To ask Her Majesty’s Government what plans they have to ensure that high-risk adults under the age of 65 are prioritised for access to any Covid-19 vaccination ahead of adults less at risk who are over the age of 65.
My Lords, the Joint Committee on Vaccination and Immunisation has found that mortality increases exponentially with age and has published interim advice accordingly. An age-based programme captures many with underlying conditions. None the less, the sub-committee is reviewing evidence on clinical risk factors, including the clinically extremely vulnerable, and the committee will update its advice if necessary after review.
I thank the Minister for his Answer. As someone who has been shielding since early March, I celebrate those involved in producing the vaccines in such a short time. However, I am concerned to learn that those under 65 in the clinically high-risk categories have been given a lower priority for the vaccine, knowing that 59% of people who have died from the coronavirus have been high-risk disabled people. Can the Minister please provide the JCVI’s evidence that informed the Government’s decision that those in high-risk categories under 65 are less vulnerable to the virus? Disabled people tell me that they have not felt shielded or protected throughout this pandemic, and this priority decision seems to confirm that belief. I urge the Government to think again.
I reassure the noble Baroness that no final decisions have been made; this is only interim advice. I point out in particular that the behaviours of individual vaccines might be quite different for different groups of people. It is only when we have the final phase 3 data on the vaccines that we will be able to make the decisions that she alludes to. We are considering the extremely vulnerable carefully. As I mentioned, a review is under way to see whether clinical factors should play a greater role in prioritisation.
Lord MacKenzie of Culkein (Lab) [V]
My Lords, I could not agree more with the noble Baroness, Lady Campbell. Motor neurone disease is an example of a fatal illness with a very short life expectancy after diagnosis. The Minister might well have seen recent publicity about the case of a six year-old child being unable to attend school in case he brings the Covid-19 virus home to his dad, who is living with motor neurone disease. I hope the Minister will agree that no family should be in the position of having to choose between their child attending school and the risk of shortening the already short lifespan of his father. Will he further agree that people living with motor neurone disease, as well as those with many other life-limiting illnesses, must be on the priority list for very early vaccination?
I hear loud and clear the conundrum expressed by the noble Lord. These prioritisation questions are very difficult. I hear his plea loud and clear and I undertake that these kinds of considerations will be considered in the prioritisation process.
What provision is being made for another group who feel totally forgotten by this Government—namely, extremely vulnerable children, whether they have medical conditions or physical or learning disabilities, many of whom have been unable to access carers or schools since March? When is the review that the Minister just spoke about likely to publish its results?
It will not be possible to publish any results until we have the clear data on the vaccines. Individual vaccines may behave quite differently with different groups of people. There may be some vaccines that work well with the elderly, some that work well with those with clinical conditions and some that work well with children. It is only when we know that data that the final prioritisation can be published.
My Lords, on 12 November I asked my noble friend’s ministerial colleague, my noble friend Lord Greenhalgh, if he would recommend to the JCVI that rough sleepers and those who work with them should be a priority for vaccination. He said he would. Does that remain the case, and will they indeed get priority?
My noble friend has made the case for rough sleepers extremely well. It is one that we are deeply concerned about. When it comes to the prioritisation list, what has been published so far is an interim and indicative list. It will be reviewed, and a more detailed list will be published in time.
As the Government keep the priority list under review, will they also look at the results of the New York vaccine rollout prioritisation? Younger adults who have been shielding are often already on a list, are at high risk and have children at school or college who are also their carers. These children are already stressed, if they attend education, knowing that they risk being asymptomatic virus carriers into the home and that Covid could kill their parent or sibling.
I am extremely grateful to the noble Baroness for suggesting the New York precedent. It is not one that I was aware of and I will look into it. I reassure her that we are liaising with all our international partners over the vaccine rollout to ensure that we put in the best possible practice that we can.
My Lords, I have read the JCVI priority list. As the Minister has indicated, some granularity is going to be vital. There is so far no mention of vulnerable BAME communities, who have borne the disproportionate burden of the pandemic. How will the Government approach those vulnerabilities in setting the priorities and their implementation?
My Lords, the underlying principles of the advice of the JCVI are to reduce mortality, to improve population health by reducing serious disease and to protect the NHS and the social care system. The basic insight is that the risk of serious disease and death from Covid increases exponentially with age and increases in those with a number of underlying health conditions. Those are the basic principles of the interim advice and they will evolve over time.