Thread by @DonnaYoungDC

.@theNASEM holds its public online "listening session" today starting at noon E.T. to discuss yesterday's draft on equitable #COVID19 #vaccines allocation.
nationalacademies.org/event/09-02-20… #FDA #CDC #NIH

Read my story free here 👇

.@VictorDzau: Initial #COVID19 #vaccines doses will be limited, at least in beginning.
Scarce vaccines will need to be allocated in ways that are thoughtful, strategic/fair.
Important we have a well-thought out framework
Objective/transparent/trusted/independent
#vaccineframework

WILLIAM FOEGE: This is a draft.
Meeting today because want final product to be better.
This is a fast draft!
Uncertainties we had were overwhelming.

We did the best we could.

We started w/ ethics/equity before we went to the science.

#vaccineframework #COVID19 #vaccines

WILLIAM FOEGE: This virus understands vulnerabilities.
Worst: Heart failure, kidney failure, body mass.
Also crowding, multigenerational occupancy.
We put those in line first.

#vaccineframework #COVID19 #vaccines

WILLIAM FOEGE: Does this committee overlap with #CDC #ACIP?
We hope recommendations will inform ACIP & the rest of government.

#vaccineframework #COVID19 #vaccines

.@helenegayle: This is a public health challenge w/ deep economic & political ramifications.

#vaccineframework #COVID19 #vaccines

.@helenegayle: #CDC #NIH sponsoring @theNASEM #COVID19 #vaccines allocation report reflects kind of collaboration so important

Expectation is #vaccineframework will inform decisions by health authorities.

.@helenegayle: We started with foundational principles: Maximization of benefits, equal regard, mitigation of health inequities, fairness, evidence-based, transparency.

#vaccineframework #COVID19 #vaccines

.@helenegayle: Primary goal: Maximize societal benefit by reducing morbidity/mortality caused by transmission of the novel #coronavirus.

#VaccineFramework #COVID19 #vaccines

Here's my story again: Health workers, ill, older adults should get COVID-19 vaccine 1st – US advisers spglobal.com/marketintellig… #VaccineFramework #COVID19 #vaccines #NIH #CDC

.@helenegayle: Ensuring equity: Within the population groups included in each four phases, committee recommends vaccine access should be prioritized for geographic areas identified as vulnerable through #CDC's Social Vulnerability Index.

#VaccineFramework #COVID19 #vaccines

.@MontagueCobb Randall Morgan: Any strategy to decrease mortality rates must account for the greater percentage of black/brown deaths per capita

Transparency must address the reality of looking at the course of the disease & the virulence of the virus

#VaccineFramework #COVID19

.@ABCardio1 Elizabeth Ofili: Should prioritize ethnics minorities severely impacted

African-Americans have poor outcomes of care, regardless of socioeconomic status. And so the vulnerability indices may not capture risk type of inequity

#VaccineFramework #COVID19 #vaccines

.@ANTHCtoday Ellen Provost: "The Great Death" — how the 1918 flu remembered by Alaskan-Native people.
It is this collective memory making people fearful this could happen again.

#VaccineFramework #COVID19 #vacciines

.@ANTHCtoday Ellen Provost: Lessons learned from 2009 #H1N1: indigenous populations suffer disproportionately

If we are to avoid another "Great Death," this committee will recognize Alaskan-Native people inequities/disparities & put them in the highest group.

#VaccineFramework

.@NHMAmd @ElenaRiosMD: Families are a big part of #COVID19 #pandemic.
Need stories about the families.

There is something missing here.

#VaccineFramework #vaccines

..@ANTHCtoday Jim Roberts: Allocation decisions related to Native-Alaskans is in fulfillment of/supported by Commerce Clause in the U.S. Constitution

#VaccineFramework #COVID19 #vaccines

.@NCAPIPComms Winston Wong: API/Native Hawaiian has been hit hard by #COVID19.
Native Hawaiians suffer COVID-19 mortality 3x higher than their proportion of population in Hawaii.
Half of the deaths in San Francisco were among Asians/Pacific Islanders
#vaccineframework #vaccines

.@NCAPIPComms Winston Wong: Must acknowledge political vulnerabilties/language used to describe #COVID19 [by Trump] & policies to change definition of poverty, impact immigrants, stoke fear/avoidance of COVID-19 screening & could threaten access to vaccination.

#VaccineFramework

.@syramadad: There should be more context for the disabled in the #COVID19 #vaccines allocation plan.

She praises draft report for not focusing on "professional titles" of health workers but rather their risk of exposure.

#VaccineFramework

.@ASTHO @MarcusPlescia: #COVID19 #vaccines allocation plan should reinforce the need for state-based flexibility to set priorities

Discord among leaders at any level will erode public trust.

#VaccineFramework

.@cramersmd: We do not need to be creating new systems of distribution. It's the worst possible idea in the middle of a pandemic to try to create something new.

Please let those of us who know what we're doing do it since we've been doing it already.

#VaccineFramework #COVID19

.@cramersmd: It's foolhardy for us to think we can ignore rest of the world & just vaccinate ourselves. We are not safe until all of us are safe. We see this all the time — infectious diseases cross borders back/forth

#VaccineFramework #COVID19 #vaccines

.@cramersmd notes difficulties in recruiting study participants from communities of color b/c historical mistrust/historical abuses.
Must be transparent.
How can expect be guinea pig when time & time again volunteered & then didn't see benefits of research?

#VaccineFramework

.@ushahmd notes the Harris Cares 2020 report here:
publichealth.harriscountytx.gov/Resources/Harr…

#VaccineFramework #COVID19 #vaccines

.@ahahospitals Michelle Hood: Mental health is significant risk & we didn't see it was necessarily included as a comorbidity that may put people at higher priority

#vaccineframework #COVID19 #vaccines

.@ahahospitals Michelle Hood: Public really needs to hear this information from one leading voice.
A "source of truth."

Lack of clarity made a lot of work difficult.

#VaccineFramework #COVID19 #vaccines

.@pharmacists .@ScottKnoer: Reconsider the placement of pharmacists. Pharmacists belong in tier 1.
Pharmacists have been on the frontlines.

Pharmacists will serve as key immunizers

#VaccineFramework #COVID19 #vaccines

.@AmerDentalAssn Kathleen O'Laughlin: Dentists & their teams are essential health care workers.

Oral health has always been associated with overall health.

#VaccineFramework #COVID19 #vaccines

.@UCSF @LouiseAronson: Not until 2019 for older people to be included in #ClinicalTrials. "Bottom of the barrel."

#NIH said in 1989 must include women & people of color in studies but "that hasn't gone as well as one might hope 30 years later"

#VaccineFramework #COVID19

.@AmerGeriatrics @TimFarrell_MD: It is often the 9th inning of life that's the most important.

#VaccineFramework #COVID19 #vaccines

VOYCE's Nicole Lynch notes a population important to older Americans in long-term care/nursing home facilities:

"Volunteer advocates"

Many of those advocates are older adults themselves.
voycestl.org/about

#VaccineFramework #COVID19 #vaccines

With this sort of request to governors by @CDCDirector, will #CDC even wait for @theNASEM & @CDCgov #ACIP #VaccineFramework?


Is @theNASEM & #ACIP being pressured by Trump administration to finalize reports to help him in #2020Elections?

Independent?

.@FarmwrkrJustice Alexis Guild: Farmworkers are at a substantially high risk for #COVID19 exposure.
Important #CDC provide vaccine info in widely accessible/in all literacy levels/languages spoken by communities & not just Spanish, but also indigenous languages.
#vaccineframework

That was great moment on @theNASEM Zoom #COVID19 #vaccineframework forum.

.@FMI_ORG Peter Matz: I apologize if you can hear the baby in the background. I promise it's not a hostage.

.@campesinasunite Mily Trevino-Sauceda: Even though #FarmWorkers are called 'Essential Workers,' we have never been treated as essential workers.

We are not even part of the Fair Labor Standards Act.

#VaccineFramework #COVID19 #vaccines

.@rweingarten: There's a lot of fear & confusion right now in the current political environment & people need a process that they can understand and trust.

Allocation of #COVID19 #vaccines must be fair, transparent & protects those most at risk.

#vaccineframework #teachers

.@AFTunion @rweingarten Schools are a reality that could be potential super-spreaders.

Some schools are reopening in a way that is not safe.

#vaccineframework #teachers #Schoolsreopening #COVID19 #vaccines

WILLIAM FOEGE: These will be recommendations.

Decisions will be made by #CDC, state/county/tribal/local levels.

#VaccineFramework #COVID19 #vaccines

.@SchoolHouseConn Alleanne Anderson: 74% of students who are experiencing homelessness are living in congregate settings.

#VaccineFramework #COVID19 #vaccines

.@naehomelessness Chandra Crawford: Homeless are uniquely at risk for #COVID19. Have higher rates of chronic health conditions/respiratory disease.
They also have hard time complying w/ #SocialDistancing, etc.
May not even be getting proper info about #pandemic.
#VaccineFramework

.@ACCP_MED Charles Lee, who is on @theNASEM #VaccineFramework Zoom forum today from a correctional facility, notes that correctional workers go home daily & may be the source of spread of #COVID19 in their communities.

.@ACCP_MED Charles Lee: Segments of our society who are forgotten & never thought of who are extremely susceptible to #COVID19.

#VaccineFramework #vaccines

Does #CDC even plan to wait for @theNASEM #VaccineFramework & @CDCgov #ACIP?

.@CDCDirector plowing forward, saying he's anticipating a #COVID19 #vaccines in November & @SteveFDA predicting could grant #EUA by election day.

All #2020Elections-driven?

.@Okanlami: "If there's a belief an expedited process means shortcuts were taken, many communities will be wary of vaccine, which could adversely impact ate at which these communities get vaccinated.

#VaccineFramework #COVID19 #vaccines

.@Okanlami: I don't imagine that I need to remind this group of the Tuskegee study.

#VaccineFramework #COVID19 #vaccines

.@Vaxyourfam Amy Pisani: #VaccineFramework must be complemented with ongoing conversation about amazing systems we have in place to monitor vaccine safety/efficacy in US. The purpose & historical success of these safety systems should be broadly shared with the public regularly.

.@PublicHealth @GeorgesBenjami7: Phase approach #COVID19 #VaccineFramework is the right approach. But some clarity needed.
If you have high comorbidies & homeless, folks going to look at categories & see which bucket.
Same if high comorbidities if you are a teacher.

.@GeorgesBenjami7: Unless we join the global effort, all of our efforts will be for naught.

Our risk of having people be totally confused about efficacy/safety, particularly in light of antivax & #2020Elections, it's important to have a national voice needed.

#VaccineFramework

.@KidneyPatients Paul Conway another today who urges #Transparency.

#VaccineFramework #COVID19 #vaccines

.@ASHPOfficial @annalegreiddopp insists pharmacists should be in top tier/high priority for getting #COVID19 #vaccines.

#VaccineFramework #COVID19 #vaccines

.@Rotary Ann Kimball: We all know that people watch as much as they listen.

[Will Trump get #COVID19 vaccine publicly?]

US vacated leadership nationally.
Our own people will suffer b/c of lack of collaboration/interchange

Could use #VaccineFramework report to call it out!

If this is the case - an Azar-OK of #COVID19 #vaccines - what's the point of @theNASEM 5+ hour public forum today?
Public statements from @CDCDirector @SteveFDA look like there's no stopping this freight train to get it done by Nov 3 - public be damned?

.@PattyMurray @SenSchumer tonight: "After so many examples of political interference at #FDA and #CDC over the past few weeks, we shouldn’t let several more weeks pass before we get answers. We are losing valuable time to prevent costly mistakes."

#COVID19

.@PattyMurray & @SenSchumer note Fauci, @SteveFDA @CDCDirector & @HHS_ASH Giroir will testify Sept 23 at @GOPHELP @HELPCmteDems but not at the Sept 9 #COVID19 #vaccines hearing, where @NIHDirector & @Surgeon_General will testify [don't know why Adams is a witness there ].

House and Senate Democrats had called on @SteveFDA & @CDCDirector to testify about whether they are being politically pressured. They also want to hear from Hahn on his misleading/false claims about #convalescentplasma
spglobal.com/marketintellig… #COVID19 #vaccines

US states told to expect COVID-19 vaccine in November; groups urge transparency spglobal.com/marketintellig… #VaccineFramework #CDC #FDA #COVID19 #vaccines