One of the issues we’re watching Congress on is funding to help states operationalize the distribution of the vaccines,” says AARP’s O’Reilly. “Right now, the money isn’t there.”


If the vaccines prove safe and effective and enough Americans do get vaccinated, the country is likely to return to “a considerable degree of normality” in the second half of next year, says Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the NIH. He recently cautioned that masks and social distancing measures are likely to stick around for much of 2021 but said he was optimistic about the vaccines in development.


Still, their efficacy depends in part on widespread participation by the public. “What would be really a terrible outcome is we have vaccines that are shown to be really good, and yet half of Americans decide not to use them,” Collins said. “And then this epidemic could go on and on and on. We need to get about 90 percent of the population immunized if we’re going to basically tell this virus that it’s done.”


Read the original article here: https://www.aarp.org/health/conditions-treatments/info-2020/coronavirus-vaccine-distribution.html