It’s still difficult to know how many under 45s or under40s are being offered in each area. Usually these are individual GPs who had supply before 12 April, as GPs we’re told no new supply being delivered for 1st does until 26 April. Most 1st doses are being delivered via the national booking system which is offering to 45+ currently.
GPs have been to,d in the JCVI guidance of last week that they can be a bit more flexible in rollout. As well as rolling out to all 45+ not yet jabbed and trying again to reach those who’ve turned it down or not been reached, they have been told to prioritise men and men in occupations that meant they needed to leave the house to go to work throughout lockdown, and those with BMI over 30 and those in areas of deprivation. There are areas outside LOndon with extreme deprivation and also hesitancy in some groups, who really need to rollout to younger groups if they have the supply to boost the geographical areas immunity. They have lots of high BMI and people in those at risk occupations who’ve been at work throughout and those on low incomes. Covid is becoming a disease concentrated in poor areas.
London is so diverse. There are areas of deprivation and the. Areas of affluence right next door. Even within wards, there can be big differences and the figures for a borough can mask significant differences. There does seem to be a push to rollout in some areas of London too, to those who are younger, but not to all areas.
The JCVI advice says that the way to reach most more at risk most quickly is still to use an age based approach because its operationally simple. Within that GPs can prioritise people, if they have supply and they are encouraged to strongly encourage those with the risks I mentioned above to take the jab as soon as it’s available.
For people who’ve been offered it earlier than the national age cohort being jabbed, although it’s nice for them, it may well reflect some th) g about their area...their area generally has lower take up and more deprivation and is more at risk. Although it’s frustrating for areas who feel they are ‘behind’ they’re only behind in the sense of not having moved belo 45s now and that is probably a sign that the risk in that area is less. Often it hat particular area the take up has been higher and that’s partly why there isn’t enough left over to offer to younger people.
These more affluent areas with higher take up, where MNetters are frustrated with having to wait a bit longer, are likely to ultimately be the areas where Covid is reduced significantly and doesn’t linger as a stubborn problem. It’s actually the areas that have been able to push ahead because of lower take up amongst older groups who in the longer term are likely to see Covid stubbornly loitering there.
The figures we will all want tos we and need to see will be the take up rates once we get to perhaps August and again in October when everyone could have had 2nd jabs. Amongst younger people in these more deprived areas, take up will in all likelihood struggle. It’s a key reason to jab them sooner if they are keen for it. The overall figures at the end of the rollout will show regional variations and there will be some correlation to Covid levels in those areas. The difference is unavoidable, but by rolling out faster to younger groups in those areas, they are consciously trying to mitigate some of those problems and minimise them.
I don’t agree about asking GPs to shift their supplies to areas which haven’t yet jabbed 40s. For one thing, no GPs actually have high supplies for 1st jabs at the moment. The total figure decline for 1st jabs shows that. The gains, I don’t think would be outweighed by the downsides of doing this...both operationally and in terms of speed and. Booking ahead, but also in terms of the fact there is a plan to rollout these limited extra supplies where they exist, in areas of lower uptake to the yiunger population to boost local herd immunity, which will be lost if they are diverted.
It probably isn’t popular to say this, but middle class women in their early 40s who have been carefully observing distancing and other restrictions, really aren’t those most at risk of hospitalisation and dying from Covid and actually aren’t those most needing the jab. Yes there is a risk of long Covid, but the risks of this need to be weighed against the risks of those who can be hospitalised and perhaps die....much more likely for men and especially for those men in deprived areas with high BMI and going out to work in places where distancing hasn’t been the best and perhaps there is more overcrowding in living. If they get the jab sooner in their early 40s or late 30s, it is no bad thing,