Post by Nadica (She/Her) on Dec 10, 2024 4:22:09 GMT
Decision to Limit COVID Vaccines Will ‘Amplify Health Inequalities and Lead To More Hospitalisations’ - Published Dec 9, 2024
By Karam Bales
The decision to further restrict access to vaccines “will leave many vulnerable people unprotected” warn academics and health professionals
Acoalition of academics and healthcare professionals have backed an open letter critical of the Government and the Joint Committee on Vaccination and Immunisation’s (JCVI) decision to restrict access to COVID-19 vaccines.
Campaign group Clinically Vulnerable Families (CVF) has expressed concerns over vaccine access for autumn 2025 and spring 2026.
Until now, COVID policy prioritised protecting “at risk” groups such as those with chronic heart failure, COPD, or diabetes, but using a bespoke, non-standard cost-effectiveness assessment developed by the Department of Health and Social Care, the JCVI has advised that only the following groups should be offered vaccination in spring 2025:
adults aged 75 years and over
residents in a care home for older adults
individuals aged six months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the Green Book)
The JCVI is also withdrawing its offer to pregnant women, despite them having been recognised for years by the NHS as being at increased risk.
Vaccinating pregnant women helps protect their babies; COVID has been linked to developmental issues. The UK is now one of only a small number of countries including Afghanistan, Sierra Leone and Turkmenistan, which doesn’t recommend COVID vaccines for pregnant women.
Professor Christina Pagel of University College London and Professor Sheena Cruickshank of the University of Manchester expressed their concerns about the JCVI’s decision in a piece for The Conversation, urging the JCVI to “either reverse its criteria on vaccination in pregnancy or provide a much more detailed and transparent explanation for why it has been discontinued”.
CVF’s letter highlights how restricting access to vaccines doesn’t align with “evidence based public health principles, as supported by the WHO, as we do for the NHS flu vaccination programme”. It prioritises a range of at risk groups including those with diabetes and asthma, and frontline health and care workers.
The JCVI has not released the full calculations and evidence base to explain the discrepancy in its approach to COVID compared to flu.
The study provided by the JCVI notes data for clinically vulnerable groups is limited, meaning the most at-risk could fall through the cracks.
CVF are concerned the JCVI is sending a message to at risk groups that the vaccine is no longer necessary and that they are safe, a signal many may trust and believe.
At risk individuals have the option of paying for vaccines, but this financial barrier will add to inequality.
The open letter notes that private COVID vaccinations are priced around £100 per dose “an amount far beyond the means of many at-risk people”. The price of vaccines supplied to the NHS are approximately £35.04.
“Private charges will leave many vulnerable people unprotected, amplifying health inequalities and increasing the need for recourse to antiviral treatments, ultimately leading to an increase in hospitalisations,” the letter explains.
Eligibility criteria for COVID antiviral treatments is at odds with the JCVI’s decision on vaccination, the letter notes.
In January, NICE (the National Institute for Health and Care Excellence) recommended COVID antiviral treatments for those over 70, or with conditions such as diabetes, a BMI of at least 35 kg/m², and heart failure, acknowledging the strong evidence of a heightened risk to these groups.
The JCVI’s decision to withhold vaccines from this group is therefore both inconsistent with known risks and contradictory, as it will increase their reliance on more costly treatments.
CVF say “prioritising ‘cost-effectiveness’ over vulnerability sends a chilling message: That our lives are less valuable because protecting us isn’t deemed ‘efficient’.”
The focus on age-based thresholds ignores the reality for younger vulnerable groups, a 30-year-old in heart failure could face far higher risks than a healthy 70-year-old, yet this new policy would exclude them from protection.
The JCVI’s cost benefit analysis only took predicted hospitalisations and deaths into account. No consideration was given to Long COVID despite increasing evidence vaccination reduces risk.
Kit Yates Senior Lecturer in the Department of Mathematical Sciences and co-director of the Centre for Mathematical Biology at the University of Bath asks “Why wouldn’t you take long COVID into account when considering who should be vaccinated?”.
Yates continues, “quite apart from the health issues of the people who get it, it clearly has an enormous economic impact.”
Yates cites a recent paper estimating the economic burden of Long COVID in the UK to be over £20 billion per year from real cohort data due to functional limitations and fatigue.
The JCVI’s focus on hospitalisations and deaths is based on incomplete data. COVID hospital data is now significantly under-reported.
Since April 2023, most patients with COVID symptoms are no longer tested to confirm if they have it, unless they are in a vulnerable group eligible for antiviral treatment, meaning data on COVID hospitalisations and deaths will not be accurate.
There are also other post-COVID consequences besides Long COVID, for instance COVID has been linked to increased risk of heart attacks, strokes and neurological harm.
The JCVI cites hybrid immunity, a combination of vaccination and infection acquired immunity as the reason they’re further restricting access to vaccines, however Professor Stephen Griffin, virologist at the University of Leeds, has criticised the JCVI’s reasoning, saying: “There are dozens of the usual platitudes, including the magical ‘endemic’. In my opinion, these are little more than misinformation, including the soothing balm of infection-induced immunity.”
Griffin warns, “we seem to value ‘normal’ over better, especially if it’s expensive up front, or gets in the way of ‘normal life’…but, complacency, ultimately, is also a devastating killer.”
By Karam Bales
The decision to further restrict access to vaccines “will leave many vulnerable people unprotected” warn academics and health professionals
Acoalition of academics and healthcare professionals have backed an open letter critical of the Government and the Joint Committee on Vaccination and Immunisation’s (JCVI) decision to restrict access to COVID-19 vaccines.
Campaign group Clinically Vulnerable Families (CVF) has expressed concerns over vaccine access for autumn 2025 and spring 2026.
Until now, COVID policy prioritised protecting “at risk” groups such as those with chronic heart failure, COPD, or diabetes, but using a bespoke, non-standard cost-effectiveness assessment developed by the Department of Health and Social Care, the JCVI has advised that only the following groups should be offered vaccination in spring 2025:
adults aged 75 years and over
residents in a care home for older adults
individuals aged six months and over who are immunosuppressed (as defined in the ‘immunosuppression’ sections of tables 3 or 4 in the COVID-19 chapter of the Green Book)
The JCVI is also withdrawing its offer to pregnant women, despite them having been recognised for years by the NHS as being at increased risk.
Vaccinating pregnant women helps protect their babies; COVID has been linked to developmental issues. The UK is now one of only a small number of countries including Afghanistan, Sierra Leone and Turkmenistan, which doesn’t recommend COVID vaccines for pregnant women.
Professor Christina Pagel of University College London and Professor Sheena Cruickshank of the University of Manchester expressed their concerns about the JCVI’s decision in a piece for The Conversation, urging the JCVI to “either reverse its criteria on vaccination in pregnancy or provide a much more detailed and transparent explanation for why it has been discontinued”.
CVF’s letter highlights how restricting access to vaccines doesn’t align with “evidence based public health principles, as supported by the WHO, as we do for the NHS flu vaccination programme”. It prioritises a range of at risk groups including those with diabetes and asthma, and frontline health and care workers.
The JCVI has not released the full calculations and evidence base to explain the discrepancy in its approach to COVID compared to flu.
The study provided by the JCVI notes data for clinically vulnerable groups is limited, meaning the most at-risk could fall through the cracks.
CVF are concerned the JCVI is sending a message to at risk groups that the vaccine is no longer necessary and that they are safe, a signal many may trust and believe.
At risk individuals have the option of paying for vaccines, but this financial barrier will add to inequality.
The open letter notes that private COVID vaccinations are priced around £100 per dose “an amount far beyond the means of many at-risk people”. The price of vaccines supplied to the NHS are approximately £35.04.
“Private charges will leave many vulnerable people unprotected, amplifying health inequalities and increasing the need for recourse to antiviral treatments, ultimately leading to an increase in hospitalisations,” the letter explains.
Eligibility criteria for COVID antiviral treatments is at odds with the JCVI’s decision on vaccination, the letter notes.
In January, NICE (the National Institute for Health and Care Excellence) recommended COVID antiviral treatments for those over 70, or with conditions such as diabetes, a BMI of at least 35 kg/m², and heart failure, acknowledging the strong evidence of a heightened risk to these groups.
The JCVI’s decision to withhold vaccines from this group is therefore both inconsistent with known risks and contradictory, as it will increase their reliance on more costly treatments.
CVF say “prioritising ‘cost-effectiveness’ over vulnerability sends a chilling message: That our lives are less valuable because protecting us isn’t deemed ‘efficient’.”
The focus on age-based thresholds ignores the reality for younger vulnerable groups, a 30-year-old in heart failure could face far higher risks than a healthy 70-year-old, yet this new policy would exclude them from protection.
The JCVI’s cost benefit analysis only took predicted hospitalisations and deaths into account. No consideration was given to Long COVID despite increasing evidence vaccination reduces risk.
Kit Yates Senior Lecturer in the Department of Mathematical Sciences and co-director of the Centre for Mathematical Biology at the University of Bath asks “Why wouldn’t you take long COVID into account when considering who should be vaccinated?”.
Yates continues, “quite apart from the health issues of the people who get it, it clearly has an enormous economic impact.”
Yates cites a recent paper estimating the economic burden of Long COVID in the UK to be over £20 billion per year from real cohort data due to functional limitations and fatigue.
The JCVI’s focus on hospitalisations and deaths is based on incomplete data. COVID hospital data is now significantly under-reported.
Since April 2023, most patients with COVID symptoms are no longer tested to confirm if they have it, unless they are in a vulnerable group eligible for antiviral treatment, meaning data on COVID hospitalisations and deaths will not be accurate.
There are also other post-COVID consequences besides Long COVID, for instance COVID has been linked to increased risk of heart attacks, strokes and neurological harm.
The JCVI cites hybrid immunity, a combination of vaccination and infection acquired immunity as the reason they’re further restricting access to vaccines, however Professor Stephen Griffin, virologist at the University of Leeds, has criticised the JCVI’s reasoning, saying: “There are dozens of the usual platitudes, including the magical ‘endemic’. In my opinion, these are little more than misinformation, including the soothing balm of infection-induced immunity.”
Griffin warns, “we seem to value ‘normal’ over better, especially if it’s expensive up front, or gets in the way of ‘normal life’…but, complacency, ultimately, is also a devastating killer.”