As we pass the one-year mark of the COVID-19 pandemic, the long anticipate vaccine is officially ready for distribution. This record-breaking advancement in medicine has been the ray of hope that everyone is eagerly anticipating for. However, with a combination of only 20 million people that can be vaccinated with the first batch of the Pfizer vaccine, resources will have to be allocated to individuals with the highest risk. The CDC recommends health care workers and nursing home residents be the first group to receive the vaccination. Even with these limitations, the first round of vaccinations is still not enough. There are 3 million people living in long-term-care facilities and 21 million health care workers in the United States. Students in health care professions such as medical and nursing students have been included in the discussion to be amongst the group to receive the vaccine first. However, with limited resources, should health care students be among the health care workers who receive the first batch of the COVID-19 vaccine?
As the U.S. prepares to distribute its vaccines, many guidelines have been released to discuss its phasic distribution. The Johns Hopkins School of Public Health, among others, has provided recommendations for COVID vaccine administration. Vulnerable populations, including those at greatest risk of severe illness and death and those most essential to maintaining core societal functions, are in Tier 1 and prioritized to receive the first vaccinations. Tier 2 includes individuals involved in broader health professions, working in conditions with an elevated risk of infection, or facing barriers to access if they were to become seriously ill. With so many high-risk groups and professions deemed vital to core societal function, the distribution of the limited number of vaccines becomes complicated, with many groups falling wayside.
Health care students are essential parts of the health care system and are actively involved in patient care. There are more than 42,000 third and fourth-year students currently receiving their clinical training in the hospital just among medical students. While these experiences provide invaluable clinical experiences, they inevitably increase student exposure to COVID. Stories such as interacting with a patient who was later found to be COVID-positive and rotating in the hectic emergency department during the second wave is not uncommon. Therefore, cities such as Chicago recognize the importance of students and are including them amongst the health care personnel recommended to receive the vaccination. While vaccinating students will be the best option to prevent this virus’s spread, the unfortunate truth is that there are not enough vaccines.
Given the discrepancy of an uneven supply and demand, the first wave of vaccines aims to prevent as many deaths as possible. With that, we propose that health care students on clinical rotations receive the COVID vaccination in subsequent vaccine distribution rounds. The primary reason for this proposition is that health care students are generally young and healthy. The average age of matriculation for medical students from 2014-2017 was 24. Nursing students are in a similar age range, with an average of late 20s in BSN programs and early 30s in ADN programs. According to preliminary data from the CDC, there have been 1,852 deaths between the age range of 25-32, consisting of 0.7% of all deaths in the U.S. In contrast, every subsequent decade sees a rise in COVID infection and death rates. With all this in consideration, health care students overall do not fall within the high-mortality group. However, we acknowledge there are health care students who are older or with comorbid conditions that would put them at higher risk for serious COVID complications and should be considered to receive the first batch of vaccinations.
This does not preclude the fact that health care institutions should make every effort in protecting students who provide patient care. According to the AAMC, institutions should mitigate the risk of infections and minimize the transmission of the virus within the community. This includes ensuring students are not interacting and providing care to COVID-positive patients. Also, schools should advocate for all students’ protection by providing full PPE and on-site COVID testing to prevent further spread of the virus.
The ultimate goal of the COVID-19 vaccination is to save as many lives as possible. This can be best achieved by providing the first phase of vaccinations to those most at risk: frontline health care workers and the elderly. While it makes the most logical sense to distribute vaccines to prevent the most deaths, we also cannot forget to protect the health care students actively participating in the health care system.
Oscar Chen, Dennis Li, David Hong, and Abhi Ganguly are medical students.
Image credit: Shutterstock.com
