As federal officials near approval of the first COVID-19 vaccine, there are questions about where truck drivers will be on the priority list.

On Dec. 9, the daily death toll from Covid-19 reached a record high of 3,124, according to Johns Hopkins University – more than the number killed in the 9/11 attacks. And experts say the death toll will get worse before vaccines can make a significant difference.

Vaccine advisers for the Food and Drug Administration were meeting Dec. 10 to discuss the Pfizer/BioNTech vaccine. If the FDA grants emergency authorization in the next few days, the first vaccines could reach Americans this month. The U.K. and Canada have already approved the vaccine and the FDA is widely expected to follow.

But who will get them first?

A Bioethicist Speaks Out

Nancy Kass believes truck drivers should be among the first people to receive vaccines during a pandemic. And she made the case long before Covid-19 came along.

The guidance emerged in 2008, when the professor of bioethics and public health at Johns Hopkins University led a report into pandemic planning, months before the H1N1 flu outbreak began to spread.

While hospital employees and those in long-term care homes are topping early lists to receive the first Covid-19 vaccines in both the U.S. and Canada, Kass stresses that those directly involved in the supply chain should follow soon after.

“There’s a much larger problem for anyone if those industries break down,” she said in an interview with Today’s Trucking, an HDT editorial partner. “When certain sectors are either unable to work because of illness, or unable to work because of a fear of becoming ill, it’s bad for all of us.”

Not All Truck Drivers Are the Same

But there are even priorities to set among truckers.

Package delivery drivers or those who stock grocery stores and pharmacy shelves and are exposed to more potential virus carriers might deserve to be vaccinated before long-haul truck drivers who interact with fewer people a day, Kass said.

If the roles are not specifically defined, she hopes that common sense comes into play when deciding who specifically should move to the front of the line.

“In that way, if we’re all being really smart, maybe the person at the cash register at the grocery store should be in line ahead of you.”

There is also a debate about whether all healthcare workers should be lumped into the top tier of those to receive vaccines, she added. Those involved in caring for Covid-19 patients are clearly at the top of the list, but others might be able to perform their duties through telemedicine.

“If you get a lot of exposure, we hope you get the vaccines soon,” Kass said. “Everything else has to keep working so that we can deliver the vaccine.”

The American Trucking Associations and the Canadian Trucking Alliance are recommending that truck drivers should be among the early waves of people to receive Covid-19 vaccines.

“Our workforce represents a central link in the nation’s supply chain and will play an essential role in the imminent Covid-19 vaccine distribution process,” ATA executive vice-president – advocacy Bill Sullivan said in a series of letters distributed to U.S. leaders.

“As the trucking industry is called upon to deliver vaccines across the country, it is imperative that truck drivers have prioritized access to the vaccine to minimize the potential for supply chain delays and disruptions.”

States Make the Ultimate Vaccine Decisions

In Canada, the CTA is advising provincial associations to make similar asks, because the vaccination plans are ultimately a provincial role. It's the same in the U.S., where states will ultimately be the ones deciding who gets the vaccine first, although it is expected most will follow federal guidelines developed by the Centers for Disease Control and Prevention.

So far, the CDC has recommended that the initial phase of the COVID-19 vaccination program (Phase 1a) should be offered to healthcare personnel and residents of long-term care facilities. Healthcare personnel are defined as “paid and unpaid people serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials.” Long-term care facility residents are defined as “adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently.”

Once the vaccine is approved, reports the Wall Street Journal, within 24 hours, 2.9 million doses are set to be sent to each state -- enough to inoculate a little under 1% of their populations. Another 2.9 million doses will be shipped about three weeks later those vaccine recipients to get the second shot of the two-dose regimen.

According to WSJ, most states are giving those first vaccines to doctors, nurses and other health-care workers who interact with patients who have COVID-19. As more doses are shipped, many said they would give priority to residents of long-term-care facilities next. Most of the population won’t be able to get the vaccine until the spring or summer.

“But state vaccination plans vary widely and leave many questions unanswered,” the article noted.

Defining Essential Workers

The CDC has discussed the need for "essential workers" to be in the second wave of the vaccine, Phase 1b.

In March, the federal government released an advisory that defined the essential workforce to assist state and local decision-making during the pandemic, which it called the “essential critical infrastructure workforce." Truck drivers are included that list, but so are many other workers, even just within the transportation sector. States must make their own decisions about which ones to prioritize.

Reuters reviewed state vaccine distribution and reported they “showed broad discrepancies over who would be considered essential, with some states clearly outlining specific worker groups and others not providing any clarity.”

Reuters also notes that trucking is far from the only industry urging the government to include its workers. More than 20 large industries have urged officials to prioritize their workers, it says, including teachers, retail workers, agricultural companies, meat packers, cleaning suppliers and dental hygienists.

State health departments are the target of many such requestions, reports The Morning Consult. In Minnesota, it reports, so many have asked for vaccine priority that the health department began replying with a stock response outlining the decision-making process.

Harald Schmidt of the University of Pennsylvania’s Department of Medical Ethics and Health Policy told the Consult that "We’re not just allocating vaccines once; this is happening over months."

If the CDC’s advisory panel does recommend essential workers are vaccinated next, a tiered system that prioritizes vulnerable subgroups, as recommended by both the World Health Organization and the National Academies, could come in future vaccine rollouts, Schmidt said. However, neither of those groups have included essential workers in the second phase, instead focusing on groups deemed more likely to suffer severe effects from the virus, such as older adults not covered in the first stage, groups with conditions that cause them to be at significantly higher risk, and sociodemographic groups at significantly higher risk of severe disease, such as the disabled and people in overcrowded prisons and homeless shelters.

In California, according to the Sacramento Bee, the strategy is to first vaccinate health care professionals and long-term care residents during Phase 1a, with essential workers to follow as the state builds its supply. But there are more than 7 million non-healthcare essential workers in the state, according to the state Department of Public Health’s community vaccine advisory committee.

John G. Smith is the editorial director of Newcom Media's trucking and supply chain publications -- including Today's Trucking, trucknews.com, and others. Some content appearing in this article first appeard on trucknews.com and was used with permission from Newcom Media as part of a cooperative editorial agreement.