Question: When it comes to vaccine distribution, what is the prioritization of underlying conditions? Is asthma included?

Answer:  As you’ve probably read, the Advisory Committee on Immunization Practices (ACIP) recommended yesterday that the first groups to get the vaccine be healthcare personnel and long-term care facility residents (Figure 1).  We still don’t know the prioritization of underlying conditions, including asthma. A new study was just published last week on the relationship between asthma and COVID infection, COVID-19 Susceptibility in Bronchial Asthma.  The results, nicely synthesized in The Jerusalem Post, indicate that people with asthma (both pediatric and adult study participants) could be nearly 30% LESS likely to contract COVID-19, even after accounting for a host of background characteristics (demographic and clinical).  The study also found no statistically significant differences in COVID-related hospitalizations by asthma status.  Surprising, right?!  Turns out, these findings fit with myriad others from various settings including China, Philadelphia, and beyond (check out the discussion section of the paper for more examples).  We’re not sure why we’re observing these relationships.  A couple of hypotheses were posited by study authors: 1) People with asthma may be more likely to adhere to public health guidance (mask wearing, social distancing, etc.) than the general population; 2) Respiratory allergies are associated with fewer angiotensin-converting enzyme 2 (ACE2) receptors in the lungs, which are known entry points for the SARS-CoV-2 virus to attach and infect host cells. 

Figure 1. ACIP Phase 1a Vaccine Prioritized Populations (from slides)