McClung N, Chamberland M, Kinlaw K, et al. The Advisory Committee on Immunization Practices’ ethical principles for allocating initial supplies of COVID-19 vaccine — United States, 2020. MMWR Morb Mortal Wkly Rep. 2020;69:1782–1786. https://doi.org/10.15585/mmwr.mm6947e3 The CDC’s Advisory Committee on Immunization Practices (ACIP) voted on December 1, 2020, on recommendations for prioritizing initial doses of the vaccines for SARS-CoV-2. This expedited review by ACIP in advance of the US Food and Drug Administration (FDA) emergency use authorization provides guidance to CDC and to the US Secretary of Health and Human Services. As there is some latitude in distribution, McClung et al. have presented the ethical underpinning of each distribution scheme to assist ACIP in formulating recommendations for allocation of COVID-19 vaccine: (1) maximizing benefits and minimizing harms; (2) promoting justice; (3) mitigating health inequities; and (4) promoting transparency. ACIP has recommended that health-care workers and residents of long-term care facilities be the first to receive vaccines for the coronavirus. There have been at least 243 000 confirmed COVID-19 cases among health-care workers with 858 deaths. Long-term care facility residents and staff account for 6% of cases and 40% of all coronavirus deaths in the United States. These two groups include about 24 million people. The first available vaccines are two-dose vaccines sufficient for about 20 million people. Immunosuppressed transplant recipients are at greater risk for mortality once infected with COVID-19 placing them among the group prioritized next, likely for February or March of 2021 depending on vaccine availability.