As the UK passed a horrific 100,000 deaths due to Covid-19 on 26 January, the question of an efficient and effective vaccination programme has never been more relevant. So how is the rollout going?

The UK is world leading in terms of the vaccine rollout and has made brilliant progress so far considering the first UK vaccine was given to 90-year-old Margaret Keenan eight weeks ago.

Government statistics reveal that as of Wednesday 27th January, 7,164,387 people in the UK had received their first dose of the Covid-19 vaccine and 474,156 have had their second dose.

In terms of the different nations, England has given 5,727,693 first doses, Northern Ireland 159,642, Scotland 415,402 and Wales 270,833 (data from Sunday 24th January).

There are three different vaccines on offer in the UK; Pfizer/BioNTech, Oxford/AstraZeneca and Moderna. Scientists from the Joint Committee on Vaccination and Immunisation have not advised a preference for which vaccines are given as all have a high efficacy and safety rate.

In England, the vaccine is currently being offered to the following groups of people, which is based on advice from the JCVI:

  • People aged 80 and over;
  • Certain people aged 70 and over;
  • Certain people who are clinically extremely vulnerable;
  • People who live or work in care homes;
  • Health and social care workers.

Currently the vaccine is being given to people with a 12-week gap in between doses to allow for twice the amount of people to have the first dose. This has been controversial due to the British Medical Association saying that it should be changed to six weeks and the decision was “difficult to justify”.

In a coronavirus press briefing on Tuesday evening, Professor Chris Whitty said: “Our limitation is the number of vaccines available. The first reason for delaying the course of the vaccines is to double the number of people who can have a vaccine and get some protection. A great majority of protection comes from the first dose.”

He said there was no evidence for any of the vaccines that the immunity would wain between three weeks and 12 weeks.

There have also been concerns that supplies to Yorkshire and the North East are being diverted due to them being ahead of the rest of the country. The region has given at least one dose to 64% of over-80s, compared with 48% in London and 13.1% in Scotland and many are arguing that once again the North is not being levelled up to meet the South, but rather levelled down.

However, UK-based supplier AstraZeneca warned that due to production issues they may have to slow down delivery of the vaccine in the EU. Pfizer-BioNTech have also had to lower supplies due to capacity issues in Belgium.

As a result, the EU has threatened to restrict exports of the vaccines to allow for fair distribution and stop vaccine nationalism, which could leave many countries behind due to supply shortages.

On Tuesday morning, Chief Executive of the NHS Simon Stevens told MPs: “Yes, there is a supply shortage. If there were unlimited vaccines then you wouldn’t see Italy attempting to sue one of the manufacturers.

“We’ve done very well in this country to get the supply we have available to us. The question is how do we use it to best effect?”

Nadhim Zahawi, Parliamentary Under-Secretary of State for Covid-19 Vaccine Deployment said on Tuesday that the UK has ordered 367 million doses from seven manufacturers and the vaccination programme was on track to give 15 million people their first dose by mid-February. It aims to have all adults offered their first dose by autumn 2021.

But there are some people that will not receive the vaccine at all. According to ONS data released on 22nd January, one in 100 people reported that they had been offered the vaccine but declined to have it. Around one in 20 also said that they would be very or fairly unlikely to have the vaccine if they were offered.

ONS also report that those who said they would be fairly or very likely to have the vaccine increased with age. Around 19% of people aged 16-29 said that they would be unlikely to accept the vaccine.

This may be because of the theories that have been circulating online about the impact of the vaccines on fertility. Dr Edward Morris, President at the Royal College of Obstetricians and Gynaecologists, released a statement last week to reassure women that there is no evidence that the vaccines would affect their ability to have children, saying: “Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data.”

A new study by the Royal Society for Public Health has revealed that 57% of respondents from Black, Asian and minority ethnic backgrounds were likely to take the vaccines, compared with 79% of White respondents.

Christina Marriott, Chief Executive of Royal Society for Public Health, said this was highly concerning and that anti-vaccination messages are being targeted to specific groups, including different ethnic or religious communities.

Chief Executive of the Race Equality Foundation, Jabeer Butt, said: “These findings are not surprising in light of past experience of the reach of vaccines to BAME communities, but they appear to be particularly worrying as it suggests the COVID vaccine may not reach communities that have been disproportionately impacted.”

Another undated study released by the government shows that 72% of Black or Black British groups stated they were unlikely or very unlikely to be vaccinated. Pakistani and Bangladeshi groups were the next most hesitant ethnic group with 42% unlikely or very unlikely to be vaccinated.

Those identifying as ‘Any other White’ (including Eastern European groups) also had a higher chance of not being willing to be vaccinated.

There are a number of reasons as to why vaccine hesitancy is higher in minority ethnic groups, such as lower confidence in vaccine efficacy and safety, lower perceptions of risk, and access barriers. The study recommended that this could be improved through general practitioners and community health centres engaging with their local areas and recommending the vaccine. It suggested that educational resources should be increased to tackle disinformation and access barriers, such as location and finances, need to be considered to ensure that it is easy for people to get the vaccine.

A report released in December 2020 acknowledged that there was a risk of greater inequalities between the Gypsy, Roma or Traveller communities and people who are homeless or refugees as it is unlikely their data is held on GP systems, meaning they can’t be offered the vaccine.

In an attempt to tackle this, the Government introduced the ‘Everyone In’ scheme in March 2020 to ensure that almost 15,000 vulnerable people and rough sleepers had somewhere to stay during the first national lockdown.

This scheme, which is still ongoing today and has given councils an additional £10 million to redouble their efforts, means that anyone who is brought in off the streets will be registered with a GP and offered the Covid-19 vaccine once eligible in accordance with the groups set out by the Joint Committee on Vaccination and Immunisation. Oldham Council is at the forefront of this movement and is drawing up plans to offer those without accommodation the vaccine as a priority.

But how does the UK vaccination programme compare to the rest of the world?

Statistics from an Our World in Data report states that the USA, China, UK, Israel and United Arab Emirates are at the forefront of the global vaccination race. There have been approximately 62.24 million first doses given to date.

COVAX, which was launched in April 2020 by the World Health Organisation, is focussing on distributing the vaccines once they are available to more than 180 countries around the world, regardless of their wealth. Doses will be given equally to the participating countries in proportion to their total population size.

With industries such as hospitality and retail on their knees after an on-off lockdown for almost twelve months, the race to vaccinate the world is on.

Martha Wilson

Featured image courtesy of @stevencornfield via Unsplash. Image license found here. No changes were made to this image.

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