I t has been reported that the head of government’s vaccine taskforce, Kate Bingham, has said that not everyone in the UK will be vaccinated against COVID-19.
Prof Eleanor Riley FMedSci, Professor of Immunology and Infectious Disease at the University of Edinburgh, said:
“This policy makes sense if the vaccines that are to be deployed are known to reduce the severity of Covid-19 but are not able to block infection or prevent transmission of the virus. If the vaccine is a disease modifying vaccine, then only those at risk of severe disease are really going to benefit. However, this does rely on being able to accurately identify those at high risk (which is easier now than it was at the beginning of the epidemic).
“This policy also does not take into account whether the vaccine might be able to reduce the likelihood that someone with relatively mild symptoms of acute Covid-19 might go on to develop post viral fatigue syndrome (one of the forms of so-called “long Covid”). It is not clear whether the current phase 3 vaccine trials are large enough to evaluate the impact of vaccination on long Covid.
“However, if the vaccines that are to be deployed are shown to also reduce transmission, then there is an argument for rolling out the vaccine more widely. Even so, this might not mean universal vaccination; the policy would need to be based on a much better understanding of exactly which groups within the population are responsible for most of the transmission. Nine months into the pandemic, this is still not well understood.”
Prof Martin Hibberd, Professor of Emerging Infectious Disease at the London School of Hygiene & Tropical Medicine, said:
“I am pleased to see a discussion opening up on how best to introduce a vaccine, if one becomes available. Any new SARS-CoV-2 vaccine is going to take a while to build up to large numbers of recipients and during this time it is right to think about how this early phase might be put to best use strategically.
“There have been a number of publications relating to this and of course it makes sense to try to protect those at most risk of COVID-19. However, we may need different strategies depending on the particular properties of any vaccine that becomes available. Some of the vaccines currently under trial may not be suitable for elderly people or those with reduced immune responses and it may be that alternative approaches – such as perhaps monoclonal antibodies (if they prove effective) may be more appropriate for these groups if there is no suitable vaccine for them.
“Alternative target groups might include key workers, but also perhaps those most likely to transmit the virus. I look forward to seeing some science being applied to the questions of how best to introduce a particular vaccine and an open discussion on the risks and benefits. This may also lead into a further discussion on what the vaccine is hoping to achieve, as, while we are hoping for the best, we are currently not expecting the first few vaccines that become available to completely eradicate SARS-CoV-2 transmission. We should start the discussion now, even if we might have to change our answers later when we see how the actual vaccine works.”
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Prof Riley: ‘no conflicts to declare’
Prof Hibberd: ‘I do not have any conflicts to declare.’