10 2GM Wednesday December 2 2020 | the times
News
Coronavirus vaccination is unlikely to
go much beyond health and care work-
ers this year because the government
does not yet have any of the jabs in its
possession, officials have admitted.
Although approval of the Pfizer jab is
expected within days, sources concede
that there will be “a lag” of a week or
more before vaccination can begin as
doses will not be released to the health
service until after the regulator comes
to a decision. Before distribution plans
can be finalised the NHS is also waiting
to be told how long they will be allowed
to keep the vaccine outside the minus
70C freezers where it must be stored.
The UK could be the first western
country to approve a coronavirus vac-
cine. The EU’s regulator said yesterday
that it would not give any the green
light until after Christmas.
The Medicines and Healthcare Prod-
ucts Regulatory Agency (MHRA) is
considering vaccines made by Pfizer-
Biontech and Oxford University-
Astrazeneca, with approval of the first
believed to be imminent. Boris Johnson
said this week that the vaccine “could be
ready very soon”.
The Pfizer jab is being made in Belgi-
um and it is understood that there are
no doses yet in this country, with the
company saying supplies can only be
released once the MHRA makes a posi-
tive decision. A government source said
it was “not for want of trying, but they
can’t release any vaccine until approval
is given. There will be a lag before the
first jab goes into arms — it will be a
number of days.”
While care home residents and staff
are top of a priority list drawn up by the
Joint Committee on Vaccination, fol-
lowed by the over-80s and NHS work-
News Coronavirus
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Edinburgh UniversityFamily doctors have demanded to
know why people from ethnic
minorities will not get priority for a
coronavirus vaccine.
GPs are unconvinced by the
government’s argument that the extra
risk to such communities can be
explained by pre-existing illnesses and
are demanding that ministers justify
their exclusion from a priority list
drawn up by the Joint Committee on
Vaccination and Immunisation (JCVI).
This is largely based on age, with people
with certain illnesses also getting jabs
ahead of others.
Professor Martin Marshall, head of
the Royal College of GPs, said there
were still “significant concerns” about
the disproportionate impact of the
virus on black and minority ethnic
communities. In a letter to Matt
Hancock, the health secretary, he asked
for “clarification of the rationale for
people from Black, Asian and minority
ethnic communities not being included
on the initial JCVI prioritisation list”.
Professor Marshall is not yet
demanding minority groups get
priority, accepting that “there may be
Doctors question rationale on ethnicity
legitimate reasons, such as data
availability, why it is not possible to
reflect ethnicity in the current list”. But
doctors needed to see “the rationale for
the decisions made, particularly as data
clearly indicates that patients from
ethnic minority backgrounds are more
susceptible to contracting and dying
from the virus”.
Professor Jonathan Van-Tam, the
deputy chief medical officer for
England, has said that “a very significant
proportion of the unfortunate, but true,
signal we see in black and minority
ethnic groups is driven by the presence
of co-morbidities that occur at an
earlier age”, and that therefore they
should be covered by the JCVI’s
targeting of underlying risk conditions.
The college does not believe it is clear
that this accounts for all of the risk and
asks “whether using a risk score that
accounts for ethnicity, geographical
socio-economic indicators, and other
related factors has been considered”.
The health department is instead
looking at targeted campaigns to
ensure that certain communities take
up the offer of vaccination.
A spokesman said: “We want as many
people as possible to access a Covid-vaccine. The independent Joint
Committee for Vaccination and
Immunisation advise government on
which groups of people to prioritise,
based on the characteristics of the
vaccine when it becomes available and
the nature of the virus at the time of
delivery, and we keep their advice
under consideration.”
A meta-analysis of the effect of
ethnicity on clinical outcomes in
patients with Covid-19 published by the
Lancet last month found people of black
ethnicity were twice as likely and
Asians were 1.5 times as likely to be
infected with Covid-19, compared with
white individuals.
The data also showed that those of
Asian ethnicities may be twice as likely
to be admitted to an intensive therapy
unit (ITU), compared with those who
were white.
The authors of the report said that “a
higher degree of morbidities within
these populations” could be one of
many reasons why Asians were at
higher risk of severe Covid-19.
The team said it did not find any
increased risk of ITU admission for
people from black and white
ethnicities.Chris Smyth
Slow start for jabs
with Britain yet to
receive single dose
Chris Smyth Whitehall Editor ers, the practicalities of transporting
the Pfizer jab in super-cold freezers
mean health staff are likely to be immu-
nised first.
“Vaccinating some people is better
than vaccinating no one. And last time
how infections got into hospitals and
care homes was via staff, so it’s not just
protecting them, it’s protecting people
they care for,” the source said. “It’s real-
istic that this year we can do healthcare
workers and care home staff and maybe
the over-80s.”
The rule has stymied plans to send
doses out to NHS distribution points
around the country, ready for release as
soon as the green light is given.
“If we had it in depots ready to go we
could do a big bang. But we’ll have to
ramp up. That’s why we’ve always said
mass vaccination won’t begin until next
year,” the source said.
Another source said the delay
between authorisation and the start of
immunisation would be “more than a
week, less than a month. If it was to-
morrow we would start in December.”
While hospitals have been put on
alert to receive supplies of the vaccine,
GPs who will oversee vaccination of the
wider population have yet to be put on
standby. However, both government
and industry remain optimistic about
plans to vaccinate all adults who want a
jab by the spring.
The UK has ordered 40 million doses
of the Pfizer jab, and has 5 million due
by the end of the year — enough for
2.5 million people.
The prime minister has made the
rapid arrival of a vaccine a cornerstone
of his argument for a toughened tiers
system, saying the country must “hold
our nerve” until mass immunisation
could “get our economies moving again
and allow us to reclaim our lives”.
Analysis
W
hen a decade’s
work has been
condensed into
ten months, it
might seem
churlish to quibble over a week
here or there (Chris Smyth
writes). But when the government
has explicitly pinned the freedom
of the entire country to the NHS
mass immunisation programme,
every day counts.
The nation is waiting on the
Medicines and Healthcare
Products Regulatory Agency,
which has assembled dozens of
independent scientists to assess
data on coronavirus vaccines.
Once they are satisfied, the
Commission on Human
Medicines will assess the data
again before an emergency
licence is issued. Only then can
companies begin shipping.
Ministers have always said that
“the bulk” of vaccination will
happen next year. But there is
now an effort to manage
expectations downwards.
The question is whether a
slower start to the programme
delays the day when social
distancing ends. There are too
many unknowns to be sure, but
there is reason for optimism.
It has been estimated that
covering the two million people
most at risk would protect the
group where 75 per cent of
deaths have occurred. This could
significantly ease pressure on the
NHS within a couple of months.‘Pay more to self-isolate’
A public health adviser has backed
calls for larger payments for people
who have to self-isolate. Kevin
Fenton, the regional director for
London for Public Health England,
spoke to MPs yesterday. He said that
while 70 per cent of people intended
to self-isolate for a fortnight, only
18 per cent did so in practice. Some
can claim a £500 payment. Sir Keir
Starmer, the Labour leader, has
called for payments to be available to
anyone who is asked to self-isolate.Hotel superspreaders
A private party at the Royal Yacht
Hotel in St Helier last week has been
linked to 500 of Jersey’s 2,
infections. The government is
investigating. Alcino Vieira, the
manager of the four-star hotel, said
that the event had followed all
guidelines, which are due to become
legally enforceable next week.
Indoor social gatherings are limited
to ten people but 20 can attend
events run by businesses.Private beds ‘unused’
The majority of private-sector
hospital capacity that the NHS
block-bought, probably at a cost of
£400 million a month, was left
unused last summer, according to
documents leaked to Health Service
Journal. Hospital leaders had been
encouraged to use the capacity to
tackle a backlog of care but only a
third was used. “The independent
sector helped 1.7 million patients
get the treatment they needed,”
the NHS said.Lockdown challenge lost
A businessman’s challenge against
lockdown rules that he called
“onerous restrictions to personal
liberty” has been dismissed by the
Court of Appeal. Simon Dolan
argued that the government had
acted beyond the powers of the
Public Health Act 1984. He said
that he could go to the Supreme
Court, adding: “This is on behalf
of the families and businesses
whose lives have been wrecked.”coronavirus in brief