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Within the last 24 hours, despite national recommendations and previous planning considerations, NYS is NO LONGER including EMS personnel in Tier 1a (First Distribution) availability for COVID Vaccine. Given our unique work environment – operating in a confined space for extended periods of time with COVID patients – there are no words for my frustration. Specifically “Following the vaccination of 'high risk' health care workers, the priority will shift to all long-term and congregate care residents and staff, EMS and other health care workers.” How EMS is not considered “High Risk” is beyond my comprehension. https://www.governor.ny.gov/news/governor-cuomo-updates-new-yorkers-states-vaccination-distribution-plan Please consider communicating to elected officials, specifically the Governor and Commissioner of Health, as well as any other elected leaders at the state, County, and even federal level, that EMS must be included alongside our high risk hospital care providers else our already crumbling system will collapse. Attached is a toolkit from the AAA and a draft letter that you may edit and communicate to elected officials. Email, call, smoke signal. Get the word out. The need is now, this is moving fast, do not wait. Vaccine will be here in days and I fear we may have already missed the window to advocate for our own lives. Communicate to elected media, leverage media connections and use social media. The need is now although I fear too late as this rug was pulled out from under us. Jeremy ________________________________________________________ Jeremy T. Cushman, MD, MS, EMT-P, FACEP, FAEMS Associate Professor and Chief, Division of Prehospital Medicine Departments of Emergency Medicine and Public Health Sciences, University of Rochester Monroe County, City of Rochester, and Monroe-Livingston Regional EMS Medical Director 
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