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Friday, December 04, 2020

JCVI has not thought through their vaccine prioritisation

My letter to the Guardian today

"NHS staff no longer top priority to receive coronavirus vaccine" (p1, 4th December). This is because the Joint Committee on Vaccination and Immunisations (JCVI)  advises that the first priority should be prevention of mortality, and to do this they have opted for immediate protection of very vulnerable elderly people in care homes, rather than general prevention of mortality by using the vaccine to reduce the reproduction rate (R-number)  of the virus.

JCVI did model the use the vaccine to interrupt transmission of the virus in society, but decided that this would only take place when a majority of the general population had been vaccinated, which would take many months to come about. It appears that they did not model giving the vaccine to potential super-spreaders, to people who encounter scores or even hundreds of other people during the course of their working day. People like doctors, nurses and other front-line health care workers, teachers,  police officers, postal workers, shop workers, delivery drivers and many other groups who keep the real economy actually turning over. The key point is that these workers are at increased risk both of contracting the disease and also of transmitting the disease.

If Government chose to vaccinate these public-facing workers, they would not only be reducing the R-number and therefore lifting the curse that the nation is under, but they would also be assuaging the concerns of those on the political right of their party and further afield who argue that the "cure is worse than the disease". This lobby has a real influence on people's behaviour in terms of non-compliance with the rules and guidelines.

It is not too late even now for the Government to allow NHS staff and other front-line workers to be vaccinated against the disease that poses such a threat to their work, their lives and the national economy.

Dr Richard Lawson

MB BS, MRCPsych


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