Organization practices a Virtual Meeting to discuss recommendations would get the covid19 vaccine first. The two groups likely to receiveposes our healthcare workers and longterm care facilityresidents. This is a portion of the meeting. Today we will revisit the allocation of the covid19 vaccine to answer the following policy questions. Should healthcare personnel and longterm care facility residents be offered vaccination to phase 1 a. After we have reviewed the evidence, then clinical considerations and safety monitoring presented by my colleagues we return to this question. Recalled that during the aca Community Meeting last week reviewed evidence to inform allocation decisions. For the finance, the workgroup examined covid19 Disease Burden as well as the balance of harmony group. Of course details of the phase 3 data will further inform this area when they become available. For implementation, the workgroup took into consideration the values and acceptability of implementation in each group. And finally, the sensible that apply to each group namely to maximize benefits and minimize harms through justice, mitigate health and promote justice in a protransparency. We used those three pillars to evaluate those groups for phase 1 a or for phase 1 vaccination. It discussed phase allocation which helps the personnel and longterm care facility residents in phase 1a, essential workers who do not work in healthcare in phase 1b and adults with highrisk medical conditions and adults 25 or older in phase 1c. In order to address policy questions before the ac ip today we will focus on the rest of adjudication on healthcare personnel and longterm care facility residents. Lets take a moment to review who these include. Healthcare personnel are defined as healthcare workers paid or unpaid who have potential for direct or indirect exposure to infectious material. There are approximately 25 million healthcare personnel working in settingssuch as hospitals, longterm care facilities, outpatient settings, home healthcare, pharmacies, emergency medical services, Public Health and others. There are several different categories of longterm care facilities including Skilled Nursing facilities in general those provide higher the qb care including rehabilitation services. There are also assisted living facilities where residents are provided help with activities of daily living but may live in own room or apartment within that facility. Other Residential Care facilities may provide specific services or cater to specific populations. Lets review the science. For healthcare personnel as of november 30, 30 been at least 243,000 confirmed covid19 cases with 858 covid deaths. Longterm care facility modeling that was presented to acip in august predicts more cases and death at a facility among everyone by vaccinating staff compared to vaccinating residents. Covid19 exposure both inside and outside the healthcare setting results in absenteeism due to quarantine, infection and illness. Vaccination has the potential to reduce healthcare personnel absenteeism. Older adults in target settings are disproportionately affected by covid19 longterm care facility residents whose staff accounted for 6 of cases and 40 of deaths in the u. S. Despite the fact longterm care facility residents account for less than 1 of the u. S. Population. The Skilled Nursing facility populations approximately 1. 3 million and as of november 15 had experienced almost half a million confirmed and probable cases and more than 69,000 covid associated deaths. Assisted living facilities are home to approximately 800,000 residents across the nation, and although surveillance is less systematic for these types of facilities, 20,000 confirmed and suspected cases were reported over 28 states and more than 5000 deaths were reported over 20 states. This figure shows the proportion of covid19 associate hospitalized patients in the covid net Surveillance System the were admitted from a longterm care facility. As you can see more than 30 of hospitalized patients aged 6574 were admitted from longterm care facility and more than half of hospitalized patients, conversations, 75 and older were admitted from a longterm care facility. Now lets review the implementation. A harris poll was completed in august, and survey respondents were asked which of the following groups should receive priority when the covid19 vaccine is available. Survey respondents most strongly supported early allocation of vexing to healthcare workers and seniors. While not expected to exactly predict covid19 uptake, influenza vaccine among healthcare personnel may give us indication of covid19 vaccine acceptance. Overall, Influenza Vaccine Coverage is high among healthcare personnel with the highest rates of uptake among hospital workers and lower rates among workers in the longterm care setting. Another early indication of longterm care facility acceptance of covid19 vaccination is the overwhelming response to the Pharmacy Partnership for longterm care program. Cdc apartment with two National Pharmacy chains to offer onsite covid19 Vaccination Services for residents and staff of Skilled Nursing facilities and assisted living facilities is partnering 99 of Skilled Nursing facilities nationwide have enrolled in this program. The Program Provides into and management of covid19 vaccination process including cold chain management, onsite vaccination and fulfillment of reporting requirements. But even with the Pharmacy Partnership for longterm care program, covid19 vaccination implementation and achieving high levels of coverage in the longterm setting will still be challenging. This is an example of a simulation of one and two dose coverage among Skilled Nursing for so the residence over time. Even if acceptance is high and three vaccination visits are made, because of the high turnover, the proportion of current residents who are vaccinated decreases over time. The situation will improve of course when vaccine is readily available in the community and adults can be vaccinated prior to admission. Now onto ethics. Vaccinating healthcare purcell supports the principle of maximizing benefits and minimizing arms so what were calling a multiplier effect. In other words, protection of healthcare personnel needs leads to preservation of capacity and Better Health outcomes for all. Vaccinating healthcare workers promotes us to speak us helped her personal puts itself a risk and would be essential to carry out the vaccination program. Vaccinating healthcare person also has the potential to mitigate Health Inequities because the Group Includes a broad range of occupations inclusive of lowwage earners and racial and ethnic minority groups. Vaccinating longterm care residents maximizes benefits by directly preventing disease and High Risk Group and minimizes harmed by potentially reducing the burden on hospitals. The federal Pharmacy Partnership program can promote justice by facilitating equal access to vaccine across most longterm care facilities. The program has the potential to mitigate Health Inequities by reaching longterm care facilities across the socioeconomic spectrum. In summary, the workers felt early vaccination of both healthcare personnel and longterm care facility residents was strongly supported by science, implementation, and ethical consideration. Heres some additional, important considerations the work group wanted to share. Whats presented here are interim guidance. Allocation policy will need to be dynamic and adapt with new information such as vaccine performance and supply demand become clear. To that end we will need dating crater to move expeditiously from one phase to the next as demand saturates. Its important to keep in mind the following vaccination measures to stop the spread of sarscov2 such as masks and social distancing will still be needed. Ultimately this interim allocation is a shortterm measure. The u. S. Government has stated its commitment to making covid19 Vaccines Available to all residents who want them as soon as possible. During the last meeting to a number of important issues raised and wanted to take this opportunity before the vote to provide Additional Information on those issues. And to summarize, for healthcare personnel acip members and liaisons expressed the need for guidance on sub prioritization of healthcare personnel when vaccine supply is limited in the beginning. To address vaccination in pregnant or lactating healthcare personnel as well as how to approach expected following vaccination. For longterm care facility residents acip members requested more information on consent and assent within facilities, and plans on interpretation of reactive reactivity is and is a and safety monitoring in the specific population. So that concludes my comments for the moment and i return the microphone back to dr. Romero expert today at 12 30 p. M. Eastern California Governor Gavin Newsom will be holding a News Conference on the states or sponsor the coronavirus pandemic as parts of california activate their stay at home orders. Watch live coverage bikini begt 12 30 p. M. Eastern on cspan2. Republican senator tim scott sat down with Manhattan Institute legal policy director James Copland to discuss policing, his criminal Justice Reform bill and working across the aisle with his democratic colleagues in congress. Welcome to the Manhattan Institutes that