Neal Browning receives a shot in the first-stage safety study...

Neal Browning receives a shot in the first-stage safety study of a potential vaccine for COVID-19 at the Kaiser Permanente Washington Health Research Institute in Seattle on March 16. Credit: AP/Ted S. Warren

Federal and state health officials are wrestling with the question of who should be first in line for scarce COVID-19 vaccines.

Both Pfizer-BioNTech and Moderna have applied to the Food and Drug Administration for accelerated authorization after their vaccines showed higher than 90% protection rates in clinical trials. Approval could come as soon as December.

New York State's Department of Health has rolled out a tentative distribution plan and the Centers for Disease Control and Prevention is working on its own guidelines.

On Tuesday, the CDC's Advisory Committee on Immunization Practices is scheduled to vote on which groups should be allocated vaccine in the initial rollout based on science, implementation and ethics considerations.

Here is New York State's proposed distribution plan:

Phase 1:

  • Health care workers providing patient care, with priority given to those in intensive care units, emergency units and those providing emergency medical services.
  • Long-term care facility workers who interact with residents.
  • At-risk long-term care facility patients.

Phase 2:

  • Police, fire and National Guard first responders.
  • Teachers, school staff and child care providers.
  • Public health workers.
  • Workers who interact with the public and maintain critical infrastructure, including pharmacists, grocery store workers, transit employees.
  • Other long-term care facility patients and those living in other congregate settings deemed to be at high risk.
  • People in the general population with comorbidities and health conditions that put them at particularly high risk.

Phase 3:

  • People over 65.
  • People under 65 with comorbidities and health conditions.

Phase 4:

  • All other essential workers.

Phase 5:

  • Healthy adults and children.

While COVID-19 strikes young adults age 18-24 most frequently, those 80-plus have the highest death rate by far, according to the CDC.

The state's sequence could be superseded by new federal guidelines or updated data on vaccine side effects and levels of protection afforded to subgroups such as senior citizens.

Clarification: Pfizer and BioNTech asked the FDA for expedited approval of their vaccine. An earlier version of this story misstated the nature of their request.

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