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Connecticut group: people 65+ or with comorbidity should be in next phase for shots

The allocation subcommittee of the state's COVID-19 Vaccine Advisory Group on Tuesday recommended adding people over age 65 and those with at least one preexisting condition to Phase 1b, in addition to its previous recommendation of front-line essential workers and people in congregate settings, such as homeless shelters and correctional facilities.

The recommendations will go to the main advisory group, which is scheduled to meet Thursday from 6 to 7 p.m., and then to Gov. Ned Lamont. The Lamont administration had announced Monday that vaccinations for people over 75 will begin next Monday.

The allocation subcommittee met at noon, just a few hours after news reports started coming out that the Trump administration would recommend vaccinating everybody over age 65 and with a comorbid condition. At noon, U.S. Health and Human Services Secretary Alex Azar announced these recommendations in an Operation Warp Speed briefing.

"There was never a reason that states needed to complete vaccinating all health care providers before opening vaccinations to older Americans and other vulnerable populations," Azar said.

He said that moving on before all health care workers are vaccinated "is not declaring victory for that category" and states should continue working to support those vaccinations, but "moving on to broader populations when supply meets demand was always part of the recommendations CDC provided to states."

Deidre Gifford, acting commissioner of the Connecticut Department of Public Health, began the allocation subcommittee meeting by acknowledging this new development and saying it would be prudent to keep the recommendations in mind.

"For us to go against the grain of what's happening nationally I think would be a mistake, so I would support this," said member Dr. Michael Carius, of the American College of Emergency Physicians.

In terms of defining comorbidities, the group is going with conditions the Centers for Disease Control and Prevention lists as putting adults "at increased risk" of severe illness from the coronavirus.

These include cancer, chronic kidney disease, COPD, Down Syndrome, heart failure, weakened immune system from a solid organ transplant, obesity, pregnancy, sickle cell disease, smoking and Type 2 diabetes. Some members of the allocation subcommittee were particularly adamant about including organ transplant recipients and people with Down Syndrome.

Neither the Pfizer nor Moderna vaccine was tested on pregnant women in trials, and the general guidance for pregnant women considering vaccination is to talk to their doctor.

The CDC has a second list of conditions for which adults "might be at increased risk" for severe illness from the coronavirus — such as asthma, cystic fibrosis and Type 1 diabetes — but the allocation subcommittee isn't including these in Phase 1b.

Dr. Marwan Haddad, medical director of the Center for Key Populations at Community Health Center, said adding people over age 65 and those with at least one comorbidity to Phase 1b would add more than 700,000 people to the phase.

Brookfield Health Department Director Raymond Sullivan said he "didn't want to give too many people false hope that the vaccine is going to be there for them tomorrow or next week," and others voiced concern that the list was becoming too broad, thereby pushing people over 75 further back.

The group is leaving it up to DPH to prioritize within Phase 1b.

Co-chair Nichelle Mullins, president and CEO of Charter Oak Health Center, summarized by saying the group was directing DPH "to use a phased, roll-in approach based on risk of mortality, increased risk for severe illness, and at the same time explicitly address issues of equity and disparate impacts of COVID."

Some group members expressed concern about access to the vaccine, noting that people over 75 are the least computer savvy.

Benjamin Bechtolsheim, director of the COVID-19 vaccination program for DPH, urged members not to worry about access Tuesday, saying "if you give us a clear direction of who you want to see prioritized, we will work to do that." He also noted that DPH has been working to set up phone-based vaccination scheduling that doesn't involve email.

e.moser@theday.com

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