The U.S. plan for distributing hundreds of millions of Covid-19 vaccine doses will likely rely on an outside advisory committee to figure out how to do it fairly.
National Institutes of Health Director Francis S. Collins told a Senate spending panel Thursday his agency and the Centers for Disease Control and Prevention are in preliminary talks with the National Academy of Medicine to form a committee by Labor Day to lay out guidelines for ethical vaccine distribution.
The committee would be tasked with determining how to make sure a vaccine successfully reaches people who have experienced higher death rates and worse outcomes, including Black, Hispanic, and elderly populations.
The hearing of the Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies came as the Trump administration faces continued scrutiny over its plan to bring a vaccine to market as quickly as possible. Collins, along with CDC Director Robert Redfield and the acting director of the Biomedical Advanced Research and Development Authority testified at the hearing.
Both Republican and Democratic heads of that subcommittee said they want more information on how the administration plans to deliver on Operation Warp Speed‘s goal of 300 million authorized Covid-19 vaccine doses by next January—truncating a process that normally takes five to 10 years down to one.
“The public is good at dealing with facts. They’re not good at dealing with very high expectations that have no chance of being met, and then we run into all kinds of problems,” Sen. Patty Murray (D-Wash.), ranking member of the subcommittee, said at the hearing.
Murray said she is working on a proposal to require the Trump administration “to provide a comprehensive plan for how it will make sure we get a vaccine that is safe and effective, produced at scale and distributed nationwide, and free and available to everyone in a way that addresses the health disparities this pandemic has made worse.”
Subcommittee Chairman Roy Blunt (R-Mo.) asked for more clarity in the next two weeks on the makeup of the advisory committee, including who will be in charge of what activities, what the deadlines are, and what the agencies need to meet those deadlines. “We can’t be helpful if you don’t tell us how to help,” he said.
Redfield said his agency will be leading vaccine distribution while relying on the logistical capabilities of Department of Defense.
But before that happens, Collins said there’s an opportunity to convene what he called “big thinkers” in ethics and public health to have a broader discussion of priorities for distributing a vaccine. The new advisory committee would lay a foundation of principles for the CDC’s Advisory Committee on Immunization Practices, which would then create an implementation plan, Collins said.
“We think that might be something that is best done in a circumstance by an organization that is not itself governmental because it’s still the case I think that people are a little bit uneasy about the government calling the shots here,” Collins said. “We are having a conversation very early on with the National Academy of Medicine about whether they would be the place to convene such a discussion.”
The National Academy is a non-governmental institution that makes non-binding but highly influential recommendations.
Sen. Lamar Alexander (R-Tenn.), chairman of the Senate Health Education Labor and Pensions Committee, said he favors the idea of a National Academy panel.
Blunt said these discussions should be happening right now. “Let’s not have it after we have a vaccine and we’re waiting to distribute it because we haven’t had a discussion of the ethics or health-care priorities,” he said.