Updated guidance on COVID-19 jabs published by the joint committee on vaccination and immunisation (JCVI) sets out an 11-tier priority list for the rollout of vaccination against the SARS-CoV-2 virus.
The committee makes clear its advice could change based on factors such as how the virus is spreading at the time a vaccine becomes available, and how effective and well tolerated it is among high-risk older adults.
If the first vaccine available is not suitable for older patients, health and social care workers could become first in line. Draft advice published in June suggested health and care workers could be first in line along with at-risk patients.
The government's chief scientific officer Sir Patrick Vallance said on 21 September that some vaccine doses could become available before the end of 2020 - perhaps enough to cover some key at-risk groups - but that it was unlikely to be available in sufficient quantities to support a wider vaccination programme until the first half of 2021.
The 'interim ranking of priorities' set out by the JCVI combines 'clinical risk stratification and an age-based approach, which should optimise both targeting and deliverability'.
Under the proposed ranking, vaccines would be rolled out in the following order:
- older adults’ resident in a care home and care home workers
- all those 80 years of age and over and health and social care workers
- all those 75 years of age and over
- all those 70 years of age and over
- all those 65 years of age and over
- high-risk adults under 65 years of age
- moderate-risk adults under 65 years of age
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
- rest of the population (priority to be determined)
COVID-19 risk factors
The JCVI added that it continues to evaluate evidence on risk factors that could increase rates of serious disease and mortality from COVID-19 infection - highlighting that in addition to age and underlying conditions 'early signals have been identified of other potential risk factors, including deprivation and ethnicity'.
Its advice says that emerging evidence on additional risk in these groups could inform further changes to the priority list, warning that any COVID-19 vaccination programme 'will need to ensure every effort is made to get good coverage in black, Asian and minority ethnic groups, in areas of higher socio-economic deprivation, and in areas with outbreaks or high levels of community transmission'.
GPs could yet be asked to deliver a national COVID-19 vaccination programme if a vaccine becomes widely available later this year or in 2021. Implementing a vaccine to tackle the ongoing pandemic would add to already-soaring practice workload - and could come after a 2020 flu campaign that will aim to vaccinate more than 30m people.