Vaccination Disparity Across the UK

[TravelDream]

I was chatting with an old school friend yesterday on Facebook, and he told me he had just been messaged to come in for his jab that afternoon.

I was a bit shocked as my LHB hasn't finished vaccinating people in their 50s yet. A family friend who is 51 has her first vaccine appointment on Tuesday.

He's 30 and lives in Powys in Mid Wales. I was just googling to see when I was likely to get my vaccine, and I saw this on Powys HB's website, 'Everyone aged 40 and over should have received their invitation by now, but if you have not received yours then please complete our Priority Access Form so that we can fast-track you to an appointment. Our reserve lists for first dose appointments help us fill cancellations and ensure no dose is wasted. They are currently open to people 30-39 (primary reserve list) and people 18-29 (secondary reserve list) for appointments in all three sites.'

Reserve Lists

pthb.nhs.wales

Why has this area invited everyone in their 40s for the jab - and seemingly has plenty to spare as it's inviting people aged 30 at lunchtime to go in for spares - when in other areas older people haven't received theirs yet? My LHB has a reserve list, but it's only for people aged 40-49.

I'm no expert on the roll-out in different areas, but is this common across the UK?

I'm a bit miffed tbh.

 

[Darandio]

Don't these vaccines come in huge batches that once opened need using within a certain timeframe. I believe they also cannot be transported elsewhere once the batch has been opened.

Surely this is just a case of offering them out to other groups so they aren't wasted?

 

[brad465]

A colleague in my town received his yesterday aged 31. At first I was surprised and asked if Maidstone was already that far ahead, but they revealed being asthmatic gave them priority in the under 50 rollout, even though I don't recall this being a national requirement/recommendation (I'm not suggesting they shouldn't have got it yet though).

 

[TravelDream]

Don't these vaccines come in huge batches that once opened need using within a certain timeframe. I believe they also cannot be transported elsewhere once the batch has been opened.

Surely this is just a case of offering them out to other groups so they aren't wasted?

I completely 100% understand that. I have nothing against reserve lists as they are totally sensible and no vaccine should be wasted even if it's given to an 18 year old in perfect health.

What I don't understand is why some areas are so far ahead in vaccinating people compared to others. Why in my LHB they haven't yet finished vaccinating people in their 50s whilst in the neighbouring LHB they've finished with people in their 50s and everyone in their 40s has been invited for their jab.

I also don't get why an 18 year old can go on the reserve list in their LHB whilst a 39 year old can't in mine.

 

[kieron]

I completely 100% understand that. I have nothing against reserve lists as they are totally sensible and no vaccine should be wasted even if it's given to an 18 year old in perfect health.

What I don't understand is why some areas are so far ahead in vaccinating people compared to others. Why in my LHB they haven't yet finished vaccinating people in their 50s whilst in the neighbouring LHB they've finished with people in their 50s and everyone in their 40s has been invited for their jab.

I also don't get why an 18 year old can go on the reserve list in their LHB whilst a 39 year old can't in mine.

Maybe they have a larger reserve list? The Powys HB covers a small population across a large area. Finding enough people in and around Builth Wells to use up a vaccine delivery may not that easy.

There's a report here which covers vaccination in different health boards. The proportion of 50+ people who had had a first dose by 4/4 (on page 14) varies between health boards from 84.8% to 92.1%, with Powys at 91.8%. Some places are ahead, but the figures from 3/3 (the next most recent I have) are 54.9% and 62.2%.

If this sort of progress is maintained (and is replicated wherever you are), your local health board should soon catch up.

 

[yorksrob]

It is frustrating. Not a whisper around here. Seems to be a case of so near, yet so far.

 

[nlogax]

A colleague in my town received his yesterday aged 31. At first I was surprised and asked if Maidstone was already that far ahead, but they revealed being asthmatic gave them priority in the under 50 rollout, even though I don't recall this being a national requirement/recommendation (I'm not suggesting they shouldn't have got it yet though).

If anything it sounds like your friend may have been a bit late to the vaccine party. I'm a few years under fifty and had my first jab a month ago.

Asthma UK states:

• If you were sent a shielding letter, you will be in priority group 4.
• If you have ever had an emergency hospital admission for your asthma, or ever been prescribed three courses of steroid tablets in a three-month period, you will fall into priority group 6.
• If you do not fall into either of these groups and are under the age of 50, you will be vaccinated after the first nine priority groups.

 

[WelshBluebird]

I think there's a few different things going on here.

• Different areas have different proportions of their population in the different age groups / risk categories. So if area A has a smaller elderly population than area B, then they will get to younger people quicker (assuming the vaccine is disrupted evenly to each area). Maybe you could argue there should be better planning on where the vaccine doses go to try to even this out but I suspect this would just add complications to the rollout that would cost time / money.
• Some people are in the higher risk categories without knowing it and so will get the vaccine earlier than what they expected (the higher risk groups aren't just the obvious - it is also based on things like weight, or certain bits of your medical history that may well be long forgotten).
• Some areas do seem to have had some anomalies (one of my work colleagues has had it and the GP couldn't explain why he had been invited!).
• And to be blunt, some areas have just done a better job!

 

[Bantamzen]

I think there's a few different things going on here.

• Different areas have different proportions of their population in the different age groups / risk categories. So if area A has a smaller elderly population than area B, then they will get to younger people quicker (assuming the vaccine is disrupted evenly to each area). Maybe you could argue there should be better planning on where the vaccine doses go to try to even this out but I suspect this would just add complications to the rollout that would cost time / money.
• Some people are in the higher risk categories without knowing it and so will get the vaccine earlier than what they expected (the higher risk groups aren't just the obvious - it is also based on things like weight, or certain bits of your medical history that may well be long forgotten).
• Some areas do seem to have had some anomalies (one of my work colleagues has had it and the GP couldn't explain why he had been invited!).
• And to be blunt, some areas have just done a better job!

I think that's a fair summary. Every area will have a different demographical spread, so differences will be driven in part from these. Plus density of services will impact, where there are more GP surgeries, hospitals, pop-up centres and even pharmacies, so there will be more capacity to vaccinate. But yes the biggest driver will be efficiency of the organisation.

For example, at the pop-up centre I used in Bradford (there are 2 in the city centre alone), the process was so streamlined that me turning up 40 minutes early was no issue. So I turned up, registered and was ushered into the queue for the jab. Within 10 minutes of arriving on site, I was on my way back out. And they were handling hundreds whilst I was there, a seriously impressive, efficient, and even friendly setup. I was seriously impressed.

 

[cuccir]

It's perhaps not surprsing that the early-vaccination you're hearing about is from Wales. The ElectionMapsUK Twitter feed collates together and shares a daily graph and table of national-level vaccination rates and it does look quite different by UK nation:

VacciNation Table (Doses per 100 adults)
Wales: 83.2 (+1.3)
England: 75.1 (+1.1)
Scotland: 72.8 (+0.7)
N. Ireland: 69.8 (+0.8)
UK-wide: 75.2 (+1.2)

Wales is quite well ahead of the rest of the country, with the other three nations more closely positioned together. That seperation happened in early March when Wales seemed to have a bigger uptick than the rest of the UK.

Within England, NHS England provide a weekly report which has data by English region, parliament constituency and MSOA. There's a lot of data in there and I'm not inclined to explore differneces by the smaller scales as there isn't a simple 'doses by location' table anywhere. But I've dived into a few different worksheets to get this chart together from the most recent release, which counted vaccinations done up to the 4th April (hence this table shows lower numbers than those quoted above)

NHS Region of Residence	Cumulative Total Doses to Date	Population estimates (over 16)	Doses per 100
South West	3,449,289	4,637,878	74.37​
North East And Yorkshire	4,978,595	7,002,063	71.10​
South East	5,080,789	7,195,535	70.61​
East Of England	3,695,561	5,250,122	70.39​
North West	3,984,162	5,702,409	69.87​
Midlands	5,944,876	8,563,867	69.42​
London	3,774,843	7,118,408	53.03​

Small differences of 1-2% I'd not read a lot into as these are based on population estimates which will have some margin of error, and people may take vaccinations in regions that they don't live in (ie someone might reasonably travel from Chesterfield in the Midlands to a vacciantion centre in Sheffield in Yorkshire, etc).

The only signficiant disparity is London v the rest, with the South-West having a little lead too. Some of this will be about age: the South West is older and that probably accounts for most of its lead.

In terms of London, it is younger than the rest of the country, and we also know that vaccine hesistancy is higher amongst most ethnic minorities and immigrants. There has been some reporting that a lot of people have left London since 2019, either permanently or to live with family/second homes in rural locaitons during the lockdowns. We know that early in the vaccination process there were issues with London receiving fewer vaccine doses to distribute too, but I don't know the extent to which that comes into play once you account for those 'external' factors.

 

[hwl]

I think there's a few different things going on here.

• Different areas have different proportions of their population in the different age groups / risk categories. So if area A has a smaller elderly population than area B, then they will get to younger people quicker (assuming the vaccine is disrupted evenly to each area). Maybe you could argue there should be better planning on where the vaccine doses go to try to even this out but I suspect this would just add complications to the rollout that would cost time / money.
• Some people are in the higher risk categories without knowing it and so will get the vaccine earlier than what they expected (the higher risk groups aren't just the obvious - it is also based on things like weight, or certain bits of your medical history that may well be long forgotten).
• Some areas do seem to have had some anomalies (one of my work colleagues has had it and the GP couldn't explain why he had been invited!).
• And to be blunt, some areas have just done a better job!

It worth adding that they used the ONS summer 2019 population estimates for each area for vaccination planning. Which were essentially updates of census 2011. If the Census 2011 data was less complete and /or there have been major changes that haven't been picked up on with good quality data since (both happening typically in large urban areas /conurbations), hence London and some other big cities are way behind (it isn't age related demographics, lots of the younger people are registered with GPs so that method of checking numbers have helped the under counting).

Some areas have managed 102% vaccination levels in older age groups because they don't have an accurate idea how many in the area are in an age group.

There will be some revisiting of the vaccination stats in few months time

 

[TPO]

I was chatting with an old school friend yesterday on Facebook, and he told me he had just been messaged to come in for his jab that afternoon.

I was a bit shocked as my LHB hasn't finished vaccinating people in their 50s yet. A family friend who is 51 has her first vaccine appointment on Tuesday.

He's 30 and lives in Powys in Mid Wales. I was just googling to see when I was likely to get my vaccine, and I saw this on Powys HB's website, 'Everyone aged 40 and over should have received their invitation by now, but if you have not received yours then please complete our Priority Access Form so that we can fast-track you to an appointment. Our reserve lists for first dose appointments help us fill cancellations and ensure no dose is wasted. They are currently open to people 30-39 (primary reserve list) and people 18-29 (secondary reserve list) for appointments in all three sites.'

Reserve Lists

pthb.nhs.wales

Why has this area invited everyone in their 40s for the jab - and seemingly has plenty to spare as it's inviting people aged 30 at lunchtime to go in for spares - when in other areas older people haven't received theirs yet? My LHB has a reserve list, but it's only for people aged 40-49.

I'm no expert on the roll-out in different areas, but is this common across the UK?

I'm a bit miffed tbh.

According to an article I saw on t'interweb (cannot remember where, sorry), Wales started inviting the 40-49 age group for the first jab a couple of weeks ago, I think it's now up to 40% of that group covered across Wales and I think Powys is the LA furthest ahead within Wales.

 

[DelayRepay]

I wonder if, now we have dealt with the over 50s, whether there should be a slightly different approach to allocating vaccines?

Would it make sense to focus resources on those areas which currently have high case numbers - which generally seem to be linked to either housing density or the type of employment in the area? Vaccine supplies and vaccinators could be moved to the areas involved. Vaccinating a 40 year old in, say, Mansfield, where case numbers are high, seems more likely to help break chains of transmission than vaccinating a similar person in an area with low case numbers. I guess this is a similar concept to local lockdowns, but using vaccination to control spread instead of restrictions.

One of the scientists today has suggested trying to create a 'ring of steel' around Lambeth using the vaccines, to try to contain any outbreak of the South African variant. I am not sure if this would work, or would be practical, but it's worthy of consideration I think.

I am not sure how practical either of these suggestions would be, but to me it makes more sense to prioritise the vaccines to areas where they will do the most good in the short term, rather than vaccinating healthy 40 year olds in areas of low risk.

Of course, this would not be palatable to those healthy 40 year olds if vaccine certificates were introduced in the mean time.

 

[Bantamzen]

I wonder if, now we have dealt with the over 50s, whether there should be a slightly different approach to allocating vaccines?

Would it make sense to focus resources on those areas which currently have high case numbers - which generally seem to be linked to either housing density or the type of employment in the area? Vaccine supplies and vaccinators could be moved to the areas involved. Vaccinating a 40 year old in, say, Mansfield, where case numbers are high, seems more likely to help break chains of transmission than vaccinating a similar person in an area with low case numbers. I guess this is a similar concept to local lockdowns, but using vaccination to control spread instead of restrictions.

One of the scientists today has suggested trying to create a 'ring of steel' around Lambeth using the vaccines, to try to contain any outbreak of the South African variant. I am not sure if this would work, or would be practical, but it's worthy of consideration I think.

I am not sure how practical either of these suggestions would be, but to me it makes more sense to prioritise the vaccines to areas where they will do the most good in the short term, rather than vaccinating healthy 40 year olds in areas of low risk.

Of course, this would not be palatable to those healthy 40 year olds if vaccine certificates were introduced in the mean time.

If you were to go for a more area targeted approach, vaccine passports would have to be shelved (as they should be anyway). Can you image people being barred from events / holidays etc simply because of their postcode?

 

[TravelDream]

If you were to go for a more area targeted approach, vaccine passports would have to be shelved (as they should be anyway). Can you image people being barred from events / holidays etc simply because of their postcode?

They already could be.
We know that some parts of the country are far ahead of others in their vaccine rollout.

 

[Huntergreed]

If you were to go for a more area targeted approach, vaccine passports would have to be shelved (as they should be anyway). Can you image people being barred from events / holidays etc simply because of their postcode?

It’s happening now (I can’t go to England and stay down there simply because of my postcode), and certainly in Scotland, the idea is to return to the “levels” system with local lockdowns where cases are high, so it’s certainly going to happen to some degree, the question is to what extent, and we can only hope that it will be as minimal as possible.

 

[cuccir]

They already could be.
We know that some parts of the country are far ahead of others in their vaccine rollout.

Not that I am in favour of vaccine passports, but even if they were to be implemented, I don't suppose that it would be before the 21st June. The window in which there'd be passports and people who had had no chance to be vaccinated would be very very short - a matter of weeks, given that we remain on track to offer a vaccination to all adults by the end of July. It'd be easy enough to bring them in but hold them off by a month until everyone had had a chance to be vaccinated if they wanted it. There are many very good reasons to not introduce vaccine passports but this one is a bit of a red herring for me.

 

[Huntergreed]

Not that I am in favour of vaccine passports, but even if they were to be implemented, I don't suppose that it would be before the 21st June. The window in which there'd be passports and people who had had no chance to be vaccinated would be very very short - a matter of weeks, given that we remain on track to offer a vaccination to all adults by the end of July. It'd be easy enough to bring them in but hold them off by a month until everyone had had a chance to be vaccinated if they wanted it. There are many very good reasons to not introduce vaccine passports but this one is a bit of a red herring for me.

Unless it’s “two doses” required for the passport, in which case the point still stands.

 

[Bantamzen]

They already could be.
We know that some parts of the country are far ahead of others in their vaccine rollout.

It’s happening now (I can’t go to England and stay down there simply because of my postcode), and certainly in Scotland, the idea is to return to the “levels” system with local lockdowns where cases are high, so it’s certainly going to happen to some degree, the question is to what extent, and we can only hope that it will be as minimal as possible.

But as things stand nobody is being excluded from day to day activities as a result. If a vaccine passport came into being, there would be a risk that they would.

 

[P Binnersley]

My local council's COVID Dashboard (vaccination tab) shows 26% of 16+ to 49 vaccinated (at 4th April), this varies from 41% near the hospital to 7% near the Universities where most of the students are probably still studying from home. The overall rate is 55% which is above the national average.

Infection rates which were above the national average are now just below with the remaining hot-spots seeming to be in low vaccination uptake areas.

You can get the number of vaccinations in your area at NHS England - Vaccinations, but this only gives totals, not percentages.

 

[cuccir]

As a new dataset has come out I thought I'd update it here - if people find it interesting! I've added in the non-England figures too for comparison, but note that these are vaccines as to the 11th April in England and 10th April elsewhere in UK. These figures are a little behind current headlines because the regional breakdown is only published weekly based on fully processed data.

NHS Region of Residence	Doses per 100	Change (week on week)
Wales	83.2	6.4
South West	79.5	5.1
East Of England	76.9	6.5
North East And Yorkshire	76.8	5.7
North West	75.8	5.9
South East	75.6	5.0
Midlands	74.6	5.2
Scotland	72.8	5.0
Northern Ireland	69.8	5.1
London	57.3	4.2

Interestingly, it suggests that the London v Elsewhere disparity is continuing to grow! This period covers the 7 days which include the Easter Bank Holiday and I think that was pretty much the low point in the April slump in numbers - we're already seeing vaccination rates starting to climb.

 

[DelayRepay]

Interestingly, it suggests that the London v Elsewhere disparity is continuing to grow! This period covers the 7 days which include the Easter Bank Holiday and I think that was pretty much the low point in the April slump in numbers - we're already seeing vaccination rates starting to climb.

Thanks for posting.

The disparity in London is interesting. I wonder whether this is because of vaccine hesitancy, a generally younger population or a lack of capacity?

If it's down to capacity, I would support resources being re-prioritised from other areas.

If vaccine stocks allowed, the sites currently being used for surge testing in South London would probably be more effective operating as mass vaccine centres.

The cynic in me wonders if the surge testing programme in parts of London is partly designed to scare encourage people to be vaccinated as a way of addressing vaccine hesitancy?

 

[Domh245]

Thanks for posting.

The disparity in London is interesting. I wonder whether this is because of vaccine hesitancy, a generally younger population or a lack of capacity?

If it's down to capacity, I would support resources being re-prioritised from other areas.

If vaccine stocks allowed, the sites currently being used for surge testing in South London would probably be more effective operating as mass vaccine centres.

The cynic in me wonders if the surge testing programme in parts of London is partly designed to scare encourage people to be vaccinated as a way of addressing vaccine hesitancy?

A bit of both. London's received fewer vaccines than most other areas as it has fewer people in groups 1-9. However, uptake amongst those eligible in London has been lower:

https://twitter.com/ThatRyanChap/status/1382685342071947265

East of England. 96%
London. 86.7%
Midlands. 95.5%
NE&Yorks. 95.7%
North West. 94.9%
South East. 96%
South West. 96.9%

 

[Butts]

When I had my first jab in Scotland I was just given some leaflets about the possible side effects.

My ex-wife had hers in England and she was given a card with the date of inoculation , batch etc, and the date for her second dose on. This seems a more sensible approach as it gives you documentary evidence of having had the jab/jabs.

Guess I will have to wait for the Blue Envelope to drop through the door again for my second jab.

I'm just a little concerned how in my area of Scotland they will be able to issue Vaccination Passports for Foreign Travel and more importantly how quickly.

Unlike her, apart form my appointment letter, I have no documentary evidence like she has to prove vaccination.

 

[eMeS]

When I had my first jab in Scotland I was just given some leaflets about the possible side effects.

My ex-wife had hers in England and she was given a card with the date of inoculation , batch etc, and the date for her second dose on. This seems a more sensible approach as it gives you documentary evidence of having had the jab/jabs.

Guess I will have to wait for the Blue Envelope to drop through the door again for my second jab.

I'm just a little concerned how in my area of Scotland they will be able to issue Vaccination Passports for Foreign Travel and more importantly how quickly.

Unlike her, apart form my appointment letter, I have no documentary evidence like she has to prove vaccination.

I'm in Milton Keynes, and being over 80 had my first jab last December, when I was given a 4 page "fact sheet" listing side effects, but these didn't include the very relaxed state* I was in the next day after the jab. Later when I had my 2nd jab, I was given a card listing the two jabs (both Pfizer), and their batch numbers. *So very relaxed that I made a formal report just in case my post heart-attack medication was part of the problem.

 

[Gloster]

I live on the Isle of Wight, turned 61 at the end of last month and received my invitation at the beginning of last month. This seemed to be a bit later than many I know off the island and I wonder if it is due to the island’s higher than average age profile, possibly complicated by the transport logistics.

(I haven’t booked yet as I got Covid within a day or two of receiving my invitation and am waiting until I feel well enough to cope with any side-effects.)

 

[cuccir]

I live on the Isle of Wight, turned 61 at the end of last month and received my invitation at the beginning of last month. This seemed to be a bit later than many I know off the island and I wonder if it is due to the island’s higher than average age profile, possibly complicated by the transport logistics.

(I haven’t booked yet as I got Covid within a day or two of receiving my invitation and am waiting until I feel well enough to cope with any side-effects.)

The NHS England data includes a tab collating vaccines by parliamentary constituency, so it's very easy to find the data for the Isle of Wight!

As of 11th April, 88,348 people had been vaccinated on the Isle of Wight. ONS population estimate of over 16s is 125,633, which gives a vaccine rate of 70.3 per 100 people. That is a bit lower than the rate in the South East (75.6), but this is made more notable by the Isle's older population - 34% are over 60 compared to 23% in England and Wales as a whole. With that data it must be significantly far behind the rest of England.

PS - I hope you're on your way to recovery!

--
Update, atuomerged by the fourm:


Data release of 22nd April, shows the real speed up that started through April. Note the jump Northern Ireland which has caught up the slight gap it had on English regions. The data I could find is as of 18th April in England and 20th in Scot/Wal/NI, so the higher weekly levels in Scotland and Wales are not as significant as they appear.

London continues to fall further behind!

NHS Region of Residence	Doses per 100	Change
Wales	92.5​	9.3​
South West	86.5​	7.0​
East Of England	83.3​	6.4​
North East And Yorkshire	82.8​	6.0​
North West	82.2​	6.4​
Scotland	82.1​	9.3​
Northern Ireland	81.9​	12.1​
South East	81.8​	6.2​
Midlands	80.7​	6.1​
London	62.9​	5.6​