The National Academies of Sciences, Engineering, and Medicine today released a consensus study recommending a four-phase framework to inform national and local guidelines for equitable COVID-19 vaccine allocation. Phase 1a, or the “jumpstart phase” of the framework includes front-line health care workers and first responders. Phase 1b includes people of all ages with 2 or more comorbidities that put them at significantly higher risk of COVID-19 disease or death and older adults living in congregate or overcrowded settings. Phase 2 includes K-12 teachers and school staff, critical workers in high-risk settings who cannot avoid a high risk of exposure to COVID-19, people of all ages with comorbidities, people of all ages in congregate or overcrowded settings, and all older adults not included in Phase 1a and 1b. Phase 3 includes young adults, children, and workers in industries that are important to a functioning society. Phase 4 covers everyone residing in the U.S. who did not have access to the vaccine in prior phases. The report also contains recommendations focused on vaccine production and distribution, vaccine cost, addressing vaccine hesitancy and increasing vaccine acceptance, and the U.S.’s global role.

“Ultimately, in these uncertain and challenging times, the integrity of the COVID-19 vaccine development, allocation, and distribution processes will be critical to ensuring widespread access to vaccines that are safe and effective, and convincingly so for the public,” said National Academy of Medicine President Victor J. Dzau. “I hope the recommendations set forth in our report contribute to society’s ability to respond to and recover from the COVID-19 pandemic here in the United States and globally.”


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