The overall news on how Covid-19 has affected the UK so far this year has been relatively positive: although the number of hospitalizations and deaths from Covid and flu is still very high, figures in England and Wales, Scotland and Northern Ireland lower than the same period last year. There is also news coming out about the next few rounds of Covid vaccine boosters. While countries like the US and France appear to be making vaccines available to anyone who wants them, the UK is likely to continue restricting free access to certain groups and may further reduce access in the future.
The spring booster campaign will, as expected, be more limited than recent fall campaigns; It will target adults aged 75 and over, seniors in nursing homes, and children and adults with compromised immune systems. The Joint Committee on Vaccination and Immunization (JCVI), which advises the government, says it is using a “bespoke, non-standard method of cost-effectiveness assessment” to inform forward priorities, but full details of the analysis are not yet available (the JCVI said material on the spring campaign will be published “in due course”). . When we look at upcoming distributions and read between the lines, it seems likely that the number of groups offered support will continue to decrease.
Autumn 2023 saw a much lower bid for launches compared to previous years, and JCVI notes that autumn 2024 is likely to be even smaller. A review of the latest JCVI statement shows that the main focus is on the risk of hospitalization or death from serious infection. Clearly serious illness is an important and important consideration, but should other factors also be taken into account? For example, children are less likely to get serious diseases, but vaccinating them has great benefits.
A recent study in four Scandinavian countries showed that vaccines reduced hospitalization rates in children aged 12 to 17 by more than 70%. And of course, children can develop long-term effects from even mild Covid-19 infection. Despite this, vaccines for children in the UK have only been on a limited offer and are no longer widely available (unless they are clinically vulnerable) and this seems likely to continue. This makes the UK an outlier, as many other rich countries recommend vaccinating children. Almost 90% of children aged 5-11 in England are not vaccinated.
The JCVI’s analysis takes into account the effects of hospitalization but does not include the effects of long Covid as part of its calculations. It is estimated that around 65 million people worldwide have long Covid (symptoms lasting four weeks or more), and the condition often presents with severe symptoms that can affect many different organs, causing cardiovascular, respiratory and neurological problems. We know vaccination helps protect against long Covid, but we’re still seeing new cases, so it’s unclear how long protection will last compared to previous vaccines.
An estimated 80,000 people in the UK have lost their jobs due to long Covid, and the cost of healthcare for people with long Covid is high and only rising over time. Despite the clear social and economic costs, neither living with long-term Covid nor its impact on the economy appear to be taken into account.
It also makes little sense to continue to narrow the number of people offered vaccines in the UK, given that the government is negotiating the purchase of millions of doses of Covid vaccines to be delivered in phases between 2021 and 2024. It is understood that there will be adequate coverage for people over 50 and other clinically vulnerable groups. As vaccine offers narrow and uptake is low in certain groups, the glut of unused vaccines will soon come to an end. It is estimated that the UK Health Security Agency expects to write off £229 million worth of vaccines that we have committed to purchase or already hold that will ultimately go unused.
It is not known whether the value of these vaccines compared to the cost of delivery and rollout was taken into account when determining which age groups the vaccines will be offered to in 2023 and 2024. The pre-purchase approach connected us to specific vaccine manufacturers and strains. It is also unclear whether there are long-term plans to develop vaccines that could provide longer-lasting protection. But if we’re going to throw away vaccines for now, why not expand the eligible age groups?
There is some good news for those wanting a Covid-19 vaccine in England and Scotland; They will now be able to purchase doses privately. But unlike the flu vaccine, which costs around £20, the price per dose is likely to be £45. The cost of vaccinating a whole family can therefore quickly reach hundreds of pounds. We are facing a cost of living crisis where many cannot afford to eat or heat their homes. Poorer people work in less secure jobs and are most at risk of contracting Covid-19 at work, so they will benefit significantly from vaccination.
There are already many obstacles to vaccination campaigns, such as low trust and ease of access to vaccines; Costs should not be added to these. While the latest vaccines in the US and many European countries are free for everyone, the UK is already moving towards a place where vaccines are the preserve of the wealthiest.
While the UK’s original commitments to vaccinate everyone against Covid-19 varied in scope depending on age and demographics, they still prevented countless amounts of death and suffering. Currently, most adults under 65 in the UK will be a year or more away from their last vaccine. I do not mean to belittle the important and voluntary work that the JCVI does or the budget constraints it faces in rolling out vaccines, but it is crucial that it provides greater transparency around its cost calculations so that there can be a public debate on the issue. How can we best use the vaccines we have and what awaits us in the future?