Vaccine Allocation Guidance by the Centers for Disease Control
Demand for COVID-19 vaccines is expected to exceed supply during the first months of the vaccination program. The Advisory Committee on Immunization Practices (ACIP) considered evidence related to SARS-CoV-2 epidemiology, vaccination program implementation, and ethical principles in developing the interim recommendation for allocation of COVID-19 vaccine following Phase 1a. Healthcare personnel and residents of long-term care facilities should be offered the first doses of COVID-19 vaccines (Phase 1a).
After Phase Ia, the allocation is anticipated to be as follows:
· Essential workers* (non-health care)
· Persons aged ≥65 years
· Persons with high-risk medical conditions
· Allocation within Phase 1 of the COVID-19 vaccination program (post Phase 1a)
Phase 1b – Frontline essential workers: first responders (e.g. firefighters and police officers), corrections officers, food and agricultural workers, U.S. Postal Service workers, manufacturing workers, grocery store workers, public transit workers, and those who work in the education sector (teachers and support staff members) as well as child care workers.
Phase 1c – All other essential workers: workers in transportation and logistics, water and wastewater, food service, shelter and housing (e.g., construction), finance (e.g., bank tellers), information technology and communications, energy, legal, media, and public safety (e.g., engineers), and public health workers.
Phase 1b – Persons aged ≥75 years
Phase 1c – Persons aged 65-74 years
Phase 1c – Persons aged 16-64 years† with medical conditions that increase the risk for severe COVID-19
Among all study vaccine recipients asked to complete diaries of their symptoms during the 7 days after vaccination, 84.7% reported at least one local injection site reaction. By age group, 88.7% in the younger group (aged 18 to 55 years) and 79.7% in the older group (aged >55 years) reported at least one local reaction. Pain at the injection site was the most frequent and severe solicited local reaction among vaccine recipients. After dose 1, the younger age group reported pain more frequently than the older age group (83.1% vs 71.1%); a similar pattern was observed after dose 2 (77.8% vs 66.1%). Injection site redness and swelling following either dose were reported less frequently than injection site pain. Redness and swelling were slightly more common after dose 2. No grade 4 local reactions were reported. Overall, the median onset of local reactions in the vaccine group was 0 (day of vaccination) to 2 days after either dose and lasted a median duration between 1 and 2 days. Data on local reactions were not solicited from persons aged 16-17 years. However, their reactions to vaccination are expected to be similar to those of young adults who were included. In addition, reactogenicity data from adolescents aged 12-15 years were obtained and reviewed and were similar to those from adults aged 18-55 years.
Among all vaccine recipients asked to complete diaries of their symptoms during the 7 days after vaccination, 77.4% reported at least one systemic reaction. The frequency of systemic adverse events was higher in the younger than the older age group (82.8% vs 70.6%). Within each age group, the frequency and severity of systemic adverse events was higher after dose 2 than dose 1. Vomiting and diarrhea were exceptions, and similar between vaccine and placebo groups and regardless of dose. For both age groups, fatigue, headache and new or worsened muscle pain were most common. The majority of systemic events were mild or moderate in severity, after both doses and in both age groups. Fever was more common after the second dose and in the younger group (15.8%) compared to the older group (10.9%). Overall, the median onset of systemic adverse events in the vaccine group in general was 1 to 2 days after either dose and lasted a median duration of 1 day. Four grade 4 fevers (>40.0°C) were reported, two in the vaccine group and two in the placebo group. No other systemic grade 4 reactions were reported. Data on systemic reactions were not solicited from persons aged 16-17 years. However, their reactions to vaccination are expected to be similar to those of young adults who were included. In addition, reactogenicity data from adolescents aged 12-15 years were obtained and reviewed and were similar to those from adults aged 18-55 years.
Local pharmacies, particularly in San Diego County, like CVS, Walgreens, Rite Aid, Costco as well as area hospitals will be carrying the vaccines. Please remember, these vaccines are free to the public. You should not pay for anything.
For further tabulated information please visit https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/reactogenicity.html
Keywords: Covid-19, Covid, Vaccine, local and systemic reactions
Lawrence D. Jones, Ph.D.