Could Lancashire set a local vaccine priority list later in the programme?

Lancashire’s public health boss says “representations” are being received from a range of groups about who should be prioritised for the Covid vaccine in the county.
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Dr. Sakthi Karunanithi stressed that there was no option for local areas to deviate from the list of nine priority categories drawn up nationally – but suggested that there may be some flexibility when it came to the order in which the rest of the population was given the jab.

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His comments came at a meeting of the county’s health and wellbeing board which also heard that it was expected all of the county’s care home residents will have received at least their first dose by the end of this week.

Once the most vulnerable groups have been vaccinated, who should be next in line? (image:  Peter Byrne/PA Wire)Once the most vulnerable groups have been vaccinated, who should be next in line? (image:  Peter Byrne/PA Wire)
Once the most vulnerable groups have been vaccinated, who should be next in line? (image: Peter Byrne/PA Wire)
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They – and the staff who look after them – were the top priority group in a list generated by the Joint Committee on Vaccination and Immunisation (JCVI).

The government is aiming to give an initial dose to around 14m people in the top four groups – which also include the over-70s and the clinically extremely vulnerable – by 15th February.

They will then work through other age groups, declining in five-year intervals to the age of 50 – as well as all 16-64-year-olds with underlying health conditions – by late spring. That totals around another 17m people.

The JCVI list concludes with a tenth category under the heading “rest of the population” – with the order “to be determined”. The government hopes to complete this group by the autumn.

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“It would appear that once we get past the first nine groups, there may be room for local prioritisation, but we don’t have any room for influence [before that],” Dr. Karunanithi said.

However, he added that a suggested local priority list had been provided to those in the NHS in Lancashire who are leading the vaccination programme, “in the context of them having a reserve list at the end of a day, where there are going to be some doses left”.

“Rather than wasting them, it will go into people’s arms. People are taking these lists and calling [those on] them – [but] it will be a bit haphazard.”

The meeting heard that it will be around a fortnight before Lancashire receives data on vaccination rates, but that there were “positive signals” about the number of doses being given.

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However, Dr. Karunanithi warned of the risk of “inequalities” in vaccine uptake.

“My concern is that there is a significant variation in our patch and when we get the data…we need to anticipate that and be prepared for addressing it fairly quickly.”

Board member and Lancashire County Council cabinet member for adult services, Graham Gooch, said it was important not to overlook one group which was particularly vulnerable.

“I’m very pleased with the way immunisation has gone in care homes – we had 70 percent done by the end of last week and I understand it will be 100 percent by the end of this week.

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“Unfortunately, people in supported living [accommodation] seem to have not been on the radar.

“People with learning disabilities and autism often have underlying health problems which mean there is greater mortality amongst them, but they don’t seem to have been identified [by the government] as a priority group in the community,” County Cllr Gooch said.

Dr. Karunanithi said that any underlying health conditions amongst those within that group, which would make them vulnerable, would be “captured” to ensure they were invited for a jab at the right time.

“We are getting quite a lot of representation – we know people with learning disabilities have got much shorter life expectancy; [and] homelessness is another example.

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“There are other groups who, by nature of national policies, are having to work – like nursery staff. We are getting a range of representations from [these groups].

“We are collating them and liaising with our local NHS colleagues, but also informing the national policy,” he added.

Last week, it emerged that the NHS in Oldham had vaccinated a group of homeless people in the borough in spite of them not featuring on the JCVI priority list. Local GP and councillor, Dr Zahid Chauhan, described it as "the human thing to do".

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