An ad hoc committee of the National Academies of Sciences, Engineering, and Medicine will develop an overarching framework for vaccine allocation to assist policymakers in the domestic and global health communities in planning for equitable allocation of vaccines against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The expectation is that such a framework would inform the decisions by health authorities, including the Advisory Committee on Immunization Practices (ACIP), as they create and implement national and/or local guidelines for SARS-CoV-2 vaccine allocation. As part of this effort, the committee will consider the following:

• What criteria should be used in setting priorities for equitable allocation of vaccine?
• How should the criteria be applied in determining the first tier of vaccine recipients? As more vaccine becomes available, what populations should be added successively to the priority list of recipients? How do we take into account factors such as:
  • Health disparities and other health access issues
  • Individuals at higher risk (e.g., elderly, underlying health conditions)
  • Occupations at higher risk (e.g., health care workers, essential industries, meat packing plants, military)
  • Populations at higher risk (e.g., racial and ethnic groups, incarcerated individuals, residents of nursing homes, individuals who are homeless)
  • Geographic distribution of active virus spread
  • Countries/populations involved in clinical trials
• How will the framework apply in various scenarios (e.g., different characteristics of vaccines and differing available doses)?
  
• If multiple vaccine candidates are available, how should we ensure equity?
• How can countries ensure equity in allocation of COVID-19 vaccines?
• For the US, how can communities of color be assured access to vaccination?
• How can we communicate to the American public about vaccine allocation to minimize perceptions of lack of equity?
• What steps should be taken to mitigate vaccine hesitancy, especially among high-priority populations?

As part of the overall study, the committee will produce a discussion draft of the framework for public comment, and hold a public workshop to solicit feedback from external stakeholders.