Age, ethnicity and wealth could determine who gets Covid-19 vaccine first

Sex, ethnicity and wealth could help determine who is prioritised for a Covid-19 vaccine, under proposals being discussed by the Government.

The body charged with devising the UK’s vaccine strategy, the Joint Committee on Vaccination and Immunisation (JCVI), is considering the best way to decide who is most at risk from becoming seriously ill from Covid-19.

The JVCI has produced an 11-tier priority vaccination list as an “interim recommendation”. The list is based largely on age, but also considers occupation and pre-existing medical conditions, the Telegraph reported.

The Government may even use an algorithm developed by academics at Oxford University, which factors in a wide range of variables also including ethnicity, sex, deprivation, smoking status, BMI and current medications.

The JCVI has already produced an 11 tier priority vaccination list as an “interim recommendation”, which is based largely on age but includes consideration of occupation and pre-existing medical conditions.

A scientist at work at the manufacturing lab at the Oxford Vaccine Group’s facility at the Churchill Hospital

However, it is currently being reviewed and an updated version is expected to be published in the next two weeks.

The committee is likely to take into consideration what we already know about who is worst affected by the vaccine.

According to Public Health England (PHE), twice as many working age men diagnosed with Covid have died compared to women; mortality rates in the poorest areas are double those in the wealthiest; and BAME communities have between a 10 and 50 per cent higher risk of death even once age, sex and social deprivation are taken into account.

Age, ethnicity and wealth could determine who gets Covid-19 vaccine first
Low skilled workers have a death rate almost four times that of professionals, according to Public Health England

Low skilled workers have a death rate almost four times that of professionals. For security guards – the hardest hit of all in the first wave – recorded deaths were almost twice that of men working in social care.

Officials say the current list is not expected to change dramatically but confirmed consideration is being given to incorporating a broader range of non-medical factors that influence risk.

There is a tension between getting a system which prioritises by risk taking all factors into account and one which is easy to understand and implement, they said.

Age, ethnicity and wealth could determine who gets Covid-19 vaccine first
There are expected to be challenges with mass vaccine delivery

“Members noted an update from DHSC on the individual risk tool developed by the University of Oxford”, say the latest published minutes from the JCVI.

“It was noted that the tool would identify an individual’s risk of hospitalisation and mortality and could be used to stratify the population.”

The minutes also noted that challenges with mass vaccine delivery could mean that a simpler programme could be the best way forward with delivery.

The optimal programme could sit somewhere between the two approaches, they read.

Age, ethnicity and wealth could determine who gets Covid-19 vaccine first
The committee is likely to take into consideration what we already know about who is worst affected by the vaccine

Pressure is growing on ministers to finalise a vaccine distribution strategy.

There is increasing optimism that interim data for up to four vaccines – Pfizer, Moderna, Novavax, and AstraZeneca – will be released before Christmas.

This puts the UK in a strong position, as the Government has secured 30 million doses of the Pfizer vaccine, 60 million doses of Novavax jab, and 100 million of the AstraZeneca candidate.

Dr Nick Jackson, head of programmes and technology at the Coalition for Epidemic Preparedness Innovations (Cepi) said the data would give an early indication of whether a potential vaccine is going to be effective.

“But even if you get a really good efficacy result in November, you will still have to wait to ensure you have the right amount of safety data,” he added.

Jackson said there was a big lag between the efficacy result and safety results.

This was important to understand, he said.


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