COVID-19 vaccine gap threatens rise in inequality and GP workload as restrictions ease

Significant gaps in COVID-19 vaccination rates between areas could increase health inequality as the government eases pandemic restrictions and drive up GP workload in underdoctored areas.

COVID-19 vaccine (Photo: Catherine Falls Commercial/Getty Images)
COVID-19 vaccine (Photo: Catherine Falls Commercial/Getty Images)

GPonline reported last month that in some CCG areas, as many as 84% of all people aged over 40 had received two doses of COVID-19 vaccine by 13 June, while in other areas just over seven in 10 people aged over 40 had received a single dose of vaccine - and only just over half had received both doses.

Further analysis by this website shows that of the 10% most deprived areas in England, around a third are in the 10 CCG areas with the lowest vaccination rates - while for the 10% least deprived areas, less than one in 10 fall into areas with low vaccination rates.

The findings come as a Health Foundation report this week reported 'emerging differences in access to and uptake of' COVID-19 vaccination. The report found that in the least deprived fifth of areas 95% of people aged 50 and older have received one dose, compared with 88% in the poorest.

Vaccination gap

It also found that '67% of black Caribbean people and 78% of Pakistani people older than 50 have received one dose compared with 94% of white people' - warning that these gaps 'threaten to exacerbate existing health inequalities'.

Numbers of GPs are in decline across the board in England - with 10% fewer fully-qualified full-time equivalent GPs in March this year compared with five years earlier. But in deprived areas, GP numbers are even lower - with practices in those areas caring for 10% more patients per GP on average with 7% less funding.

The government has admitted that numbers of COVID-19 cases could nearly double to 50,000 per day by 19 July when it plans to relax pandemic restrictions - and that cases could rise further to as many as 100,000.

Health and social care secretary Sajid Javid said this week that vaccination was building 'a wall of protection against hospitalisations' - but official figures show that cases of COVID-19 are rising fast across the UK and that hospitalisations are also increasing.

COVID-19 cases

A total of 186,422 new cases of COVID-19 were reported in the seven days to 6 July, around 50% up from the previous week - and 2,092 patients were admitted to hospital in the past week, a figure up by about a third in the past fortnight.

The gap in vaccination coverage suggests that as rules are relaxed, the exponential rise in cases predicted by the government could hit deprived areas far harder.

The Health Foundation report showed that these areas have already been hit hardest by the pandemic to date, warning that 'COVID-19 mortality rates were more than twice as high for people from the most deprived 10% of local areas compared with people from the least deprived'.

In addition to deepening health inequality, a disproportionate impact of COVID-19 after rules are relaxed could drive up pressure on practices in some of the areas most likely already to be struggling with low GP numbers.

The BMA has questioned government plans to ease restrictions and warned that a sharp rise in cases could threaten efforts to work through the NHS backlog - a factor that has driven up pressure on primary care as practices manage patients facing long waits for hospital treatment.

BMA chair Dr Chaand Nagpaul said this week: 'The NHS is already under immense pressure trying to cope with an unprecedented backlog of care. While admittedly the link between hospitalisations and deaths has weakened, it has not been broken and we now have twice as many people in hospital and on ventilators compared to a month ago. Even modest rises in patients being admitted to hospital will undermine our ability to treat the record 5m patients waiting for treatment.

'Worryingly, approximately one in 10 people who contract the virus will have symptoms of long COVID, with an estimated 2m people having been ill for more than 12 weeks. This is having a frightening long-term impact on health and wellbeing, wrecking the lives of many.'

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