Covid Vaccine Priority Groups

[Chris-Bromsgrove]

I was just wondering what people’s thoughts are on the government’s interim advice on priority groups for the Covid-19 vaccines (see link).

gov.uk/government/publicati...

Whilst priorities 1 and 2 do make complete sense, I am somewhat surprised that it appears those people who have been classified as clinically extremely vulnerable will now be re-classified as high risk and moderate risk and ranked 6th and 7th respectively in the priority list. However if you are over 65 that will move up the pecking order, dependent on which age bracket you fit into. This seems a major change of policy for the clinically extremely vulnerable who received letters in both March and now November telling them they are at risk and need to shield. It now appears from the ranking that they are lower priority than a healthy 65-year-old. Have I got this completely wrong or am I missing something?

[Nadine99]

Someone has to come first and last, I don't envy them making the decision

[gooseflight]

If the rollout is well-managed (jury's out on that one), things should happen quite quickly. It might almost make more sense to give the most mobile the vaccine first as they are more likely to pass it around.

Anyway aside from the when?, the other question is will it work? For those of us on immunosuppressive meds that eliminate B and T cells (e.g. rituximab) it may not and we may have to wait for alternative vaccines to come along.

[Chris-Bromsgrove in reply to gooseflight]

Yes, it is a bit difficult for those on Ritux. In the absence of an alternative vaccine maybe administering the current vaccines would need to be appropriately timed between infusions, when the immune system has sufficiently recovered. I believe my poison (Mycophenolate) does leave you with some B and T cells. I'm hoping it will be enough.

[amms43]

I also have MPA and I am on Rituximab and Prednisolone. Just from what I have heard on the television, I am wondering if we are unsuitable for the vaccines but may look to the other AstraZeneca discovery which is the injections ( not yet fully tested) of two sorts of antibodies. They were speaking of this solution - which is considerably more expensive - as suitable for people already sick with something else such as cancer or transplants and with suppressed immunity or on Rituximab or chemotherapy for immune suppression. This solution also gives immediate immunity without the four to six weeks wait for the vaccines to become fully active. I have a consultation at my clinic in about three weeks and thought I would inquire when I am there.

[Mooka]

Hi Chris

I’ve been scratching my head on this one too. Having been robbed of my immune system by rituximab I probably won’t get much protection from the vaccine so I’m not so bothered about being down the pecking order but cannot understand how the people who top that list aren’t being told to shield. At the moment I’m thinking it will be a case of which comes first the vaccine for the immune compromised or everyone around me having been vaccinated. I guess it’s all a waiting game.

[Chris-Bromsgrove in reply to Mooka]

One thing of relevance is we are all told to get the flu jab in autumn (at least I think we are). That would suggest there is sufficient of your immune system left to generate an immune response. Otherwise giving us the flu jab would serve little purpose. The main thing about the vaccine administration is to reach herd immunity as quickly as possible. The order of things is secondary priority. However as you point out, the priority list does call into question why all over 65's were not told to shield.

[Mooka in reply to Mooka]

Yes I’m always advised to get the flu jab but told it will provide limited help. I’ve asked my immunologist if I should have the COVID vaccine if and when one was found and was given the same response. Happily I have another immunology appointment next month so I will broach the subject again. Hopefully this vaccine will be the answer we are all hoping for and I’ll look forward to seeing if John can find an answer to your question.

[John_Mills Volunteer]

You have raised a very interesting question , I don’t know the answer but I may know a lady who does...I will get back to you Chris

[John_Mills Volunteer]

It is not yet known, the “exact” details about any vaccine and when it “may be available” and what the vaccination doses and scheduling will be for the immunosuppressed, for example. We do need clarification on this. I know how much everyone who has had to shield wants to get out and back to normal life.

We will endeavour to find some more answers out, it is a rapidly changing and evolving process.

We understand, from yesterday, that Matt Hancock has indicated that CEV individuals may be included in earlier vaccination waves but that this would be dictated by clinicians – We suspect there will be recommendations from the Royal College of Physicians, we do believe there are meetings scheduled over the next few weeks.