Vaccine expert tells ministers: Stop boasting and get public onboard – The Guardian

Last Updated on December 4, 2020 by

Government ministers should stop politicising the Covid-19 vaccine by boasting about being the first to license it, the head of a leading research group has said.

Heidi Larson, the director of the London-based Vaccine Confidence Project (VCP), said the government should instead focus on building support for the jab or it will lose the confidence and trust of the British people.

“I don’t think it is in the interest of the government to be racing along without building the ground,” Larson said. “Unfortunately it feels like announcements are made more politically.

“The message – ‘We are the first ones in the world to get there’ – may be a message to other countries but that does not matter if you don’t have your public behind you.”

Heidi Larson.

Heidi Larson. Photograph: The Guardian

Larson, an anthropologist, said she did not think the British public were overtly against taking a Covid vaccine but, having announced the licensing of one, ministers needed to explain “what it will look like between now and April”.

“[We need] the longer term plan rather than bit-by-bit headline news. Telling the full story will be important.”

Now that the UK has authorised the first Covid vaccine, who will get it first?

The government’s Joint Committee on Vaccination and Immunisation (JCVI) says its priority is to prevent Covid-related deaths and protect health and social care staff and systems.

Elderly care home residents and their carers are first on the JCVI’s list because their risk of exposure to the virus is higher and because the risk of death closely correlates with older age. They are followed in priority by anyone else over 80 and frontline health and social care workers.

Even so, for pragmatic reasons NHS staff are likely to be the first group to receive the Pfizer/BioNTech jab. This is because the vaccine needs to be stored at ultra-cold temperatures, which can be achieved more easily by using hospital facilities

Are there enough doses to reach all the priority groups?

Together, care home residents, their carers and the over-80s make up nearly 6 million people, and frontline NHS staff a further 736,685. Matt Hancock, the health secretary, has said he expects 10m doses of the Pfizer/BioNTech vaccine to be available this year, so if this is the only vaccine authorised, everyone else would have to wait until further doses become available next year. 

Where will I go for the vaccine?

Covid-19 vaccines are expected to be delivered at three types of venue: NHS trust “vaccine hubs” at hospital sites; mass vaccination centres, which are in the process of being set up at places such as football stadiums, conference buildings and racecourses – these are expected to vaccinate up to 5,000 people a day; and at GP surgeries and pharmacies. GPs can also visit care home residents and housebound patients at home without them needing to travel.

How far apart will the two doses be administered, and will I protected after the first?

While there is some evidence to indicate high levels of short-term protection from a single dose of vaccine, a two-dose schedule is what has been approved by the MHRA.

The second dose will need to be delivered at least 21 days after the first, and both will be injected into the deltoid muscle – the thick triangular muscle we use to raise each arm.

For the Pfizer vaccine, its efficacy rate was calculated seven days after the second shot. It is likely that people will have some protection before this, but this is how long it will take for full protection to kick in. We will learn more about the extent of protection and how long it lasts as data from ongoing clinical trials comes in.

Can I pay to get the vaccine privately?

Unlikely. England’s deputy chief medical officer, Jonathan Van-Tam, has said he believes Covid-19 vaccines should be delivered according to clinical priority rather than allowing people to jump the queue if they can afford it.

Will I be able to choose which vaccine I have?

Also unlikely, at least in the short to medium term. Assuming more than one vaccine is approved, the priority will be distributing any available doses to the people who need it as quickly as possible.

Linda Geddes

The VCP was developed in response to hesitancy and misinformation about vaccination programmes, such as those that caused a boycott of polio eradication efforts in northern Nigeria in 2003–04.

Larson pointed out that while the UK had approval for emergency use of the vaccine, more regulation was needed before mass immunisation was possible. Only a small number of people were likely to be vaccinated in January, she said, and the plan beyond that “needs to be carefully” thought out.

There was a need to get out into communities, “hearing them, engaging with them and building that ground before vaccines are widely given. If we don’t do that it risks being a problem.”

Survey work done by the VCP about people’s feelings towards a vaccine was “a wakeup call to the public health community … we have some work to do to build confidence”, she said. But if the vaccine was delivered in the right way it could be a “huge opportunity” to build confidence in inoculation more broadly.

Larson said the UK was only at the beginning of the process of learning about the Covid vaccines. “We should make that as much a public-wide journey as possible and bring people along together, rather than deciding which bits of information are given from time to time.”

She noted there were logistical challenges around delivering mass vaccinations. She said: “Particularly the Pfizer one needs extremely cold refrigeration and the handling of it is not overcomeable but will require extraordinary logistical support and training up of those who will be handling it.”

Healthcare professionals also needed to be brought onboard, not just in terms of taking the vaccine but answering questions from members of the public.

Larson said all vaccines underwent extensive scrutiny and progress would be monitored “to make sure that people are safe”.

“No company or government has any interest in putting out a vaccine that is not safe enough. That is bad for business, bad for government and bad for the public. The public need to remember that, even if they hate big business, they have no interest in putting out a vaccine that will ruin their reputation. And no government wants to put something out to harm the voting public. I think there are some highly distrusting people who just distrust as the default.”

She said her message to government was to get out into, and listen to, communities, and use “every moment we have before we are ready to go widely with the vaccine”. And she warned against waiting and getting “lost in statistics”.

In terms of mandatory vaccination, Larson said she could not see the government adopting this approach, but proof of vaccination could be required for travelling to some places. “Certain countries, for example, now require you to get yellow fever vaccinations or they don’t let you into the country, some countries may add Covid to that.”

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