The next group of Wisconsinites eligible for the COVID-19 vaccine could include educators, child care workers, public transportation employees, adults who are 65 years and older, and prisoners.
The State Disaster Medical Advisory Committee (SDMAC), a volunteer committee of medical officials and experts, voted unanimously Thursday morning to send its recommendations for vaccine group 1B to the Department of Health Services for final approval.
The final draft added some groups that had not initially suggested for 1B, including workers in public transportation and food service, including grocery stores, meatpacking plants, food pantries and agriculture.
The committee included prisoners despite pushback from Republican lawmakers, among others.
If approved, the recommended 1B group would include almost one-third of Wisconsin’s population. Combined with group 1A, almost half of Wisconsinites would be eligible for the vaccine. A DHS spokesperson said they anticipate final approval for the 1B list could come early next week.
Vaccinating grandmas and prisoners
Broadly speaking, SDMAC is making its vaccine group recommendations based on two criteria: the first is based on which groups are at higher risk of complications or death from COVID-19, and the second is based on which occupational groups would provide the greatest positive societal impact from widespread vaccinations.
Based on the first criteria, the committee had recommended 1B include adults 70 years and older. Ann Lewandowski, founder of Wisconsin Immunization Neighborhood and co-chair of the vaccine subcommittee, said that was based on strong epidemiological evidence.
However, Jonathan Temte, associate dean of public health at UW-Madison, said that based on feedback they’d received and because Wisconsin’s neighboring states have all started vaccinating 65 and older, sticking with 70 would, “create a nightmare of public discord.”
“Even though the epidemiological evidence is for 70, it is untenable at this time,” Temte said.
Also based on vulnerability, the committee recommended keeping prisoners on the list, along with other people living in congregate settings. Lewandowski pointed out that, while controversial, removing prisoners from the list could violate the Eighth Amendment, which prohibits, “cruel and unusual punishment.” Under that definition, prisoners have a right to access healthcare. Since they, by definition, live in a congregate environment, separating them from other members of that group would raise legal questions.
“If we include any other congregant setting, by Constitutional rights we would have to include prisoners,” Lewandowski said.
Back to school
For the occupation-based recommendations, the committee recommended prioritizing education and childcare workers so children could resume in-person schooling, which would have ripple effects: with children in school, parents could get back to work full-time, and districts would be able to work with children who have struggled with virtual learning and the isolation of staying at home.
And Silvia Munoz-Price, a professor of clinical medicine with the Medical College of Wisconsin pointed out reopening schools would address some of the disparities with how the pandemic has impacted families, such as families that rely on lunch programs or cannot afford child care. Marcia Stickel, a clinical nursing specialist with the Waisman Wellness Inclusion Nursing Program, said it would also be a huge benefit in rural areas that lack access to broadband internet speeds.
There was some discussion of whether the committee should specify if the education group included school staff, such as custodians, bus drivers, food service workers, or substitute teachers. The panel decided to leave that up to each school district to decide. For substitute teachers, in particular, members of the committee pointed out that with social distancing and teachers occasionally needing to quarantine, some districts are relying on substitute teachers more than usual.
“If the school district feels that’s appropriate, we need to support them in getting back [to work] in any way,” Lewandowski said.
The committee had a similar discussion over non-frontline hospital staff and whether they should spell out who qualifies and who doesn’t. Again, they decided to defer to the entity—in this case, hospitals—to decide who they wanted vaccinated to ensure operations continued to run smoothly.
“We can’t micromanage down to every job description,” said Chris Green, professor emeritus and UW-Madison’s School of Medicine and Public Health. “So discretion is the word of the day.”
Public transportation employees were added to ensure safe, reliable transportation for workers. There was some brief discussion of whether to include rideshare and airline employees, but committee members were concerned that would make 1B too large.
Grocery, meatpacking, agriculture, and hunger relief workers, such as food pantry employees, were not initially on the list for 1B but were added after the committee received more than 1,785 comments supporting their inclusion. The committee also stated they included that group in order to keep food systems secure and because many of those workers receive low wages without paid sick leave.
The decision to include approximately 300 mink husbandry workers was made not only for their health but also for the general public’s. Wisconsin is the second-largest mink producer in the US, and there is concern that the virus could be transmitted from a handler to a mink, then spread and mutate among the animals and jump back to humans as a new, potentially more dangerous variant.
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