The first phase of the UK’s Covid vaccination programme is under way, with priority groups including health workers and vulnerable groups. But debate continues over who will get first access to the vaccine among the rest of the population.
Nicola Davis www.theguardian.com looks at the options.
Black and minority ethnic (BAME) communities
According to data from the Office for National Statistics for deaths between 2 March to 28 July 2020 in England and Wales, males of black African ethnic background had a death rate 2.7 times higher than those of white ethnic background, while among women the death rate was almost twice as high for black Caribbean females as white.
“All ethnic minority groups other than Chinese had a higher rate than the white ethnic population for both males and females,” the report says.
Dr Mohammad Razai, the lead author of a study on the issue from St George’s, University of London, said people from ethnic minority backgrounds were more likely to have poor outcomes if exposed to coronavirus.
“Therefore, any meaningful risk assessments should take ethnicity into account in combination with these other factors, and where it has been assessed that their risk is high, ethnic minority groups should be prioritised for Covid-19 vaccination,” he said.
Data from the ONS, covering 2 September and 16 October 2020, found no evidence of a difference in the rates of positive coronavirus cases between teachers and other key workers in England, such as those in healthcare. The data also showed no evidence of any difference compared with other professionals overall.
But Dr Patrick Roach, the general secretary of the NASUWT teaching union, said teachers should be prioritised to make sure schools can stay open without disruption.
“Teachers and education staff are unable to practise social distancing from their pupils and few are provided with essential PPE,” he said. “Many schools are continuing to operate through the lockdown with very high numbers of children and young people on site and alternative, special and nursery provision continues to operate as normal.”
Police leaders say forces need to have priority access to Covid vaccines to keep officers safe as they deal with members of the public, and prevent the service from being hampered by staff sickness.
“My colleagues are at the frontlines of this pandemic, risking infection from this vile and deadly disease every day to keep the public safe. We have a growing number of officers who are off sick after catching the virus or who are off self-isolating – this creates a serious concern over policing maintaining resilience,” said John Apter, the national chair of the Police Federation.
The National Police Chiefs’ Council has also raised the need for officers to be vaccinated.
ONS figures for England and Wales between 9 March and 25 May 2020 reveal that for both men and women, sales and retail assistant roles were among the occupations that had increased rates of Covid deaths compared with the general population.
Paddy Lillis, the general secretary of the Union of Shop, Distributive and Allied Workers (Usdaw), said close proximity to the public as well as the indoor working environment were among the factors behind this.
“Retail workers, including grocery delivery drivers, have played a key role in ensuring the country is able to get through the current crisis. These critical workers have played a vital role in our communities ensuring that food remains on the shelves,” he said.
“Given the risks involved in their public-facing roles, retail workers should be one of the groups prioritised [for vaccination].”
He said Usdaw also wanted to see other key workers in settings such as food manufacturing and pharmaceutical distribution prioritised for vaccination.
People with learning disabilities
Jackie O’Sullivan, the executive director of communication, advocacy and activism at the learning disability charity Mencap, is among those calling for people with learning disabilities to be prioritised for vaccination.
“Those with a severe or profound learning disability are in group six [on the priority list for the first phase of the vaccination programme], but people with a more mild or moderate learning disability are not being prioritised at all – yet we’ve seen no evidence that they are at any less risk of dying from Covid,” she said.
“Prioritising the vaccine for all people with a learning disability would mean that doctors can roll it out without having to make time-consuming distinctions between the types and severity of disability.”
Dimensions, a not-for-profit organisation providing support to people with learning disabilities and autism, said people with learning difficulties had a Covid death rate more than four times higher than the general population.
“The increased mortality can most likely be attributed not only to clinical issues associated with having a learning disability, but also barriers and systemic inequalities experienced by people in health services,” said Steve Scown, the chief executive of Dimensions.
According to ONS figures from the first wave in England and Wales, bus, coach, van and taxi drivers had an increased risk of Covid-related death among men, while Transport for London has said that by 11 January, 57 of its staff had died from the disease.
“From getting key workers to hospitals and moving vital supplies around the country, our transport key workers have kept the country moving through the pandemic. Many have lost their lives to the virus, but they bravely continue to serve during this time of crisis,” said Manuel Cortes, the general secretary of the Transport Salaried Staffs’ Association (TSSA).
In the US, members of Congress are at the front of the queue for the vaccine, even getting the jab before many doctors and other health workers. Some have argued that vaccinating politicians builds trust among the public.
“We should do MPs and core house staff as well so we can get our democracy back,” the Conservative backbencher Steve Brine told the Telegraph last week. “Parliament is a shadow, at best, of itself and it’s never been more important we can ask questions. Good policy comes through scrutiny, in my experience.”
Asked whether MPs should be among professions prioritised in the next phase of vaccinations, Boris Johnson’s spokesman said this would be a matter for the Joint Committee on Vaccination and Immunisation (JCVI).
“JCVI are looking at what phase 2 should look like, and whether certain professions that are at higher risk of exposure should be prioritised.”
However, the JCVI has previously said it will not advise on which occupations will be prioritised for the next wave of vaccinations.