Frontline health and social care workers should be among those prioritised for a Covid-19 vaccination when it becomes available, the Joint Committee on Vaccination and Immunisation (JCVI) has said.
The committee, which advises UK health departments on immunisation, published the list of priority groups last week (25 September) but said it is based on preliminary information on the vaccines currently being developed, and is subject to change.
Care home staff and older residents should be first in line, the advisory group said, followed by all those aged 80 and above and health and social care workers.
The priority ranking system would then see older age groups and those under 65 considered to be at high or moderate risk vaccinated before the rest of the population, as ‘current evidence strongly indicates that the risk of serious disease and death increases exponentially with age,’ the JCVI said.
However, it added that the prioritisation could change ‘substantially’ if the first available vaccines were not considered suitable for, or effective in, older adults.
The system, designed to ensure a ‘safe and effective’ Covid vaccination programme, has been developed using mathematical modelling on its potential impact, and by reviewing data on the effects of Covid-19 and the development of different vaccines.
Frontline health workers
The committee said it considers frontline health and care workers a ‘high priority’ for a Covid vaccination, particularly as this protection would help ‘maintain resilience’ in the NHS and care sectors.
‘Frontline health and social care workers are at increased personal risk of exposure to infection with Covid-19 and of transmitting that infection to susceptible and vulnerable patients in health and social care settings,’ the experts said.
They added that there is evidence that infection rates are higher in residential care home staff than in those providing domiciliary care or in healthcare workers and care home workers are therefore considered a ‘very high priority for vaccination’.
The JCVI said a finalised list of prioritisation for health and social care workers will be dependent on evidence gathered at the start of a Covid-19 vaccination programme, based on issues such as vaccine efficacy and safety in different age groups.
The advisory group said care home residents are given the highest priority for vaccination because they are at ‘increased risk of outbreaks, morbidity and mortality in these closed settings’. This is also a group that has been disproportionately affected by Covid-19 so far.
It added that clinical risk factors typically increase with age, therefore justifying an age-based prioritisation – a system which also makes the programme ‘easier to deliver and therefore achieve higher vaccine uptake’.
The JCVI also said there is ongoing work to refine the identification of persons at risk of serious disease and mortality from Covid-19, with potential risk factors, including around deprivation and ethnicity, already identified
‘As more evidence on at-risk groups emerges, this work will inform the review of the composition, and order of priority, of groups for vaccination, it said.’
‘Any programme will need to ensure every effort is made to get good coverage in black, Asian and minority ethnic (BAME) groups, in areas of higher socio-economic deprivation, and in areas with outbreaks or high levels of community transmission.’
Provisional ranking for Covid-19 vaccinations:
- older adults’ resident in a care home and care home workers1
- all those 80 years of age and over and health and social care workers1
- all those 75 years of age and over
- all those 70 years of age and over
- all those 65 years of age and over
- high-risk adults under 65 years of age
- moderate-risk adults under 65 years of age
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
- rest of the population (priority to be determined)