The Joint Committee on Vaccination and Immunisation (JCVI) recommended that health and care staff are among the first people to be offered the vaccine in order to prevent death and protect health and social care staff and systems.
With more locations and vaccines available, we are now able to invite all health and care workers to book a vaccination at one of the six hospital-based vaccination sites across Sussex. This includes:
- All NHS staff from primary (including general practice and general dental practice), community and secondary care.
- Staff of independent and third sector health providers.
- Care and care home staff in public, private and not for profit sectors.
More information is available here: https://www.sussexhealthandcare.uk/keepsussexsafe/sussex-covid-19-vaccination-programme/workforcevax/ including the booking system for appointments and the process (for example presenting ID).
Phase 1 – direct prevention of mortality and supporting the NHS and social care system
JCVI advises that the first priorities for the COVID-19 vaccination programme should be the prevention of mortality and the maintenance of the health and social care systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age. The order of priority for each group in the population corresponds with data on the number of individuals who would need to be vaccinated to prevent one death, estimated from UK data obtained from March to June 2020:
- residents in a care home for older adults and their carers
- all those 80 years of age and over and frontline health and social care workers
- all those 75 years of age and over
- all those 70 years of age and over and clinically extremely vulnerable individuals
- all those 65 years of age and over
- all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19.
JCVI advises that implementation of the COVID-19 vaccine programme should aim to achieve high vaccine uptake. An age-based programme will likely result in faster delivery and better uptake in those at the highest risk. Implementation should also involve flexibility in vaccine deployment at a local level with due attention to:
mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity
vaccine product storage, transport and administration constraints
exceptional individualised circumstances
availability of suitable approved vaccines, for example for specific age cohorts
JCVI appreciates that operational considerations, such as minimising wastage, may require a flexible approach, where decisions are taken in consultation with national or local public health experts. To be assured that outcome is maximised however, JCVI would like to see early and regular comprehensive vaccine coverage data so that the committee can respond if high priority risk groups are unable to access vaccination in a reasonable time frame.
The next phase – further reduction in hospitalisation and targeted vaccination of those at high risk of exposure and/or those delivering key public services
As the first phase of the programme is rolled out in the UK, additional data will become available on the safety and effectiveness of COVID-19 vaccines. This data will provide the basis for consideration of vaccination in groups that are at lower risk of mortality from COVID-19.
The committee is currently of the view that the key focus for the second phase of vaccination could be on further preventing hospitalisation.
Vaccination of those at increased risk of exposure to SARS-CoV-2 due to their occupation could also be a priority in the next phase. This could include first responders, the military, those involved in the justice system, teachers, transport workers, and public servants essential to the pandemic response. Priority occupations for vaccination are considered an issue of policy, rather than for JCVI to advise on. JCVI asks that the Department of Health and Social Care consider occupational vaccination in collaboration with other government departments.
Wider use of COVID-19 vaccines will provide a better understanding of whether they can prevent infection and onward transmission in the population. Data on vaccine impact on transmission, along with data on vaccine safety and effectiveness, will potentially allow for consideration of vaccination across the rest of the population.
As trials in children and pregnant women are completed, we will also gain a better understanding of the safety and effectiveness of the vaccines in these persons.