Smokers under the age of 65 are considered high-risk for severe COVID-19 symptoms, and federal guidelines recommend that they be eligible for the vaccine in the early phases of distribution. This recommendation has frustrated essential workers that have been pushed further down the priority line.

New Jersey and Mississippi are currently offering the vaccine to smokers under the age of 65, and several other states have included smokers among those next in line, but haven’t opened the phase yet, according to ABC7.

The move to prioritize smokers over teachers and other essential workers has been met with criticism, though the phased rollout is in line with federal guidelines from the US Centers for Disease Control and Prevention (CDC) that place smoking on a list of conditions “that cause increased risk of severe illness from the virus that causes COVID-19.”

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Phase 1C includes persons 65-74 years of age, persons 16-64 years of age with high-risk medical conditions, and other essential workers. Phase 1A includes health care workers and long-term care facility residents and phase 1B includes persons 75 years of age or older and non-health care frontline/essential workers.

The CDC’s Advisory Committee on Immunization Practices (ACIP) advises smokers to be vaccinated in Phase 1C but leaves it up to states to decide how they prioritize administering the vaccine to constituents.

The rationale isn’t meant as a reward. The CDC has recognized smokers as being at higher risk. Vaccinating them would reduce chance they’d get very sick, tie up hospital and ICU resources. Keeping them out of ICUs would benefit the general public. (BTW, I’m not a smoker)

— Alan (@GammaCounter) January 16, 2021

“While ACIP makes recommendations, we understand that there will be a level of local adaptation. The phased vaccine recommendations are meant to be fluid and not restrictive for jurisdictions. It is not necessary to vaccinate all individuals in one phase before initiating the next phase; phases may overlap,” CDC spokeswoman Kristen Nordlund said in a statement to CNN.

Bergen County Education Association President Sue McBride told CNN that teachers in New Jersey are disappointed and frustrated that they’ve been pushed back in line,

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“From what I’m hearing, it’s just another round of frustration and another round of difficulty, you know, our educators and our education support professionals have working contact with the students and with their colleagues in their school buildings,” McBride said.

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