Age-based approach to vaccine rollout ignores evidence, charities warn

The decision not to prioritise people with certain health problems or disabilities in the next wave of the Covid-19 vaccine rollout “ignores the evidence”, charities have warned.

The government on Friday endorsed the Joint Committee on Vaccination and Immunisation’s (JCVI) recommendation to adopt an age-based approach to offering the vaccine once all at-risk people in phase one of the programme have been invited to receive at least one dose.

The recommendation means those aged between 40 and 49 will be prioritised next for a coronavirus vaccine, followed by 30- to 39-year-olds and 18- to 29-year-olds.

Government scientific advisors said the plan would “ensure more people are protected more quickly”.

Professor Wei Shen Lim, the Covid-19 Chair for the JCVI, said: “Vaccinations stop people from dying and the current strategy is to prioritise those who are more likely to have severe outcomes and die from Covid-19.

“The evidence is clear that the risk of hospitalisation and death increases with age. The vaccination programme is a huge success and continuing the age-based rollout will provide the greatest benefit in the shortest time, including to those in occupations at a higher risk of exposure.”

But the decision has been criticised by charities, who have called for people with certain health problems and disabilities, who are not already covered in phase one, to be prioritised.

Sarah Woolnough, the chief executive of Asthma UK and the British Lung Foundation, said the age-based vaccination rollout approach “ignores the evidence” that people with asthma are more at risk of going to hospital with Covid and more at risk from long Covid.

“There are thousands of people with asthma who will rightly feel anxious, angry and ignored by government,” Ms Woolnough said.

“We have been urging the government to ensure everyone with asthma is prioritised in the next vaccine rollout, and more than 18,000 people with asthma have signed our petition in support of this.

“The government must reconsider this decision, which is unacceptable and could put people with asthma at risk.”

Nik Hartley, the chief executive of Spinal Injuries Association, also urged the government to prioritise people according to clinical need rather than age.

He said: “This decision doesn’t take into account that many spinal cord injured people – those with tetraplegia and high-level paraplegia – have a compromised respiratory function or a suppressed immune system. And they are significantly more likely to need acute medical care if they contract Covid-19.

“We urge the government to reconsider this decision and ensure everyone is prioritised according to their clinical needs. People living with high-level spinal cord injury show how stark the issue is and how urgently it needs addressing.

“There are 50,000 spinal cord-injured people in the UK who feel forgotten and ignored, and this is adding to the difficulties they face every day, especially those who’ve been cut off from loved ones while self-isolating.”

And Sonya Chowdhury, the chief executive of Action for ME, said people with ME, who are at increased risk of facing their long-term illness being exacerbated by Covid-19, should receive the vaccine at the earliest possible stage regardless of age.

“The green book on immunisations against infectious disease says those at risk of Covid exacerbating underlying diseases as well as serious illness from Covid should be considered for the vaccine earlier,” she says.

“The announcement today goes against that.”

People with disabilities made up six in 10 deaths involving Covid-19 in England up to November 2020, data from the Office for National Statistics has shown.

More than 30,000 of the 50,888 people who died with coronavirus from January to November were disabled people.

The risk of death from Covid-19 was more than three times greater for severely disabled people than the rest of the population, the ONS found.

Dr Mary Ramsay, the head of immunisations at Public Health England, said: “Delivering a vaccination programme on this scale is incredibly complex and the JCVI’s advice will help us continue protecting individuals from the risk of hospitalisation at pace.

“The age-based approach will ensure more people are protected more quickly. It is crucial that those at higher risk – including men and BAME communities – are encouraged to take the vaccine, and that local health systems are fully engaged and reaching out to underserved communities to ensure they can access the vaccine.”

A government spokesperson said age-based rollout is “the most effective way to minimise hospitalisations and deaths ... This is because age is assessed to be the strongest factor linked to mortality, morbidity and hospitalisations, and because the speed of delivery is crucial as we provide more people with protection from Covid-19.

“All four parts of the UK will follow the recommended approach, subject to the final advice given by the independent expert committee. The UK government remains on course to meet its target to offer a vaccine to all those in the phase one priority groups by mid-April, and all adults by the end of July.”