COVID-19: The CIDRAP Viewpoint

Report 7: "Reassessing COVID-19 vaccine deployment in anticipation of a US B.1.1.7 surge: stay the course or pivot?" (Feb 23, 2021)

Report 6: "Ensuring a resilient US prescription drug supply" (Oct 21, 2020)

Report 5: "SARS-CoV-2 infection and COVID-19 surveillance: a national framework" (Jul 9, 2020)

Report 4: "Contact tracing for COVID-19: Assessing needs, using a tailored approach"
(Jun 2, 2020)

Report 3: "Smart testing for COVID-19 virus and antibodies" (May 20, 2020)

Report 2: "Effective COVID-19 crisis communication" (May 6, 2020)

Report 1: "The future of the COVID-19 pandemic: lessons learned from pandemic influenza" (Apr 30, 2020)

Welcome to "COVID-19: The CIDRAP Viewpoint." Our intent with the Viewpoint series is to add key information regarding the pandemic, address issues that haven't garnered the attention they deserve, and reflect the unique expertise among the CIDRAP team and our expert consultants.

In this periodic series of reports, we will address timely issues with straight talk and clarity. And the steps we recommend will be based on our current reality and the best available data. Our goal is to help planners envision some of the situations that might present themselves later this year or next year so that they can take key steps now, while there’s still time.

Upcoming reports will address other timely, pressing topics.


In the seventh Viewpoint report, published February 23, 2021,"Reassessing COVID-19 vaccine deployment in anticipation of a US B.1.1.7 surge: stay the course or pivot?" CIDRAP and other top US experts note that, with a likely surge of the B.1.1.7 SARS-CoV-2 variant in the US, there is a small window to maximize protection from COVID-19 vaccines by focusing first doses on people 65 years old and older and delaying second doses to other groups.

In the US, nearly half of all COVID-19 hospitalizations and 80% of COVID-19 deaths are among those 65 and older. Compared with 5- to 17-year-olds, the elderly have a 35-fold to 80-fold increase in hospitalizations and a 1,100-fold to 7,900-fold increase in deaths, depending on age-group within those 65 and older.

In addition, data so far show strong protection from one dose of COVID-19 vaccine.

The authors recommend several steps:

  • Advisers to the FDA and CDC should urgently review the existing data (e.g., epidemiology, virology, immunology, modeling) to determine how best to use the current vaccine supply and the supply that will be available in the coming months. The review should cover all available data on vaccine protection afforded by one and two doses of the two FDA-approved mRNA COVID vaccines—those produced by Pfizer/BioNTech and by Moderna—as well as any vaccines likely to be approved in the coming weeks. 

  • To optimize the vaccine supply, experts should consider whether existing data support age-based allocation with highest priority given to adults 65 and older, deferring second doses of mRNA vaccines to after the surge, deferring the second dose of mRNA vaccines in individuals with confirmed previous COVID-19 infections, and/or the authorization and use of a half-dose regimen for the Moderna vaccine. 

  • If the data review supports a change of current authorizations or recommendations, the FDA should revise its authorization determination as soon as possible.

  • A coordinated public communications campaign must be undertaken to provide clear and consistent messaging to the public regarding any change in the vaccine schedule or prioritization groups due to the deferment of second doses of vaccines.