JCVI facing calls from within for greater transparency over decision-making on vaccinating children

The UK’s vaccine watchdog is facing calls from scientists and its own members for greater transparency over recommendations it has made for vaccinating children against Covid-19.

The Joint Committee on Vaccination and Immunisation (JCVI) has been criticised for failing to publish the detailed minutes, modelling and analysis behind its decision to advise vaccinating all over-16s in Britain but not those aged 12 to 15.

A JCVI insider told The Independent that it was “regrettable” that the public was still waiting for the written evidence, while Professor Christina Pagel, the director of the Clinical Operational Research Unit at University College London, said the limited data made it “impossible to understand” how the committee had concluded it could not support child vaccinations.

“They don’t give you enough estimates or allow you to understand how they’ve come to their decision,” she said. “Or how it correlates with the fact we’ve had so many hospitalisations in unvaccinated kids this summer.”

Other modelling and minutes from key meetings that were held over the summer, during which Covid vaccine advice was drawn up and provided to the government, have also not been published by the JCVI. The last Covid-specific meeting from which minutes are available to the public was held on 16 February.

The committee’s code of practice states that it aims to release minutes, statements, and papers within six weeks of a meeting.

The JCVI source said “significant concerns” had been raised internally throughout the summer about “our apparent lack of transparency and timeliness related to committee minutes”.

“The lack of written evidence and discussion/conclusion does the committee no favours at all in the eyes of the media and the public,” the member said, adding that the government wasn’t providing enough support or funding for the body’s increased administrative duties during the pandemic.

Experts believe access to minutes, modelling and internal analysis would help to combat any lingering ambiguity surrounding the JCVI’s recommendations – especially with regard to the advice on child vaccinations – but also clarify why the committee took a different and slower approach from that of other vaccine watchdogs.

The UK was months behind the likes of France, the US and Israel in approving the vaccination of children, as the government waited on the JCVI for its advice. It eventually concluded last month that “the margin of benefit is considered too small to support” the vaccination of 12- to 15-year-olds, and deferred to Britain’s chief medical officers, who approved the policy.

As part of its review into the vaccination of children, the JCVI published an analysis that explored the advantages of immunising against Covid versus the risk of developing heart inflammation, known as myocarditis.

But Prof Pagel said the written evidence and calculations behind this analysis were missing, making it “hard to work out how they reached the view that the vaccines only offered a marginal benefit, when we know it’s much more than that”.

“Child vaccination has been late in the UK and there’s a lot of hesitancy around it,” she added. “People cite the JCVI and the fact that they said it’s not really beneficial. So we need to understand how the JCVI came to that conclusion, as it is different to other countries.”

Prof Pagel said the “whole process has been drawn out and really damaging”, with some children and their parents unsure of whether to consent to vaccination as a result.

Dr Stephen Griffin, a virologist at Leeds University, said the “ambiguity” that has been created within recent weeks was “being used as a weapon by people who oppose the vaccines”.

Government analysis obtained by The Independent shows that the UK population is one of the most willing in Europe to receive a Covid booster, but is far more cautious about vaccinating children.

“Why is this the case? It hasn’t helped that the JCVI hasn’t been more transparent about its data, or that it’s been equivocal in its decision-making,” said Susan Michie, a professor of health psychology at University College London.

“Openness in science is really important. For the public to have confidence in policy decisions that are being made, they have a right to be told what the basis of those decisions are. If that isn’t shared, then it undermines trust.

“There’s a huge number of uncertainties around Covid and there will continue to be. But where there are uncertainties or differences of opinion, it’s even more important that everyone is open about the basis behind their thinking.”

Prior to April, when minutes from the 16 February meeting were released, the JCVI regularly provided documentation and evidence to support its recommendations. In publishing their priority lists for Covid-19 vaccination in December, the committee released modelling and discussions around the policy.

But as greater demand has been placed on the committee throughout the past year, members and staff have found it difficult to keep on top of administrative duties, said the JCVI source.

“We’re staffed to provide full scientific papers for three full meetings per year, with occasional sub-committees,” they said. “The minutes require significant scientific training and understanding of the complexities discussed.

“Imagine this service being required to serve weekly or even twice-weekly meetings over the past 12 months without any significant increase in the number of secretariat staff.

“Committee members as well as our staff are very tired, bearing in mind we are completely unpaid and often have other jobs that may or may not allow flexibility.

“The Department of Health is not adequately funding or supporting the JCVI as a key element of their vaccine programme.”

The Independent has been told that minutes of all JCVI meetings on Covid-19 are being prepared and will be published in due course.