That's the draft vaccine allocation plan of the National Academy of Sciences (NAS) in a nutshell. The Cystic Fibrosis Foundation has submitted comments urging that the nation's 30,000 Cystic Fibrosis patients be included in Phase 1b as opposed to Phase 2. As a CF dad, that sure makes sense to me (even though, given my age -- neither an "Older Adult" (>64) nor a "Younger Adult" (<31and >17) -- I would land in Phase 4, assuming the NAS plan is implemented. That would make me among the very last people in the U.S. to get vaccinated.)
Here's a link to the comments the CFF sent to the NAS on September 4. And here's the salient excerpt from the Foundation's comments:
Respiratory viruses can be devastating for people with CF. One study found that sixty-five percent of pulmonary exacerbations among people with CF were associated viral infections. Another study demonstrated that viral associated pulmonary exacerbations in adults with CF are associated with more severe pulmonary involvement and respond less well to standard treatment. Moreover, as a multi-system condition, cystic fibrosis itself can represent multiple comorbidities, including chronic pancreatic insufficiency, malnutrition, diabetes mellitus, liver disease, bone disease, and others—further increasing this population’s vulnerability to complications from COVID-19. Many people with CF have bronchiectasis associated with chronic obstructive pulmonary disease as well. As such, we believe it is appropriate to include people with cystic fibrosis with other patients for whom COVID-19 poses a significant risk.
Apparently the NAS did not put CF in Phase 1b because the Centers for Disease Control has classified Cystic Fibrosis merely as a condition that "may increase the risk of severe disease from COVID-19." The CFF pointed out that this classification is "due, in part, to a lack of evidence—which is unavoidable for a rare disease."
It is true that, according to the most recent CF National Patient Registry I have seen, there have only been two known COVID 19 deaths among the nation's CF population. But, of course, that's due to the excellent job people with CF have done with social distancing -- hardly surprising given that social distancing has long been a way of life for CF patients given the dangers posed by opportunistic bacteria like our friends B. cepacia, MRSA, pseudomonas Aurugenosa, etc.
Just as, earlier in the pandemic, the CF Foundation fought aggressively and effectively to prevent people with CF from being triaged out of access to ventilators (back when there was concern that ventilators and ICU beds would have to be rationed) it is important that CF patients have priority access to the COVID 19 vaccine when it arrives. Thank you CFF for doing this important work!
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