In CT, Who Should Get The Coronavirus Vaccine Next? Which One?

CONNECTICUT —More than a half-million coronavirus vaccine doses have been administered in Connecticut as of Friday, 358,000 being first doses. Around half of the state's 75 and older population has received at least one dose.

As the number of jabs trend higher, the number of coronavirus cases and hospitalization have continued to trend lower over the past week. The 827 patients currently in the hospital for COVID-19 is the lowest since the middle of November.

Can we keep the rally going? On Thursday, Gov. Ned Lamont voiced his worry that Super Bowl parties might cause a spike in infections.

This week, the state published town-by-town information on how many people of what age groups have gotten the vaccine. As the state moved out of vaccine rollout Phase 1a which focused on healthcare personnel, long-term care facility residents and medical first responders, age became the criterion for who got the medicine next, with residents 75 and above at the front of the line.

But is that the right move? There are those in the state who don't believe they should have to wait.

States have the autonomy to distribute the vaccines as they see fit, but usually take the advice of the career epidemiologists at the Centers for Disease Control and Prevention. In turn, the CDC looks to the Advisory Committee on Immunization Practices, an independent panel of medical and public health experts. It's the ACIP who have recommended states prioritize the elderly for the vaccine.

Interviewed by National Public Radio this week, Lamont said he was sympathetic but unyielding to the cries of many groups, particularly teachers, who have been lobbying to move to the head of the line. (In Chicago, teachers have made receiving the vaccine one of the conditions for their return to in-school learning.)

The science, or at least the statistics, indicates that Connecticut's focus on inoculating the elderly first has more than a little merit:

Since March 2020, 4,202 residents age 80 and above have died of COVID-19 in Connecticut, more than two-and-a-half times the number from the next oldest age group, 70-79.

While still vaccinating members of the Phase 1a group at the end of last month, the state moved ahead into Phase 1b. Here Lamont went off-script slightly, adopting what he called a "tiered approach" that focused first exclusively on residents aged 75 and over due to a shortage of the medicine. That "75+ Tier" is where the state sits now, even as clinics have begun scheduling vaccinations for the next group in line, those residents over the age of 65.

Although the break-out of the second phase into tiers has been the subject of a lot of teeth clenching and caterwauling on social media from those anxious to be vaccinated, the truth is that the state is way ahead of the curve, based on the latest CDC data:

The darker the state is colored in the map above, the more doses of the coronavirus vaccine it has administered, per 100,000 residents. Connecticut currently ranks 5th by that metric, behind Alaska, West Virginia, North Dakota and New Mexico. Click on a state or hover your mouse above it for more information.

Many who are eligible to receive the vaccine soon won't have to travel as far to get it. CVS will begin distributing about 6,800 vaccine doses in 12 of their stores starting Thursday, Feb. 11. Bookings will begin as early as Monday.

Which Vaccine is the Best One?

National and state officials have made it clear that the most effective vaccine is the one you can get into your arm the fastest. But, we're Americans, and we do love our choices. There are also enough subtle differences among the medicines to at least make you go "hmmm," even if they don't actually delay your jab.

As of now, there are only the two original players on the stage. Pfizer's vaccine has proven to be 95 percent effective, and Moderna's is close behind at 94.1 percent, but slightly lower than that in the key demo of people 65 and over.

A new vaccine from Johnson & Johnson will become available in March if the company receives emergency authorization from the U.S. Food and Drug Administration, as reported by Reuters. The agency's advisory committee will likely authorize the vaccine for use within a few days after reviewing J&J's application on Feb. 26. Another new vaccine, from Maryland company Novavax, has soldiered through a rocky phase of clinical trials and could be deployed as early as the summer.

The new vaccines were the first to include in their trials populations affected by the UK, South Africa and Brazil variant, all of which appear to be more infectious. That may account for some of the negative buzz about their reduced "efficacy", according to Dr. Howard P. Forman, a public health professor and director of the healthcare curriculum at Yale's School of Management. The Johnson & Johnson jab was 72 percent effective among clinical trial volunteers in the U.S., and Novavax is touting an 89.3 percent potency for its UK Phase 3 Trial.

The state DPH, managing the logistics of the medicine's rollout, will likely be more than happy to forgive a few potency points for the new medicines' upside. Both new vaccines only require a single dose to fully inoculate a resident, cutting the current number in half, and neither require crazy-cold temperatures to ship and store.

There's a lot to think about, but don't. Akiko Iwasaki, a virologist at Yale University, told Stat the emphasis should be on simply vaccinating as many people as possible, as quickly as possible. The current lack of immunity in the majority of the population, and the high number of cases, is giving the virus an opportunity to mutate more often, Iwasaki said.