States struggling to prioritize COVID-19 vaccinations are leaning on healthcare providers to make the decisions, arguing that they are better equipped to determine who should be first, Politico reported.
"They know who is most at risk," Kentucky Gov. Andy Beshear said during a news conference, according to Politico.
The CDC recommends the first doses of the vaccine go to healthcare workers and long-term care facility residents, but there likely won't be enough doses to cover all of them at first. Priority should go to healthcare workers who come into direct contact with COVID-19 patients and their families, the CDC advises, but those recommendations aren't binding. Hospitals and other healthcare facilities will have to determine which of their employees to vaccinate first.
Kentucky, Mississippi and New York have all instructed their hospitals to create a tiering system to decide which employees to prioritize.
Nebraska Medicine in Omaha told The Wall Street Journal it will likely use a lottery system to decide which employees to vaccinate first. Mayo Clinic in Rochester, Minn., said it is using data on occupational risks to make the decision, and Mass General Brigham in Boston is prioritizing the hospital units where workers have the most exposure to patients with COVID-19.
Emory Healthcare in Atlanta told the Journal it will prioritize employees in essential units, such as the emergency department and intensive care, regardless of whether the units are dedicated to COVID-19 patients.
Some experts worry that letting healthcare providers decide who to vaccinate first could hurt transparency and equity in vaccine distribution, according to Politico.