Dr Mary Ramsay, head of immunisation at Public Health England (PHE), told MPs there is a desire for the population to move together – in contrast to the US, which is allowing fully vaccinated people to meet indoors without the need for social distancing.
Dr Ramsay told the Commons Science and Technology Committee the UK’s policy of leaving up to 12 weeks between vaccine doses – a move she said has saved lives – means the UK is behind the US when it comes to fully vaccinated individuals.
“I think they (US) are able to be less cautious, perhaps, than us because of the fact that more people have had two doses, which one would expect to get even better protection against transmission,” she said.
“Our data is now coming through showing that even one dose is very good (against transmission), so I think we can begin to look at those factors and we are looking at those factors.
“I think the other thing is we have a slightly different cultural perspective in this country in that we tend to do everything together.
“We are trying to say that this is about the population as a whole rather than the individuals, those privileged individuals who have had two doses, being somehow able to do things that other people cannot.”
Greg Clark chairman of the committee, asked Dr Ramsay if that means decisions are being taken for sociological reasons, rather than being based on the science.
She said the road map and policy decisions are being taken by the Government, not by PHE, and the road map reflects “doing everything as a whole”.
Dr Ramsay added: “It may be that, within the future road map, we are able to pick out individuals.
“I think that is the direction of travel, that we will all be able to release certain things as time goes on, but you know the next level will be to allow people to meet indoors, and it won’t necessarily depend only on having been vaccinated.”
It came as Health Secretary Matt Hancock announced he was booking his own Covid-19 vaccination.
He tweeted: “Delighted to have received my text inviting me to book my vaccination. This feels like a huge personal step towards normal. I got the call, I’m getting the jab.”
In the committee hearing, Dr Ramsay also told MPs it was “very important” that as many people as possible are vaccinated before all restrictions are eased.
“It is really very important that we have as many people vaccinated before we release all those restrictions, so at the moment we are trying to balance it very carefully,” she said.
“As more people get vaccinated, we are releasing gradually, we’re observing what happens, and then that’s allowing us to carry on, but it does depend on what the future holds, how people behave, how the vaccine works.”
I think it will be very hard to say confidently that by X we can stop doing Y and I think it really is a question of keeping observing and keeping monitoring, so that we can get that balance right
Dr Mary Ramsay, Public Health England
Dr Ramsay said that while the proportion of people with two jabs is increasing, there are still some elderly who have not been vaccinated and children cannot yet have a vaccination.
“I think it will be very hard to say confidently that by X we can stop doing Y and I think it really is a question of keeping observing and keeping monitoring, so that we can get that balance right,” she said.
“There is a risk that we get a resurgence as we release restrictions – hopefully that will mainly lead to mild disease and younger people, but there will still be the risk that those people can potentially pass this on to older individuals who are, for whatever reason, either unable to respond to vaccine, unvaccinated or maybe if the vaccine begins to lose protection over time.”
Dr Ramsay said that there will be a need to monitor regional spikes in future coronavirus cases.
“One of the things we’ve found with this virus in general is it’s not equal across the country – we know last year we had pockets of transmission in certain parts of the country,” she said.
“There is always the risk that if that pocket of transmission – whether it’s due to social factors, housing, behaviour, vaccination or lack of vaccination – they could potentially all coalesce and you could have potentially pockets where there was quite worrying rates of transmission, so I think the real importance is that we continue to monitor this on a very careful basis and we continue to look at the local level.”
She added: “I think it is a mistake to just assume that everyone is the same, and every area is the same; you know, uptake has been incredibly high but there are some pockets where it’s a little bit lower – we know London, for example, is lagging behind.
“I think we expect to see an increase in rates; the question is whether that increase in rates is translating into increases in the more worrying things like hospitalisations and deaths, and that’s what we haven’t seen – they are still continuing to go down at very sharp rates, very sharp decline because the vaccine is adding that protection to the population.”
We need to celebrate our success with vaccines... but we also need to be cautious because we don’t want to see what’s happening in other parts of Europe and other parts of the world here in the UK
Professor Anthony Harnden, JCVI
Professor Anthony Harnden, deputy chairman of the Joint Committee on Vaccination and Immunisation (JCVI), was asked how close the UK is to herd immunity.
He said: “Herd immunity depends on the R number… so, for instance, if you’ve got an R number of 3, so the actual individual transmits to three other susceptible individuals, then you would need to vaccinate at least three out of four of the population to stop transmission.
“So you’re right in saying that the higher than the levels of immunity within the population, the less ‘susceptibles’ there are.
“And so you’re getting much more towards herd immunity, but I don’t think we’re there yet, although clearly a vaccination programme, and higher levels of natural infection, will get us pretty close to it.”
Prof Harnden said if “we all go completely wild” and ignore everything that has been learned about social distancing in the last year, it could lead to a large coronavirus wave.
“We need to celebrate our success with vaccines… but we also need to be cautious because we don’t want to see what’s happening in other parts of Europe and other parts of the world here in the UK.
“If we can carry on with the messaging that we carry on being cautious, even though we are unlocking slowly in terms of the social distancing, the mask wearing, etc, we may keep infection rates down.”