The Centers for Disease Control and Prevention will meet Tuesday to establish guidelines on who should receive the coronavirus vaccine or vaccines once they are approved by the Food and Drug Administration. Moderna has announced it will file for emergency use approval for its vaccine today, and Pfizer has already requested EUA for its drug. Both have been shown to be highly effective in clinical trials. Now the question is, who will get the vaccine first?

 According to CNN, the Trump administration intends to distribute the vaccine quickly and fairly to millions as soon as one is ready. The maneuver to tap into health officials to help expedite Operation Warp Speed, as it’s called, has earned high marks from experts. Operation Warp Speed aims to deliver 300 million doses of a safe, effective vaccine for COVID-19 by January 2021.

It's obvious, says CNN, that not all Americans will be able to get the vaccine at once and the organizations President Trump has called upon to help coordinate efforts will have to take into account vulnerable populations, such as those in nursing homes and assisted living.

But some experts say that obese Americans should also be on the top priority list. According to The Washington Post, Barry Michael Popkin, a nutrition and obesity researcher at the University of North Carolina at Chapel Hill says, “Obesity was ignored for the longest time and overweight was completely ignored.” Recently, the CDC has mentioned both weight issues in its guidelines for COVID-19 risk.

The agency’s Advisory Committee on Immunization Practices has structured its vaccine priority recommendations starting with healthcare workers, those working in essential services, and older adults with underling medical conditions, including “severe obesity.”

Popkin says that people who are obese are at greater risk for dangerous COVID-19 because they carry more fat, the kind of host tissue the virus loves to attack. They also have more lung issues, he told the Post.

Obesity is not only a leading risk factor for COVID-19 complications, it may also hinder immune response to a vaccine. Recent studies have shown that carrying excess weight increases the severity of the disease and causes a 50% increased risk of dying from COVID-19. The rate of obesity has been skyrocketing in America, prompting healthcare experts to refer to its juxtaposition with the coronavirus as an “epidemic within an epidemic.”

According to Forbes, statistically, obesity is the most common risk factor for severe disease, with over 30% of the population affected. Obesity causes several health issues that predispose people to COVID-19 complications. One of fat’s most powerful effects is suppressing the immune system’s response to the virus.

According to The New York Times, the immune cells of an overweight 30-year-old resemble those of an 80-year-old person. Excess fat not only affects the immune system, it also compresses the lungs, making it harder for people to breathe. The blood from an obese person is more prone to clotting, according to the Times, stripping the tissues of oxygen.

Great Britain is prioritizing its morbidly obese population, people with a body mass index of over 40, ahead of people younger than 65 in its vaccine distribution guidelines. In America, 42% of the population meets this threshold, according to the Post.