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Guidelines
Patient Prioritization

Patient Prioritization

Note

Guidance adopted from the NIH (original statement available here)

Patient Prioritization Principles

In the event that logistical or supply constraints make it impossible to offer the available therapy to all eligible patients, the following principles apply:

  • Treatment of COVID-19 in unvaccinated or incompletely vaccinated individuals with clinical risk factors for severe illness and vaccinated individuals who are not expected to mount an adequate immune response

Risk Categorization

Risk groups are based on 4 key elements:

  1. Age
  2. Vaccination status
  3. Immune status
  4. Clinical risk factors (see the CDC webpage Underlying Medical Conditions Associated with High Risk for Severe COVID-19 for a list of risk factors)

Groups are listed by tier in descending order of priority

  • Immunocompromised individuals not expected to mount an adequate immune response to COVID-19 vaccination or SARS-CoV-2 infection due to their underlying conditions, regardless of vaccine status (see Monoclonal Antibodies for Treatment - Outpatient for Immunocompromising Conditions)
  • Unvaccinated individuals at the highest risk of severe disease (age ≥75 years or age ≥65 years with additional risk factors)

Unvaccinated individuals at risk of severe disease not included in Tier 1 (age ≥65 years or age <65 years with clinical risk factors)

Vaccinated individuals at high risk of severe disease age ≥65 years or age <65 with clinical risk factors

Note: Vaccinated individuals who have not received a COVID-19 vaccine booster dose are likely at higher risk for severe disease; patients in this situation within this tier should be prioritized for treatment