Making the Same Public Health Mistake Twice?

The CDC has formulated guidelines prioritizing healthcare workers and individuals in assisted care facilities for the first limited batch of the experimental COVID-19 vaccines. CDC officials reason that the former group operates in an environment with heavy exposure to the SARS-COV2 virus, while the latter is comprised of individuals at high risk for serious complications of COVID-19. Medical considerations aside, this decision also pays tribute to the sacrifices and courage of hospital staff and demonstrates compassion to our vulnerable and cherished elderly friends and family members.

But is this the ideal strategy given the current unprecedented surge? To reign in escalating numbers of infections and fatalities and keep Americans out of the hospital, the best approach is to target those individuals most likely to infect others. Medical professionals, who receive training in universal precautions, tend to be careful on and off the job and are rarely a source of community spread. Similarly, the risk of seniors quarantined in care homes transmitting disease to the larger population is low. So, even if the vaccines prove safe and effective in these first two groups, we may not see an immediate or marked shift in the transmission and spread of COVID-19.

Earlier in the pandemic, U.S. health authorities discouraged the use of masks by the public as late as April. They argued that although mask-wearing was necessary for any healthcare professionals who experienced frequent and concentrated exposure to the virus, it was not appropriate for the average American citizen. This misguided policy not only put the whole country at risk, it also placed immense strain on our hospitals and clinics, overwhelming staff and, ironically, increasing the chances for healthcare workers to become infected. Once again, one cannot help but wonder if the recommendation to vaccinate medical workers first is a case of a road paved with good intentions that will not lead to the desired destination.