ON THE FRONTLINE: A new dilemma for the vaccination programme
This week 1.7 million people have been added to the 2.3 million already on the nation’s shielding list. These people have been defined as at the highest risk of having severe complications from Covid-19 infection.
This change is based on work from researchers at Oxford University. It takes into account a very wide range of health and social factors. Interestingly it now incorporates factors previously overlooked in terms of both the shielding advice and prioritisation of vaccines. These include ethnicity, deprivation as defined by your postcode, and obesity. These factors where identified early on in 2020 as key contributors to your outcome from Covid. The research has been tested against the data emerging across the pandemic, demonstrating that the risk modelling is holding true.
It is perhaps a little surprising that it is only now that these considerations are now making it into the national guidance. It reflects what we as heath care professionals have been observing in our day-to-day practice. The data in Sheffield and South Yorkshire clearly matches this new risk model, with higher death rates in areas of poverty and disproportionately effecting different ethnic groups.
So now this is in the mainstream it poses some immediate dilemmas to the way we roll out the vaccine program.
Across the city we have just moved into vaccinating cohorts 5 and 6 in the JCVI priority list. Cohort 5 is a reasonably simple age-defined group (age 65-69). People are being invited to the mass centre at the Arena, and approach that raises access challenges of its own (I’ll not go there now!). Cohort 6 is more complex. It’s the largest group, consisting of people aged 16-64 living with a long-term health condition. Now we have the dilemma of needing to prioritise this newly identified cohort, who technically fit into cohort 4, higher up the priority list.
When we start to consider ethnicity and poverty there are parts of our city with much large volumes of people at higher risk. We have the ethical dilemma about how proactive we are at diverting our limited supplies of vaccines to the highest risk populations first. I really hope as a city we will do the right thing. I am proud that the GPs in Sheffield have committed to doing this, and I hope people will support us.