Groups seek vaccine priority for psychiatric hospital patients

Following the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices' recommendation for allocating initial supplies of the COVID‐19 vaccine, the Judge David L. Bazelon Center and other mental health groups released a statement on Jan. 14 calling on states to include individuals in psychiatric hospitals for priority vaccination. The National Association of State Mental Health Program Directors, the American Psychological Association, Mental Health America and the National Alliance on Mental Illness have also joined in this effort. In a Dec. 2, 2020, letter to leaders of the National Governors Association, the National Association for Behavioral Healthcare requested that the nation's governors be encouraged to ensure that mental health and addiction treatment providers are included among the top‐priority sites for the first round of vaccine distribution (see MHW, Dec. 11, 2020). On Dec. 3, 2020, the CDC issued recommendations for allocating initial supplies of the COVID‐19 vaccine, according to the statement. It recommended that the first groups to receive vaccines be health care workers, including hospital staff, and residents of “long‐term care facilities,” including nursing homes and assisted living facilities. According to the statement, the committee's recommendations do not directly address whether psychiatric inpatients are or should be included among those first to receive the vaccine (Phase 1A). However, the committee did make clear that “health care settings in general [such as hospitals], and long‐term care settings in particular, can be high‐risk locations for SARS‐CoV‐2 exposure and transmission.” Many psychiatric inpatients, including most psychiatric inpatients in general hospitals, will be discharged after a relatively short stay. In the allocation of vaccines, inpatient psychiatric patients who are likely to be discharged after a short stay should receive the same priority for vaccination as other hospital patients, according to the statement. Many psychiatric inpatients, however, especially those in state and other public hospitals, will experience stays of weeks and months. In the allocation of vaccines, these patients should have the same priority for vaccination as residents of other longer‐term congregate care facilities, such as nursing homes and as‐sisted living facilities, according to the statement. Accordingly, to implement the CDC's recommendations, state authorities making vaccine‐allocation decisions should include psychiatric inpatients whose hospital stay is likely to be weeks or months in the first group to receive the vaccine (Phase 1a) and give short‐term psychiatric inpatients the same priority as other hospital inpatients and require that hospital discharge plans provide for the administration of a second dose of the vaccine.