by The overall news about the impact of Covid-19 on the UK so far this year has been fairly positive: although we still have many hospitalizations and deaths from Covid and flu, figures are lower in England and Wales , in Scotland and Northern Ireland compared. with the same period last year. News is also coming about the next rounds of Covid vaccine boosters. It appears that while countries such as the US and France have made vaccines available to anyone who wants them, the UK is likely to continue to restrict free access to selected groups, and may to be further reduced in the future.
The spring booster campaign will, as expected, be more limited than recent autumn campaigns – targeting adults aged 75 and over, older people in care homes and children and adults who are immune suppression. The Joint Committee on Vaccination and Immunization (JCVI), which makes recommendations to the government, says it is using a “prescriptive, non-standard method of cost-effectiveness assessment” to inform future priorities, but does not have full details of its analysis available. just yet (the JCVI said content for its spring campaign will be published “in due course”). Looking ahead to the upcoming rolls, and reading between the lines, it seems that the number of groups offered a booster will continue to decrease.
The 2023 harvest rollout has already seen a significant drop in supply compared to previous years, and the JCVI notes that the 2024 harvest is likely to be even smaller. Reading through the latest JCVI statement, there seems to be a strong focus on the risk of hospitalization from severe infection or death. Serious illness is obviously a major consideration, but should other factors be taken into account? For example, children are less likely to develop serious disease, but vaccinating them has a major benefit.
A recent study in four Nordic countries showed that vaccines reduced the number of hospitalizations by more than 70% among children aged 12 to 17 years. And of course, children can develop long-term effects even from a mild Covid-19 infection. Despite this, children’s vaccines have only been on limited offer in the UK and are no longer widely available (unless they are clinically vulnerable), and this seems likely to remain the case. This makes the UK an outlier, as many other wealthy countries recommend vaccination of children. In England, almost 90% of children between the ages of five and 11 are unvaccinated.
The JCVI analysis considers hospital-related impacts, but does not include prolonged Covid-related impacts as part of its calculations. Around 65 million people worldwide are estimated to have prolonged Covid (symptoms lasting four weeks or more), and the condition often causes severe symptoms that can affect many different organs, which causes cardiovascular, respiratory and neurological problems. We know that vaccination helps to protect against covid for a long time, but we are still seeing new cases, so it is not certain how long the protection from previous vaccinations lasts.
In the UK, an estimated 80,000 people have left employment due to prolonged Covid, and the cost of providing healthcare to people with prolonged Covid is high and only increases over time. Despite the obvious social and economic costs, it seems that Covid will not be long-lasting or its effect on the economy.
Reducing the number of people offered vaccines in the UK also makes little sense in the UK as the government has already negotiated to buy millions of doses of Covid vaccines, to be delivered in stages between 2021 and 2024. Purchased vaccines under this agreement on the understanding that there would be adequate coverage for people over 50 years of age and other clinically vulnerable groups. With vaccine supply dwindling and uptake low in certain groups, there is an excess of unused vaccines that will soon expire. The UK’s Health Security Agency has estimated that it expects to write off £229m worth of vaccines that we are committed to buying, or already hold, that will ultimately not be used.
It is not known whether the value of these vaccines, compared to the cost of delivery and rollout, was considered when deciding which age groups to offer vaccines to during 2023 and 2024. The pre-purchase approach tied us to manufacturers and types certain vaccines. , and it is unclear whether there is a long-term plan to develop vaccines that could provide longer-term protection. But at the moment, if we are going to throw away vaccines, why not widen the eligible age groups?
There is some good news for those in England and Scotland wanting Covid-19 vaccines, as they can finally look at buying doses privately. However, unlike the flu vaccine, which costs around £20, the likely price per dose is £45. Therefore the cost of vaccinating an entire family can quickly add up to hundreds of pounds. We are in a cost of living crisis with many struggling to eat or heat their homes. People who are poorer in work tend to be more insecure, and are most at risk of contracting Covid-19 at work, so they would benefit significantly from vaccination.
There are already many barriers to vaccination campaigns, including low confidence and convenience of access to vaccines – they should not be expensive. The latest boosters in the US and many European countries have been free for all, but the UK is already moving to a place where vaccines are the preserve of the wealthiest.
The UK’s original pledges to vaccinate everyone against Covid-19 have had variable delivery across age and demographics, but have prevented untold amounts of death and suffering. At the moment, most adults in the UK will be under 65 years away from their last booster. I don’t mean to diminish the important voluntary work the JCVI does, or any budgetary constraints it faces in rolling out vaccines, but it is vital that it provides much greater transparency in its calculations costing, so that there can be a public conversation about it. how best to use the vaccines we have, as well as what lies ahead.
