Looks like if you're under 50 with 'moderate' asthma, you're not getting the vaccine

[denfit]

Since March, if you take a daily steroid inhaler (e.g. Symbicort), but you don't take steroid tablets (e.g. Montelukast), then you have been in the 'moderate' risk group and are clinically vulnerable instead of clinically extremely vulnerable.

So far so good, right?

Well the latest vaccine priority groups have chucked moderate asthmatics completely off the list for vaccination!

Link here. You only get a vaccine in priority group 6 if you take systemic steroids. Which a daily steroid inhaler isn't.

Unbelievable.

I dont think this is true from.what I have seen in the news.

They need around 80% of the population to be vaccinated for herd immunity so basically everyone will be offered at some point.

There isnt enough to vaccinate everyone next year so people will have to wait their turn based on most vulnerable needs first.

That isnt the same as being excluded.

This document doesn't make it clear whether all adults will eventually be vaccinated, with the list simply showing who is the priority, or whether any one not on the list will not be vaccinated.

@MoirasRoses

I thought Asthma sufferers didn’t fair any worse with Covid than none suffers? I’ve got asthma & my doctors always told me that luckily for me, I’m no higher risk than anyone else. 🤷🏼‍♀️ I think as times gone on, they are much more aware of the high risk groups & it seems to be the more vascular illness rather than lungs!

I suppose the steroid taking lowers the immune system a bit..

This.

And, since it's been discovered that steroids are a treatment for Covid, there's potentially a lower risk. Certainly lower then diabetes, hypertension, cardiovascular conditions, and obesity.

I read of another potential treatment today. An inhaled steroid that's used for asthma and COPD.

More concerning than OP's issue, is that the cutoff is 50. The risk starts to increase at 40-45. 'There have been few deaths under 40' is often reported.

@SheepandCow

More concerning than OP's issue, is that the cutoff is 50. The risk starts to increase at 40-45. 'There have been few deaths under 40' is often reported.

Yes, it doesn't make it clear whether the list is just for initial prioritisation, and after those people have been vaccinated, all other adults will be. Or whether any adults under 50 without any of the health issues listed can expect not to be offered a vaccine.

As you say the risk increases from 40, but also younger people are at risk of Long Covid and ongoing damage from what I understand. And if the vaccines do stop transmission, herd immunity would have no chance of being reached. Ultimately it just doesn't seem sensible to leave a whole swathe of the adult population unvaccinated.

However it really isn't clear what is meant. On the actual Government website it does give the last group as:

'rest of the population (priority to be determined)'

Yes that's exactly it.

It's right that the most vulnerable to death should be vaccinated first, but after that we need to roll it out to younger groups.

Weren't there reports a while back about women in their 30s being hospitalised?

They might be at lower risk of dying, but we don't want to see large numbers of people suffering from disabling Long Covid.

The plan is for everyone over 18 to get vaccinated at some point but realistically that won’t be until late next year or 2022 as the most vulnerable in poorer countries need to be prioritised over the general population in the UK. It would be incredibly selfish of us to take it all for ourselves. The priority list is set to cover those who are most vulnerable and need it first. Not everyone can be on that list, there simply isn’t enough vaccine. In an ideal world over 40s would also be vaccinated in the first load but again there isn’t enough for that and they will have to wait until there’s enough for the worlds general population. We need to get back to normal, we need to vaccinate those defined as most vulnerable first, that list has been created by scientists.

@Racoonworld

The plan is for everyone over 18 to get vaccinated at some point but realistically that won’t be until late next year or 2022 as the most vulnerable in poorer countries need to be prioritised over the general population in the UK. It would be incredibly selfish of us to take it all for ourselves. The priority list is set to cover those who are most vulnerable and need it first. Not everyone can be on that list, there simply isn’t enough vaccine. In an ideal world over 40s would also be vaccinated in the first load but again there isn’t enough for that and they will have to wait until there’s enough for the worlds general population. We need to get back to normal, we need to vaccinate those defined as most vulnerable first, that list has been created by scientists.

No, the plan is for everyone over 18 to be vaccinated by the middle of 2021. The government has ordered more than 300 million doses.

This came as a bit of a blow for me. I'm on sybicort and have been holding onto the fact that I'll be in group 6.

I still will be, just means I've got to phone my GP and have an embarrassing conversation about my BMI which is over 40 but not according to their records as I haven't been weighed there for years 😅

From studies I’ve read there is no link between asthma and increased risk of covid-19.

They need around 80% of the population to be vaccinated for herd immunity so basically everyone will be offered at some point.

It is very unlikely any of the current batch of vaccine candidates will provide herd immunity. Most vaccines don't provide sterilising immunity, which is why we only get relatively few childhood vaccinations (the ones that do). The current generation of covid vaccines are being assessed for disease modification, there are no results yet indicating lasting immunity.

Covid 19 itself doesn't give immunity to covid 19 in all cases, and when it does it's likely for no more than 2-18 months varying by the individual. Other coronaviruses don't provide cross immunity to each other. I hope one day we will develop sterilising immunity to Covid 19 but it's likely to be difficult.

No, the plan is for everyone over 18 to be vaccinated by the middle of 2021. The government has ordered more than 300 million doses.

Do you have a source for this? It seems a colossal waste to me and I can't see how it's doable by summer 2021.

Do you mean the 300M doses of the various vaccine candidates? There are only 70M people in the UK but the government paid advances on all the likely candidates so it would be first in the queue for which ever one worked. IIRC we only have 5M doses on order of the best one and 30M of the (hard to distribute) pfizer one.

I think under 60 asthmatics who have been defined as clinically vulnerable should get the vaccine ahead of under 60s who are not clinically vulnerable, yes.

Could I clarify, are you:

a) Speaking on behalf of SAGE, NHS England or perhaps NIHCE and describing the Consensus position? If so, why are the government ignoring you?

b) An independent specialist? Could you explain a bit about your qualifications in immunology, epidemiology, virology and thoracic medicine? I'm trying to understand whether you are coming at this primarily from the PoV of the population data or the inflammation response in individuals.

c) Completely unqualified?

I have to say, as an asthmatic biochemist, my opinion is that the qualified specialists who have spent many months on this should decide.

Well, we aren't really supposed to flaunt our qualifications on the interweb. But I think it is more complicated than the categories imply. I think ECV teachers should be a relatively high priority for example.

I think there are multiple issues but 2 major issues are

1 .risk if infected, so yes the elderly are very high priority but also

2. exposure, which is why it's important to vaccinate NHS staff. ECV people in non NHS key roles really do need to be considered for early vaccines.

I'm not a teacher by the way, I am NHS and ECV but on a break. I will go back if possible to NHS work (a shortage speciality) after being vaccinated. On one level, I would also be only too happy to pay for a vaccine, if only the cost were a consideration, but that opens another can of worms; and I wouldn't want to queue jump.

A new priority list has been issued:

I think ECV teachers should be a relatively high priority

The CEV are now priority 4 and will be done at the same time as 70yos

I think under 60 asthmatics who have been defined as clinically vulnerable should get the vaccine ahead of under 60s who are not clinically vulnerable, yes

They will. They remain category 6 and will be done after over 65yos and before 60yos. So the government does agree with you

@UnmentionedElephantDildo

A new priority list has been issued:

I think ECV teachers should be a relatively high priority

The CEV are now priority 4 and will be done at the same time as 70yos

I think under 60 asthmatics who have been defined as clinically vulnerable should get the vaccine ahead of under 60s who are not clinically vulnerable, yes

They will. They remain category 6 and will be done after over 65yos and before 60yos. So the government does agree with you

The government do not agree with me. Read the definition in the link. It has changed. Moderate asthmatics are no longer on the priority list to receive the vaccine.

To a PP; I do have a PhD, so I’m not thick

Those with the most severe asthma are classed as CEV and will be in category 4

Those with moderately severe asthma are classed as CV and will be in category 6 - note that was the category I was explicitly referencing

Other people with milder asthma (not falling in to either vulnerable category) will be immunised according to their age.

There has been no info on whether there will be any prioritisation for the remaining u50s (eg by occupation, or cohabitation with vulnerable people)

@Lurkingforawhile

I’m very confused now - aren’t those in table 3 CEVs anyway who would get the vaccine as part of priority group four?

No, that's what I thought to start off with, but I am on table 3 because I have stage 3b chronic kidney disease, i wasn't on the shielding list, only those renal patients under transplantation or dialysis were advised to shield.

You certainly won't be vaccinated until all the categories of people more likely to die are vaccinated. That's reasonable isn't it?

Well hopefully it will be possible to pay for it.

Well hopefully it will be possible to pay for it.

I was wondering about that. I have no idea how they would get hold of it.

@notevenat20 It will be possible somehow, if you have connections at least.

Inhaled steroids might help against Covid because they might stop the inflammatory response, but it might depend upon how good your compliance is. I think I read somewhere that for my age and asthma chance of death is only 2x the lowest risk, but it is hard to reconcile this with the scary narrative put out since March for people with lung conditions. I do know that I don’t fare well with flu, so I’m happy to pay for the vaccine if that’s an option.

Every adult will be offered the vaccine it will just take a bit of time.

Better than there being no vaccines in the pipeline.

It will be ok. Just need a little more patience.

Wonder what will happen with me. I’m BMI 35 and losing more weight as on a diet. However my medical records have me recorded at bmi 40. I did tell the gp over the phone that I am now under BMI 40 so not so vulnerable, and she just re-recorded me as BMI 40. But I’m not allowed an in person appointment to prove the weight loss. God knows what they’ll do with me

@notevenat20

Well hopefully it will be possible to pay for it.

I was wondering about that. I have no idea how they would get hold of it.

It's not going to be available privately. At least not initially. However, I suspect that the super rich and famous (and MPs) will, if they want it, somehow manage to get it. Possibly abroad.

Do you have a source for this? It seems a colossal waste to me and I can't see how it's doable by summer 2021.

I agree it’s ambitious, and I can’t remember where I read it in the public domain. I don’t see why you think it’s a waste?

IIRC we only have 5M doses on order of the best one and 30M of the (hard to distribute) one.

No we’ve ordered 100M doses of the Oxford/AZ one alone. 5M is the Moderna one I think. The others, before Moderna was ordered, are here:

www.pharmaceutical-journal.com/news-and-analysis/features/the-covid-19-vaccines-being-backed-by-the-uk-and-when-we-might-get-them/20208405.article?firstPass=false