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CDC Panel Takes on COVID Vaccine Rollout, Risks, and Side Effects

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Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

A Centers for Disease Control and Prevention (CDC) panel received a detailed briefing on Friday about potential strategies for a future rollout of COVID vaccines and a possible strategy for monitoring adverse events from these new drugs.

The Advisory Committee on Immunization Practices (ACIP) of the CDC will play a key role in shaping the policies for eventual distribution of these vaccines. CDC staff presented detailed reports on various issues surrounding the potential introduction and administration of COVID vaccines. The US Food and Drug Administration (FDA) has not yet cleared any product of this kind for distribution.

ACIP was not slated to take any formal votes Friday about COVID vaccines. Instead, the panelists asked questions of presenters from the FDA and the CDC about plans for approving and then distributing the vaccines. As of 4 pm, the panel was still in the midst of hearing presentations from CDC staff.

A presentation from the CDC’s Matthew Biggerstaff, ScD, MPH, underscored challenges ahead for distributing what are expected to be limited initial supplies of COVID vaccines.

Biggerstaff showed several scenarios the CDC’s Data, Analytics, and Modeling Task Force had studied, based on a premise of an initial allocation of vaccines for healthcare workers. What would follow would be what the CDC called Phase 1B in these models.

Choices for a rollout may include giving COVID vaccines next to people defined as high-risk, such as having one or more chronic medical conditions like heart disease, diabetes, kidney disease, or obesity. Other options for the rollout could be giving vaccinations to people aged 65 and older or essential workers, indicating those whose employment puts them in contact with the public thus raising the risk of contracting the virus.

The CDC’s research found that initially vaccinating adults 65 and older in Phase 1B generally had the greatest impact in preventing death. The agency staff described this approach as likely to result in an about “1 to 11% increase in averted deaths across the scenarios.”

Initially vaccinating essential workers or high-risk adults in Phase 1B generally would have the greatest impact on infections. The agency staff described this as an about “1 to 5% increase in averted infections across the scenarios,” according to  Biggerstaff’s presentation.

Other findings of the CDC staff’s modeling were:

  • Earlier vaccine roll-out relative to increasing transmission, the greater the averted percentage and differences between the strategies

  • Differences not substantial in some scenarios

  • Emphasis on the need to continue efforts to slow the spread

 

Adverse Effects

ACIP members also heard about strategies that may be used to track potential side effects of future vaccines. A presentation prepared by Tom Shimabukuro, MD, MPH, MBA, from the CDC’s COVID-19 Vaccine Task Force/Vaccine Safety Team, included details about a new smartphone-based active surveillance program for COVID-19 vaccine safety.

Known as v-safe, this system would use text messaging to initiate web-based survey monitoring. It would conduct electronic health checks on vaccine recipients, which would occur daily for the first week postvaccination and weekly thereafter until 6 weeks postvaccination.

Clinicians “can play an important role in helping CDC enroll patients in v-safe at the time of vaccination,” Shimabukuro’s presentation noted. This would add another task, though, for clinicians, the CDC staff noted.

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