Second-phase COVID-19 vaccine rollout maintains prioritisation by age

The Joint Committee on Vaccination and Immunisation (JCVI) has published advice on rolling out COVID-19 vaccination beyond the initial nine priority cohorts - with jabs to continue to be targeted by age.

The JCVI said it had considered options including prioritising vaccination of occupational groups at higher risk of exposure, protection for those at higher risk 'including groups associated with an increased risk' and targeted vaccination within the population to drive down COVID-19 transmission.

The committee found, however, that more targeted approaches would be more complex to deliver and require extremely high uptake among the target groups to be effective - and concluded ultimately that 'an age-based delivery model will facilitate rapid vaccine deployment'.

The JCVI said: 'There is good evidence that the risks of hospitalisation and critical care admission from COVID-19 increase with age, and that in occupations where the risk of exposure to SARS-CoV2 is potentially higher, persons of older age are also those at highest risk of severe outcomes from COVID-19.

COVID-19 vaccination scheme

'JCVI therefore advises that the offer of vaccination during phase 2 is age-based starting with the oldest adults first and proceeding in the following order:

  • all those aged 40 to 49 years,
  • all those aged 30 to 39 years,
  • all those aged 18 to 29 years.'

A UK government spokesperson said: 'The independent JCVI has today published its interim advice for phase two of the COVID-19 vaccination programme, setting out that the most effective way to minimise hospitalisations and deaths is to continue to prioritise people by age.

'This is because age is assessed to be the strongest factor linked to mortality, morbidity and hospitalisations, and because the speed of delivery is crucial as we provide more people with protection from COVID-19.

JCVI priority groups

“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.'

In background information explaining its stance, the JCVI added: 'There is evidence that some occupations have an increased risk of morbidity due to COVID-19 and that males aged 40 to 49 years are more likely to be employed in these occupations.

'A mass vaccination strategy centred specifically on occupational groups would be more complex to deliver and may require new vaccine deployment structures which would slow down vaccine delivery to the population as a whole, leaving some individuals unvaccinated for longer. Operationally, simple and easy-to-deliver programmes are critical for rapid deployment and high vaccine uptake.'

It added: 'Data indicate that in individuals aged 18 to 49 years there is an increased risk of hospitalisation in males, those who are in certain black, Asian or ethnic minority (BAME) communities, those with a BMI of 30 or more (obese/morbidly obese), and those experiencing socio-economic deprivation.

'JCVI strongly advises that individuals in these groups promptly take up the offer of vaccination when they are offered, and that deployment teams should utilise the experience and understanding of local health systems and demographics, combined with clear communications and outreach activity to promote vaccination in these groups.

'Unvaccinated individuals who are at increased risk of severe outcomes from COVID-19 on account of their occupation, male sex, obesity or ethnic background are likely to be vaccinated most rapidly by an operationally simple vaccine strategy.'

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