Why vaccinate our most frail? Odd vote out shows the dilemma

The vote to recommend long-term care residents be among the first to receive Covid-19 vaccinations was not unanimous.

Out of a panel of 14 CDC vaccine advisers, a lone doctor said no.

"Odd woman out, I guess," Dr. Helen "Keipp" Talbot, of Vanderbilt University, told her colleagues. "I still struggle with this. This was not an easy vote."

Talbot was worried about whether the vaccine would even work in such frail, vulnerable patients. Even more, she worried about how it might look if the vaccine failed in that group, or how it would affect public perception if residents died soon after getting the vaccine.

On the other hand, these are the people worst hit by the pandemic. They make up 40% of all deaths so far.

Nursing homes in the Midwest have been particularly hard hit, with a more than 400% increase in weekly cases since mid-September, according to a report published Tuesday by the American Health Care Association and National Center for Assisted Living. During the week of November 15, 49% of new nursing home cases were in the Midwest.

Between mid-September and the week of November 15, there was a 177% rise in new weekly nursing home cases nationwide. The rise in cases has been accompanied by a rise in coronavirus deaths in nursing homes.

"Our worst fears have come true as Covid runs rampant among the general population, and long term care facilities are powerless to fully prevent it from entering due to its asymptomatic and pre-symptomatic spread," said Mark Parkinson, the organization's president and CEO.