People under 50 will be vaccinated by age rather than occupation or ethnicity in the next phase of the UK’s coronavirus response, after scientific advisers to the government said the plan would “ensure more people are protected more quickly”.
Under recommendations laid out by the Joint Committee on Vaccination and Immunisation (JCVI), those aged between 40 and 49 will be prioritised first, followed by 30- to 39-year-olds before concluding with the 18-29 age group.
The JCVI said modelling studies for phase two of the vaccination programme indicated that the speed of vaccine deployment was the most important factor in helping prevent severe illness and death.
It concluded that the targeting of certain professions, such as teachers and police, would be more complex to deliver and may slow the UK’s rollout, leaving some vulnerable people unvaccinated for longer periods of time.
Instead, the JCVI has advised that the government should continue to work down the UK’s age groups once all at-risk people in phase one of the programme have been offered at least one dose.
With more than 19.1 million doses administered to date, it is expected this first stage will be completed by mid-April.
Professor Wei Shen Lim, Covid-19 chair for the JCVI, said the “the current strategy is to prioritise those who are more likely to have severe outcomes and die” from the disease.
“The evidence is clear that the risk of hospitalisation and death increases with age,” he said.
“The vaccination programme is a huge success and continuing the age-based rollout will provide the greatest benefit in the shortest time, including to those in occupations at a higher risk of exposure.”
Addressing the JCVI’s age-based strategy, a government spokesperson said: “All four parts of the UK will follow the recommended approach, subject to the final advice given by the independent expert committee.
“The UK government remains on course to meet its target to offer a vaccine to all those in the phase one priority groups by mid-April, and all adults by the end of July.”
Prof Lim said the JCVI had “carefully” considered an occupation-based approach to phase two but realised it posed too much of a logistical challenge, one that risked derailing the speedy nature of the deployment so far.
“One of the difficulties with occupational status is that it’s not very well recorded or completely recorded in primary care records,” he said.
“Trying to work out the association between occupational risk and exposure and severe disease has been difficult enough, and I think structuring an entire mass vaccination programme [around] occupation would be even more difficult.”
The JCVI also acknowledged that people at higher risk of hospitalisation from Covid-19 included men, those from black, Asian and minority ethnic groups, people with a BMI over 30, and those living in poorer neighbourhoods.
Amid growing concern that vaccine acceptance has been slower among ethnic minority groups and in more deprived parts of the country, the JCVI said it was vital that people took up their offer of vaccination.
According to the Royal College of GPs, white people in England are more than twice as likely to have been vaccinated as people from black backgrounds, and three times as likely as those from mixed ethnic communities.
And despite the government’s ongoing efforts to address health disparities between different communities in the UK, research has shown that the risk of death from Covid-19 remains at an “alarmingly” high level for South Asian people.
Dr Mary Ramsay, head of immunisations at Public Health England (PHE), said: “It is crucial that those at higher risk – including men and [ethnic minority] communities – are encouraged to take the vaccine, and that local health systems are fully engaged and reaching out to underserved communities to ensure they can access the vaccine.”
The JCVI’s recommendations follow an intense debate over which groups in society should be prioritised in the next phase of the rollout.
Sir Simon Stevens, the head of NHS England, was one of many high-profile figures who insisted that key public service workers and teachers should be considered sooner rather than later.
Speaking last month, Sir Simon said reducing the number of hospital beds occupied by Covid-19 patients was not "the only consideration" policymakers would take into account when deciding the vaccination priority list.
“Fundamentally, the most important thing is to get the overall infection rate down, this is not principally about pressure on the NHS, this is principally about reducing the avoidable death rate,” he added.
Modelling from government scientists has shown that the reopening of schools in England on 8 March could push the country’s R rate above 1.0, raising concerns among education chiefs over the safety of teachers.
The R value currently ranges between 0.6 and 09, meaning the UK’s epidemic is shrinking, while the latest survey from the Office for National Statistics shows that infections in England are at their lowest level since early October.
Geoff Barton, general secretary of the Association of School and College Leaders, said the body was “disappointed” that teachers had not been prioritised by the JCVI.
“The government needs to make a policy decision on this matter having insisted that education is a national priority and having announced a ‘big bang’ return to the classroom in England,” he added.
In the build-up to Friday’s announcement, reports also emerged that the JCVI had advised government ministers to vaccinate prisoners en masse.
Outbreaks in the UK’s prisons have been surging throughout the winter wave. According to the Ministry of Justice, there were 2,400 positive cases recorded in December – a rise of nearly 70 per cent in a single month.
While justice secretary Robert Buckland said that inmates would not be prioritised over other groups, he emphasised the need for speed and for protecting prison staff.
"Prisons are a closed environment, like care homes,” he said on Friday morning. “I have got to think about the welfare of staff. I am particularly anxious to make sure that prison staff get the vaccine.”
Earlier this month, at least 150,000 more people with learning disabilities were added to the vaccine priority list, after concerns that too many with severe problems were being missed.
Meanwhile, most frontline health and social care staff, elderly care home residents, clinically extremely vulnerable people and those aged over 70 have now received at least one dose of the Covid-19 vaccine.
The latest recommendations from the JCVI have been widely welcomed by the scientific community.
Dr Michael Head, a senior research fellow in global health at the University of Southampton, said: “In order to maintain this pace of rollout, it seems a reasonable decision to continue inviting people for immunisation by age.”
Dr Peter English, a consultant in communicable disease control, said that simplicity was key. “As soon as you introduce complexity, you risk a drop in uptake, or delays in implementing the programme,” he said.