So who SHOULD get the coronavirus vaccine first? The elderly top the Covid jab priority list in UK – but in France hospitality workers, shop staff and teachers are also at the front of the queue
- UK is taking largely age-based approach to deciding who to prioritise
- Care home residents and those aged over 80 will be the first to be vaccinated
- In France, guidelines include prioritising five-million workers in high-risk jobs
France is taking a different approach to the UK in choosing who will be prioritised in getting a coronavirus vaccine by including people who have a lot of interaction with the general public.
Based on guidance from the Joint Committee on Vaccination and Immunisation (JCVI), the first people in the UK to get any new vaccine will be elderly care homes and those who work in them.
However the UK strategy makes no mention of other workers who have close contact with the general public, including those in the hospitality sectors, teachers and cab drivers.
By contrast, the French guidelines prioritise high-risk occupations, including shop workers, school staff and transport workers.
The differing approaches come after evidence showed how coronavirus deaths differed significantly by occupation in the first lockdown, with people who interact more with the public at a higher risk of death.
France is taking a different approach to the UK in choosing who will be prioritised in getting a coronavirus vaccine by including people who have a lot of interaction with the general public
Office for National Statistics data from June showed how factory workers and security guards were twice as likely to die of coronavirus than healthcare workers during the height of the outbreak.
They were among the most likely to have been interacting with others.
Chefs, carers, taxi drivers and sales and retail assistants – all of whom are frequently in contact with the public – were also more likely to die than healthcare workers.
The JCVI previously argued in its guidance that age-based programmes are easier to deliver, meaning more people are likely to have a vaccine.
The JCVI’s priority list has 11 categories for vaccination, nearly all based on age.
Care home residents and staff will be the first to get a Covid-19 vaccine when one is approved, according to Government advice published in late September.
Based on guidance (pictured) from the Joint Committee on Vaccination and Immunisation (JCVI), the first people in the UK to get any new vaccine will be people in care homes and those who work in them
They will be followed by people over the age of 80 and NHS staff. All other age groups will then receive the jab in stages, with people under 50 the last to get it
By contrast, the French guidelines prioritise high-risk occupations, including shop workers, school staff and transport workers. Pictured: Students line up outside a French school
Everyone over the age of 80 and NHS staff will be second in line, guidance from the Joint Committee on Vaccination and Immunisation says.
Those over 75 will be next in the queue, followed by over-70s, over-65s and high-risk adults under 65 with diseases like cancer.
The UK’s 11-point vaccine priority list
1. Older adults resident in a care home and care home workers.
2. All those 80 years of age and over and health and social care workers.
3. All those 75 years of age and over
4. All those 70 years of age and over
5. All those 65 years of age and over
6. High-risk adults under 65 years of age
7. Moderate-risk adults under 65 years of age
8. All those 60 years of age and over
9. All those 55 years of age and over
10. All those 50 years of age and over
11. Rest of the population
Source: Joint Committee on Vaccination and Immunisation
They will be followed by moderate risk adults under 65 – including diabetics and asthmatics.
Over-60s will be next, with over-55s and over-50s the final priority groups.
The general population will be last to get their hands on a vaccine and they will most likely be prioritised based on age or underlying conditions.
But in France, published guidelines show that whilst the elderly and ill people will also be prioritised, five million other professionals will be included because of their contact with the general public.
They will include shop workers, school staff, transport staff and hospitality workers, as well as those who work in small spaces such as abattoir staff, taxi drivers and construction teams.
The UK and French approaches also differ in that the UK prioritisation guidance has not undergone a public consultation process.
But in France, President Emmanuel Macron’s government is consulting the general population to inform how the vaccine is rolled out and who is prioritised.
The aim is to ensure that enough people choose to have the vaccine for it to be effective in suppressing Covid-19.
Elsewhere in Europe, there are also differing prioritisation strategies.
In Germany, the aim is to first vaccinate people in higher risk groups, based on age and their state of health.
The next group on the list will be people working in the emergency services and in healthcare and care homes.
Chancellor Angela Merkel said recently, ‘At the forefront are of course nurses, doctors and also people who belong to a risk group.
‘However, that is already quite a large number in our country.’
The differing approaches come after evidence from the Office for National Statistics in June showed how coronavirus deaths differed significantly by occupation in the first lockdown
Men working in so-called ‘elementary occupations’ were the worst-hit group during the height of the coronavirus outbreak in Britain. These workers are mostly in public-facing jobs and are least likely to have been able to work from home. Whereas men in ‘professional’ occupations had the lowest death rate, largely thought to be because they continue to work home and avoid contact with others
Among these workers, those in factories were the worst hit, suffering 73.3 deaths per 100,000 men, followed by security workers (72)
In Italy, Walter Ricciardi, a senior scientific advisor to the country’s minister of health, said in comments reported by newspaper La Repubblica and picked up by The Guardian that his country’s priority would be health workers, the elderly and people with underlying conditions.
The military and the police would also be among the first to get the vaccine.
In Spain, it was suggested by health minister Salvador Illa that healthcare workers and the elderly should get priority.
The US’s tiered vaccination approach has a five-phase plan which includes essential service workers at high risk of exposure.
This means that, like in France, teachers and school staff, as well as those in prisons and homeless shelters, will also be prioritised.
Data shows the disease was also killing male taxi drivers (65) and busmen (44.2) at up to six times the rate of men in ‘professional’ occupations
Women in care homes (19.1 deaths per 100,000) were also worse affected than female doctors and nurses (11). But the risk of dying from coronavirus was significantly smaller than observed in men
On Friday, Health Secretary Matt Hancock said coronavirus vaccines would start to roll out next month if one is approved by the British drug regulator.
Mr Hancock said in a TV briefing that the Government had asked the regulator, the MHRA, to consider licensing the vaccine produced by pharmaceutical firms Pfizer and BioNTech.
A study last week confirmed the jab was 95 per cent effective in clinical trials.
In Germany, the aim is to first vaccinate people in higher risk groups, based on age and their state of health. Pictured: Chancellor Angela Merkel
HOW DOES HANCOCK PLAN TO VACCINATE A MILLION PEOPLE A DAY?
The Health Secretary has revealed ambitions to inoculate a million Brits against Covid every day as soon as a vaccinate is given the green light by the UK drugs watchdog.
Though Mr Hancock has admitted it was going to be ‘one of the biggest civilian projects in history’.
Normally the NHS vaccinates 15 million people against flu every year winter over the space of about four months.
The Government plans to set up dozens of mass coronavirus vaccination sites across the country in the coming weeks.
Doctors, nurses, firefighters and soldiers will be trained up to help deliver the inoculations.
Retired medics, medical students and other NHS staff who normally don’t give vaccines – including physiotherapists – are also being recruited.
GP surgeries have been told to organise the initial wave, which will involve using community centres, village halls, and practices themselves to administer the jabs to care workers and the elderly as soon as next month.
The NHS is establishing a series of much larger venues to inject millions of others once those at the top of the priority list have had the jabs.
Empty NHS Nightingale Hospitals and sports centres, including the Derby Arena, area are reportedly being lined up as possible venues.
Mr Hancock told Sky News the roll out should be ‘relatively straightforward’ because the NHS has the infrastructure.
But the health service will have to juggle the unprecedented Covid drive with the biggest flu vaccination programme ever – 30million people are being vaccinated on the NHS compared the 15million normally.
There is also the logistical problems with Pfizer’s vaccine – which looks set to be the first jab to be approved.
It needs to be stored at -70°C (-94°F), which means the UK will need to buy specialist freezers and huge supplies of dry ice.
It also appears to protect people of all ages from coronavirus.
The £15-a-dose jab is currently the odds-on favourite to be approved first by the MHRA.
However, candidates from Moderna and Oxford University are close behind.
On Saturday, Britain recorded 341 deaths from coronavirus – a 26 per cent drop on last week’s 462 deaths.
The number of cases also fell dramatically from 26,860 last Saturday to 19,875 yesterday.
Analysis by the ONS in June showed that 74 male security guards or bouncers died for every 100,000 men during the brunt of the crisis, followed by a rate of 73 for male factory workers.
In comparison, male nurses and doctors – who were treating the sickest Covid-19 patients, many without proper protective gear – died at a rate of 30 per 100,000 men, as a whole.
The rate among ambulance staff (82.4) was still higher, however.
The ONS – who cautioned there was not enough data to accurately look at the most dangerous jobs for women – said its data does not prove these jobs are more dangerous than working in hospitals because it does not take into account ethnicity or deprivation, two factors linked to a higher risk of dying.
And statisticians warned the rate for factory and security workers will also be skewed upwards because there are many more healthcare workers.
For example, 130 male healthcare workers died from coronavirus during the two-and-a-half month period from March to June, compared to 62 deaths among factory employees.
Factory workers have worked throughout the crisis to keep the nation fed during lockdown, and are among the most likely to have been interacting with others when the disease was spreading at its fastest.
Security guards had to be deployed to supermarkets during the outbreak to ensure social distancing was adhered to inside shops and in queues, exposing them to hundreds of potential Covid-19 carriers each day.
Data also shows the death rate was higher in 17 different occupations for men, including taxi drivers (65), chefs (56.8), busmen (44.2) and shop assistants (34.2) at a higher rate than the national average (19.1).
They were up to six times more likely to die from Covid than men in ‘professional’ occupations (11.1 per 100,000).
This is largely thought to be because they continue to work from home and avoid contact with others.
Experts said the findings showed that Covid-19 ‘is largely an occupational disease’ and called for all workers who have regular contact with patients or the public to be supplied with personal protective equipment (PPE).
WHICH VACCINES HAS THE UK SECURED DEALS FOR?
1. GlaxoSmithKline and Sanofi Pasteur: 60million doses
The Government revealed on July 29 it had signed a deal with pharmaceutical giants GlaxoSmithKline (GSK) and Sanofi Pasteur
If the vaccine proves successful, the UK could begin to vaccinate priority groups, such as frontline health and social care workers and those at increased risk from coronavirus, as early as the first half of next year, the Department for Business, Energy & Industrial Strategy (BEIS) said.
Human clinical studies of the vaccine will begin in September followed by a phase 3 study in December.
The vaccine is based on the existing technology used to produce Sanofi’s seasonal flu vaccine. Genetic material from the surface protein of the SARS-CoV-2 virus is inserted into insect cells – the basis of Sanofi’s influenza product – and then injected to provoke an immune response in a human patient.
2. AstraZeneca (manufacturing University of Oxford’s): 100million
AstraZeneca, which is working in partnership with Oxford University, is already manufacturing the experimental vaccine after a deal was struck on May 17.
Professor Sarah Gilbert, who is leading the Oxford team, is confident the jab could be ready for the most vulnerable people by the end of the year.
Her comments came after the results from the first phase, published in The Lancet on July 20, showed promise.
The team have genetically engineered a virus to look like the coronavirus – to have the same spike proteins on the outside – but be unable to cause any infection inside a person. This virus, weakened by genetic engineering, is a type of virus called an adenovirus, the same as those which cause common colds, that has been taken from chimpanzees.
3. BioNTech/Pfizer: 30million
US drug giant Pfizer – most famous for making Viagra – and German firm BioNTech were revealed to have secured a deal with the UK Government on July 20.
It reported positive results from the ongoing phase 2/3 clinical trial of one called BNT162b1 on July 1. The company is still running phase 2 trials at the moment.
Pfizer’s vaccine is one called an mRNA vaccine, which do not directly inject bits of the virus into the body but send genetic material.
mRNA vaccines programme the body to produce parts of the virus itself by injecting the body with a molecule that tells disease-fighting cells what to build. The immune system then learns how to fight it.
4. Valneva: 60million
The Government has given Valneva — whose vaccine is understood to be in the preclinical stages of development — an undisclosed amount of money to expand its factory in Livingston, Scotland.
While the Government revealed a 60million dose deal on July 20, the company said it had reached agreement in principle with the UK government to provide up to 100million doses.
Valneva’s jab is an inactivated whole virus vaccine, meaning it injects a damaged version of the coronavirus itself into the body.
The virus has been destroyed in a way that makes it unable to cause infection, but the body still recognises it as a dangerous intruder and therefore mounts an immune response which it can remember in case of a real Covid-19 infection.
5. Janssen (Johnson & Johnson): 30million
The Government has agreed to buy 30million doses of a vaccine made by Janssen if it works.
Officials have agreed to help the company in its development of the jab by part-funding a global clinical trial. The first in-human trials of Janssen’s jab began in mid-July and are being done on adults over the age of 18 in the US and Belgium.
The jab is named Ad26.COV2-S, recombinant, and is a type of jab called a viral vector recombinant vaccine.
Proteins that appear on the outside of the coronavirus are reproduced in a lab and then injected into the body to stimulate an immune reaction.
The ‘Ad’ part of the vaccine’s name means it works using an adenovirus – a virus best known for causing the common cold – as a vehicle to transport the coronavirus genetics into the body.
6. Novavax: 60million
Britain has ordered 60million doses of a vaccine being developed by the US-based company Novavax. It will help to fund late-stage clinical trials in the UK and also boost plans to manufacture the vaccine in Britain.
Novavax’s jab, named NVX-CoV2373, showed positive results in early clinical trials.
It produced an immune response in 100 per cent of people who received it, the company said, and was safe and ‘generally well-tolerated’.
Novavax’s candidate is also a recombinant vaccine and transports the spike proteins found on the outside of the coronavirus into the body in order to provoke the immune system.
7. Imperial College London: Unknown quantity
Imperial College London scientists are working on Britain’s second home-grown hope for a jab. The candidate is slightly behind Oxford’s vaccine in terms of its progress through clinical trials, but is still a major player.
The UK Government is understood to have agreed to buy the vaccine if it works but details of a deal have not yet been publicised.
Imperial’s jab is currently in second-phase human trials after early tests showed it appeared to be safe.
Imperial College London will try to deliver genetic material (RNA) from the coronavirus which programs cells inside the patient’s body to recreate the spike proteins. It will transport the RNA inside liquid droplets injected into the bloodstream.
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