How CDC Is Making COVID-19 Vaccine Recommendations
When the Food and Drug Administration (FDA) authorizes or approves a COVID-19 vaccine, the Advisory Committee on Immunization Practices (ACIP) will quickly hold a public meeting to review all available data about that vaccine (sign up to receive email updates whenever ACIP’s Meeting Information is updated). ACIP is an independent panel of medical and public health experts. Before making recommendations, ACIP reviews all available clinical trial information, including descriptions of:
● Who received the vaccine (age, race, ethnicity, underlying medical conditions)
● How different groups responded to the vaccine
● What side effects people had
From these data, ACIP will then vote on whether to recommend the vaccine. While vaccine supplies were limited, ACIP also voted on recommendations for who should be offered COVID-19 vaccine first.
Ethical principles
ACIP identified four ethical principles to guide their decision-making process when supply is limited:
● Maximize benefits and minimize harms — Respect and care for people using the best available data to promote public health and minimize death and severe illness.
● Mitigate health inequities — Reduce health disparities in the burden of COVID-19 disease and death, and make sure everyone has the opportunity to be as healthy as possible.
● Promote justice — Treat affected groups, populations, and communities fairly. Remove unfair, unjust, and avoidable barriers to COVID-19 vaccination.
● Promote transparency — Make a decision that is clear, understandable, and open for review. Allow and seek public participation in the creation and review of the decision processes.
Other frameworks
Input from the public and the following professional groups is informing ACIP’s discussions on who should receive COVID-19 vaccines when supply is limited:
● Johns Hopkins Bloomberg School of Public Health
● The National Academies of Sciences, Engineering, and Medicine
● World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE)
● WHO SAGE
Vaccine Rollout Recommendations
When the U.S. supply of COVID-19 vaccine was limited, CDC provided recommendations to federal, state, and local governments about who should be vaccinated first. CDC’s recommendations were based on those from ACIP.
The recommendations were made with these goals in mind:
● Decrease death and serious disease as much as possible.
● Preserve functioning of society.
● Reduce the extra burden COVID-19 had on people already facing disparities.
While CDC made recommendations for who should be offered COVID-19 vaccine first, each state had its own plan for deciding who would be vaccinated first and how they could receive vaccines.
On April 19, 2021, as COVID-19 vaccines became more widely accessible, vaccine eligibility expanded to everyone in the U.S. aged 16 years and older.