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Age, ethnicity and wealth could determine who gets vaccine first

Customers queue in a socially distanced manner to enter a supermarket in Leeds. The Joint Committee on Vaccination and Immunisation has already produced an 11-tier priority vaccination list as an “interim recommendation”, which is based largely on age - Oli Scarff/AFP
Customers queue in a socially distanced manner to enter a supermarket in Leeds. The Joint Committee on Vaccination and Immunisation has already produced an 11-tier priority vaccination list as an “interim recommendation”, which is based largely on age - Oli Scarff/AFP
Coronavirus Article Bar with counter
Coronavirus Article Bar with counter

People could be prioritised for a coronavirus vaccine depending on their sex, ethnicity and wealth under proposals being discussed by the government.

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

It may even use an algorithm developed by academics at Oxford University which factors in a wide range of variables including “age, sex, ethnicity, deprivation, smoking status, body mass index, pre-existing medical conditions 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.

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.

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.

“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.

“It was [also] noted that challenges with mass vaccine delivery could mean that a simpler programme could be the best way of delivering a programme.

“The optimal programme could sit somewhere between the two approaches”.

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

Prime Minister Boris Johnson gestures during a visit to the Jenner Institute in Oxford - Kirsty Wigglesworth/AP
Prime Minister Boris Johnson gestures during a visit to the Jenner Institute in Oxford - Kirsty Wigglesworth/AP

There is growing 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.

“There's a big lag between the efficacy result and safety results. That is quintessential to understand.”