Thursday 26 November 2020

Day 255 of self-isolation - Who to vaccinate first?

Who to vaccinate first?

Vaccination will start in December, and, obviously, not everyone can be vaccinated at once. I'm very optimistic about how fast this can happen. As an example, I look at my own small town, Little Chalfont, population 6858.

So who will be able to do vaccinations? There is one doctor's surgery there, and one pharmacy. In addition, there is an optician and a hearing specialist. If each of those are able to offer one nurse to do vaccinations (I had a flu jab recently, and it really isn't difficult to do), and if it takes two minutes per jab (more like half a minute), and they work a 7 hour day, then that's 4*7*30 per day = 840 per day. So that's 8 days. 

Obviously, that's just one small town, but it does give a flavour of the size of the vaccination task, and that's why I think it doesn't look as immense as some people are saying.

But I'd like to think about the order in which people are offered vaccination. The current plan is to first vaccinate healthcare workers and people who work or live in care homes. That makes sense to me; the care homes have been decimated by Covid (decimated means one in ten are killed) and the NHS have been the front-line heroes who are exposed to the virus, but work hard nevertheless.

But after that? Government plans currently are to vaccinate age 80+, then 70+, and so on down the age cohorts. That makes sense because age is a major risk factor for Covid. But another major risk factor is skin tone. The darker your skin tone, the higher the risk.

This might be for socio-economic factors, or it might be vitamin D related. The US CDC said that hospitalization rates among non-Hispanic Black people and Hispanic or Latino people were both about 4.7 times the rate of non-Hispanic white people. 

So, whatever the reason, skin tone is a big risk factor. So shouldn't this be taken into account when deciding the priorities? 

And there are other known risk factors - asthma, diabetes, compromised immune system.

So then we get into a complex algorithm, which will be difficult for ordinary people to understand (and we all remember the unpopular algorithm for A level results).  And how to you measure skin tone, and whether someone has asthma, and to what degree?

The age-based system has the virtue of simplicity. It's easy to understand, and easy to apply. The NHS already has my age on record, so when I'm called, I shall answer. 

Soon, I hope.


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