Vaccinating the under-50s - who should get priority?

[py_megapixel]

The head of the vaccine task force in the UK has said that the risk of covid for people under 50 does not outweigh any potential risk from the vaccine.

Could you possibly provide a link to this? It's not that I doubt this was said, it's just not something I've head.

We won’t be getting it. Therefore restrictions for us are pointless.

Everyone isn't going to get it, so its a moot point.

I would be very surprised if under-50s would be artificially denied vaccination, once it was sufficiently available and once it is proven not to be dangerous. This will take years, but I would imagine the virus will exist for long enough that it will still be worth vaccinating against in a few years' time.

Do you think there should be another year of lockdowns and restrictions until every pensioner gets their shot?

No, but some pragmatic measures should remain - for example, restricting capacity in indoor public spaces. (In many cases pre-Covid I found the likes of shopping malls, leisure centres etc. to be more crowded than is comfortable)

Clearly the Government's strategy of just throwing random restrictions which sound about right needs to go, but that doesn't mean that some changes, executed correctly, couldn't be beneficial.

You're missing my point. I'm not offering an alternative vaccination strategy because prioritising vulnerable groups is the only sensible strategy to my mind.

Sorry, I misread your previous point... my apologies.

 

[Bantamzen]

I would be very surprised if under-50s would be artificially denied vaccination, once it was sufficiently available and once it is proven not to be dangerous. This will take years, but I would imagine the virus will exist for long enough that it will still be worth vaccinating against in a few years' time.

Vaccination of under 50s will only be offered once all the other groups have had the chance to have it, with perhaps the exception of the most seriously ill in that group who might be a risk.

 

[big_rig]

Could you possibly provide a link to this? It's not that I doubt this was said, it's just not something I've head.




I would be very surprised if under-50s would be artificially denied vaccination, once it was sufficiently available and once it is proven not to be dangerous. This will take years, but I would imagine the virus will exist for long enough that it will still be worth vaccinating against in a few years' time.


No, but some pragmatic measures should remain - for example, restricting capacity in indoor public spaces. (In many cases pre-Covid I found the likes of shopping malls, leisure centres etc. to be more crowded than is comfortable)

Clearly the Government's strategy of just throwing random restrictions which sound about right needs to go, but that doesn't mean that some changes, executed correctly, couldn't be beneficial.


Sorry, I misread your previous point... my apologies.

Ms Bingham said the government was aiming to vaccinate about 30m people, compared with a UK population of about 67m, if a successful vaccine against Covid-19 was found. “People keep talking about ‘time to vaccinate the whole population’, but that is misguided,” she said. “There’s going to be no vaccination of people under 18. It’s an adult-only vaccine, for people over 50, focusing on health workers and care home workers and the vulnerable.”


Ms Bingham said vaccination policy would be aimed at those “most at risk” and noted that vaccinating healthy people, who are much less likely to have severe outcomes from Covid-19, “could cause them some freak harm”, potentially tipping the scales in terms of the risk-benefit analysis.

Less than half UK population to receive coronavirus vaccine, says task force head | Free to read

PM warns of ‘bumpy’ winter while data ‘issue’ blamed for 16,000-case backlog pushing numbers to record high

www.ft.com

People under 50 aren’t getting it. There’s no need. I am not bothered if they don’t allow football stadiums or nightclubs to open immediately but the other economically and socially ruinous social distancing measures need to be binned and people who are in line for the jab can stay inside. There’s been enough sacrifice for the elderly and starting from day one of the program it’ll be time for them to repay the favour. To propose otherwise (ie lockdowns, banning people from working must continue until every OAP has had the jab) as I said would be the greatest act of selfishness in human history. End of story in my view

There’s also the matter that the justification for lockdowns is hospital capacity. I would be very interested in seeing age breakdowns for people in hospital (the only data provided seems to be the graphs showing the over 85s are something like 10x more likely per person than under 65 or 50s to enter hospital). If you could halve the number of over 85s going into hospitals then the last justification for any action to be taken falls over.

 

[AM9]

I agree that there would need to be a transition period of less onerous restrictions whilst vulnerable people are receiving the vaccination as opposed to full party mode.

However once this has been completed, and the threat to NHS services has been mitigated, I'm of the view that restrictions should be removed and people allowed to judge their own risk.


You're missing my point. I'm not offering an alternative vaccination strategy because prioritising vulnerable groups is the only sensible strategy to my mind.

Experience so far has shown that people judging "their own" risk doesn't always mean that other innocent people aren't put at risk. Hence my statement about "Less onerous ristrictions may be gradually introduced for all"

 

[yorksrob]

Experience so far has shown that people judging "their own" risk doesn't always mean that other innocent people aren't put at risk. Hence my statement about "Less onerous ristrictions may be gradually introduced for all"

That's true of all walks of life.

However, if you've vaccinated the more vulnerable parts of the population against this virus, the risk to everyone else from the it is far closer to all of those other everyday risks that we take in our stride.

 

[big_rig]

Experience so far has shown that people judging "their own" risk doesn't always mean that other innocent people aren't put at risk. Hence my statement about "Less onerous ristrictions may be gradually introduced for all"

You will need to have a chat to the Prime Minister then to get him to fundamentally change the approach taken by the Government. The purpose of lockdowns and restrictions is not to prevent every single last death of an unfortunate, high risk person from covid. They are intended to prevent hospitals from being overwhelmed, to prevent larger scale pandemic death. That’s all we’re doing this for, and it is wishful thinking to propose anything else.

 

[PTR 444]

I understand if there are not enough doses to give to the under-50s but if we leave them out after immunising the most vulnerable, how long will it be before the media stop reporting daily cases and deaths? At that point, it would make sense to remove restrictions such as the rule of six, 10pm pub curfew and face masks on trains, but on such announcement I would expect the young to go back to their pre-pandemic ways of living, and when there is the virus still around you can imagine that it would spread like wildfire through that demographic. What if the government decide to keep restrictions in place until everyone is vaccinated just because they are facing pressure from the media that 100,000 young people will catch it every day from their celebratory antics, even though it no longer poses a risk to the immunised elderly and vulnerable.

 

[Bantamzen]

I understand if there are not enough doses to give to the under-50s but if we leave them out after immunising the most vulnerable, how long will it be before the media stop reporting daily cases and deaths? At that point, it would make sense to remove restrictions such as the rule of six, 10pm pub curfew and face masks on trains, but on such announcement I would expect the young to go back to their pre-pandemic ways of living, and when there is the virus still around you can imagine that it would spread like wildfire through that demographic. What if the government decide to keep restrictions in place until everyone is vaccinated just because they are facing pressure from the media that 100,000 young people will catch it every day from their celebratory antics, even though it no longer poses a risk to the immunised elderly and vulnerable.

The sooner the media stop fixating on the figures the better in my opinion. This continual grind of daily "cases" when they should be named as infections or positive test results is making it harder for decision makers to look towards getting things moving again.

 

[Yew]

From a utility perspective, not much.

They won't live long enough to get substantial benefit.

Indeed, I wonder if in terms of 'years of life saved per vaccine dose' a better effect would be achieved by giving those doses to an equivalent number of people in a lower risk (say, 65+, as an example) group.

 

[AM9]

You will need to have a chat to the Prime Minister then to get him to fundamentally change the approach taken by the Government. The purpose of lockdowns and restrictions is not to prevent every single last death of an unfortunate, high risk person from covid. They are intended to prevent hospitals from being overwhelmed, to prevent larger scale pandemic death. That’s all we’re doing this for, and it is wishful thinking to propose anything else.

He is addressing the biggest (political) risk first, i.e. the possibility of the health (and care) system being overwhelmed. Once that has subdued, the next problem will come into focus, we don't know exactly what that is but as I said in post #26,

... this virus hasn't finished yet.

In addition to that, we don't know how long any immunity that the vaccine brings is going to last, and then there's always the political bottom line, governments know (especially right-wing ones) that their survival depends on older people's votes.

 

[Yew]

In addition to that, we don't know how long any immunity that the vaccine brings is going to last, and then there's always the political bottom line, governments know (especially right-wing ones) that their survival depends on older people's votes.

This feels like the sort of baseless doom-mongering that we've had to suffer throughout the last six months. This isn't some unknown mega virus, it's just another coronavirus. Given that SARS antibody responses last decades, it'd be very surprising if this wasn't the same.

 

[37424]

Your also going to have the potential issue as to whether the current vaccine front runner will be available to some highly vulnerable groups, people with weakened immune systems frequently cannot have live vaccine types, only inactivated vaccine types of which flu is one. The current front runner I gather is a type which has never been used before but sounds more closer to a live vaccine so whether people with compromised immune systems will be able to have this I guess is something the medical people will be scratching their heads at, and it could be they will have wait for one of the other vaccines that are being developed.

 

[cuccir]

I did a very rough crunching of the numbers on the other vaccine thread. From the initially announced capacity and characteristics of the vaccine, I reckon we could do all over 60s, NHS workers and teachers fairly comfortably by September 2021, with an extra ~2 million vaccinations available for vulnerable people or other key workers. It's worth remembering how few deaths occur in under 60s compared to the over 60s based on deaths in England as reported by NHS England by 12th November:

0 - 19	22
20 - 39	241
40 - 59	2634
60 - 79	12624
80+	19119

Note too when reading these figures that there are around 15.6 million over 60s in the UK and 53 million under 60s.

Imagining that a large chunk of those who died under 60 were those who were vulnerable in some way and who we could capture with that 2 million extra vaccines by September, I'd say that this seems a pretty achievable target. September is important as the start of the new school year and return of autumnal weather, which are what drove the second wave this time round. With nearly 1/4 of the population vaccinated by then, any outbreak would spread much more slowly, noting too that we can expect something like 15-20% of people to have a level of protection based on previous infections.

This projection is probably quite cautious too. There are likely to be some people able to get vaccines privately, and it is almost guaranteed that other vaccines come through as well, though the capacity to administer these is under question. Hypothetically though if we used our dose of the Pfizer vaccine (Which requires two injections 28 days apart so is slow to get out to a population) for these vulnerable groups, we may well then from September-December be able to more quickly vaccinate a further 20 million people under 60 with a single-injection vaccine; this is likely to offer lower protection than Pfizer's, but by that point the reduced mortality rate and emerging vaccine-induced herd immunity would make that less of a concern, and it will become important to return NHS resources to other healthcare. We could then have vaccinated close to everyone by the middle of 2022.

 

[AM9]

This feels like the sort of baseless doom-mongering that we've had to suffer throughout the last six months. This isn't some unknown mega virus, it's just another coronavirus. Given that SARS antibody responses last decades, it'd be very surprising if this wasn't the same.

Your assertion that "it's just another coronavirus", is a fair bit of baseless optimism, so there's no real justification in planning the nation's way forward on the basis of such wishful thinking.

 

[MikeWM]

Your also going to have the potential issue as to whether the current vaccine front runner will be available to some highly vulnerable groups, people with weakened immune systems frequently cannot have live vaccine types, only inactivated vaccine types of which flu is one.

You don't even need to be highly vulnerable. There are various immune system conditions that don't really affect normal life that nevertheless are contraindications for live vaccines. Selective IgA deficiency for example, which most people don't even know they have unless they donate or receive blood.

 

[AM9]

So back on topic to the pecking order of the under 50s.
So far there is suspicion that certain ethnic minorities have a heightened vulnerability to the effects of infection. Black African, Indian, Pakistani and Bangladeshi men have suffered higher hospital fatalities, and more serious consequences so they would appear to be a higher priority than the general population. Given that extended families are prevalent in their communities, that would also require that their close relatives would also need to be included. Given that many of this group are subject to greater exposure to infection in the occupations as well, this also requires that their case is carefully considered. This document is an in-depth analuysis of the whole ethnic issue: https://www.ifs.org.uk/inequality/w...COVID-19-than-others-V2-IFS-Briefing-Note.pdf
The document is too long to add enough quotes from it that tell the whole picture so it isn't practicable to insert them into a single post.

Conclusion

Taken together, Sections 1 and 2 of this report paint a complex picture, with much still unknown about the unequal effects of the COVID-19 crisis on different ethnic groups in England and Wales in the short term and in the future. Some minority groups have already been disproportionately exposed to risk of infection, and the ongoing sector shutdown also has implications for ethnic inequalities. There is no single narrative that can describe or account for the impacts of the current crisis on all minority groups.

Overall, given demographic and geographic profiles, most minority ethnic groups are suffering excess hospital fatalities in England. Official non-hospital deaths can only account for a small part of the disparity compared with the white British majority so far. Age and location clearly play a role – and seem to explain important differences between different minority groups – but they do not tell the full story. Underlying health conditions, occupational exposure and a range of other factorsare likely to be important, with some more important for particular groups: Bangladeshi men have high rates of underlying health problems, and black Africans and Indian men are particularly exposed to the virus due to their prevalence in healthcare roles. The importance of each factor for each group will become clearer as more research is undertaken.

Ethnic groups also vary substantially in their economic vulnerability under the restrictions currently in place. ‘Other white’ and Indian ethnic groups face lower economic risks and are more comparable to white British people in this regard.Bangladeshi and Pakistani groups, by contrast,appear to be particularly at risk due to the high percentage of each group working in shut-down sectors and/or in self-employment, combined with the prevalence of single-earner households which reduces the potential for income buffers within the household. The pervasiveness of key worker employment in other minority groups reduces their risk of income losses, while leaving them at a heightened risk of exposure to the virus itself. Both scenarios though are ,in part, a consequence of the way the current labour market draws on both immigrant and ethnic minority workers to fulfil roles in care, transport and delivery sectors and in the more marginal hospitality and self-employed sectors

 

[MattA7]

I believe some countries such as turkey had a plan to do the opposite (vaccinate the “young and healthy”) because older people and those with weakened immune system don’t respond to vaccination as well and effectively. That’s why over 65s receive a different flu vaccine from under 65s.

as someone under 65 with underlying health issues I suspect I would be no 6 or 7 on that list. Not that it matters as I would refuse it anyway.