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Letter to the Hon. Alex Azar, Secretary of the U.S. Department of Health and Human Services - ER Doctor Congressman Ruiz Leads Charge for Health Equity in COVID-19 Vaccine Distribution


Dear Secretary Azar:

We are writing to urge that the national COVID-19 vaccine plan include strategic efforts with a public health approach to ensure the equitable distribution of COVID-19 vaccines to the American public, so that the highest-risk individuals are prioritized. This public health approach requires the plan to be fair and effective; prioritize those at highest risk for transmission and dying of the disease; and save the greatest number of lives.

We cannot repeat the debacle we continue to have with the distribution of tests, where even now health care providers who are risking their lives to take care of COVID-19 patients are not tested, but low-risk non-essential workers, like professional athletes, are. Where low-risk residents in affluent communities can get tests just because they came back from vacation, but higher-risk farmworkers who are working to maintain our food supply chain cannot.

It is critical that we prioritize vaccinating people who need it the most. This disease hits certain populations harder; statistics show that older people and those with underlying health conditions are at higher risk for developing severe symptoms1, with greater infection and mortality rates among people of color.2 And essential workers are risking their lives every day to protect our communities, save lives, and keep our food supply chain intact. It is critical that these higher risk individuals are prioritized to get vaccines once they become available.

We are cautiously optimistic at the current pace of vaccine development and encouraged by promising clinical trials. It is going to take hundreds of millions of vaccine doses to be effective at curbing this virus, and current projections show that we may begin vaccinating the public by the end of the year or early in 2021. Regardless of this progress, not all of those vaccine doses are going to be available at once, so difficult decisions must be made as to how to prioritize their distribution.

We cannot wait until the vaccine is ready to start thinking about vaccine distribution objectives, or scramble to create plans at the last minute, or simply give them to the highest bidder. We cannot look back in a year and see that we created additional disparities because we didn't make the conscious effort to make sure that vulnerable populations have access to vaccines, not just wealthier low-risk people in affluent zip codes. We cannot look back in a year and have to correct a mistake that we have already made. Health equity must be a priority and not an afterthought. We must plan now to ensure equitable allocation and distribution.

We urge you to aggressively and immediately pursue coordinated, strategic efforts based on science and public health expertise that puts individuals most at risk of getting infected and dying from COVID-19 at the forefront of vaccine use. We understand that both the National Academies of Medicine and the Advisory Committee on Immunization Practices are beginning to examine this issue, and that those recommendations may inform your own plans--however, the broader plan remains unclear. We request further details on the Administration's national COVID-19 plan, and specifically how you intend to construct your strategic distribution efforts including the following information by August 31, 2020.

What are the principles that will guide your prioritization of vaccine distribution?
What factors are you taking into account in the formulation of the vaccine distribution plan?
What data sources are you using, and which experts are you consulting?
How will the amount, timeline, and location of distribution reflect these priorities?
What is your timeline to solidify a plan, and will you make that plan public or available to Congress?
How will you make the amount, timeline, and location of vaccine distribution transparent to the public?
Time is of the essence; these plans need to be ready to implement as soon as the first round of vaccines is available for use, and we need to ensure that those most at risk have access, regardless of where they live or how much money they make.

Thank you for your attention to this critical matter, and we look forward to receiving your response.