U.K. reports high vaccine participation, but some hesitancy among nursing home staff, minorities
By Karla Adam and William Booth,
Henry Nicholls Reuters
LONDON — Britain’s fast-running vaccination campaign appears to have hit its early target, offering a first dose to 15 million elderly people and health care workers by Monday, as the government promised.
Prime Minister Boris Johnson hailed the National Health Service (NHS) for nailing the deadline, calling the rapid rollout of two vaccines a “significant milestone.”
The first doses were offered to all those older than 70, alongside nursing home residents, caregivers, front-line medical workers and those with serious illnesses that might make them more vulnerable to covid-19.
Despite early fears about vaccine hesitancy, a spokesman for 10 Downing Street called the takeup of the vaccines “very high.” Like the United States, Britain has a small but vocal anti-vaccine community. Many of the hesitant, however, have told pollsters that they are taking a “wait-and-see” approach vs. outright refusal.
Overall, the uptake is surpassing what many infectious-disease experts thought likely. Simon Stevens, the chief executive of NHS England, said that vaccine takeup rates across the U.K. have been far higher than the 75 percent anticipated.
Health Secretary Matt Hancock said Monday that, overall, uptake was almost 90 percent among those age 70 and older, with variation in different age groups.
He told the BBC said that, among those ages 75 to 79, “over 97 percent have taken up the offer.”
Participation for residents of hard-hit nursing homes, who were “clinically eligible” for the vaccine, was more than 90 percent, Hancock said.
Within the National Health Service, takeup was 80 percent for health care workers at doctor’s offices and hospitals, the health secretary said. That is considerably higher than the takeup for seasonal flu vaccines for medical workers. Last year, 74 percent of NHS front-line medical staff members received a flu shot, but in many past years it was about 60 percent.
One group that appears to be lagging is low-wage workers who care for residents of nursing homes. The health secretary reported that about two-thirds of the staff members who work in social care had received their first dose.
Johnson’s government insists that it wants all to take their doses voluntarily and that vaccines will never be mandatory, even for health care workers.
But some nursing homes have begun to insist on a shot. Barchester Healthcare, a private provider that runs more than 200 care homes nationwide, said that it changed its hiring policy. A spokesman said that “new staff have to have been vaccinated, but this does not currently apply to existing staff.”
The quick rollout, combined with the high uptake, is clearly a win for the Johnson government. Britain has been plagued with problems confronting the pandemic, and on many days has suffered the highest death toll from the virus in the world. The country is now its third national lockdown, with all schools and universities closed and strict stay-at-home orders enforced by fines.
But Britain is way ahead on vaccine deployment, leading Europe, and behind only much smaller countries, such as Israel and the United Arab Emirates. Johnson wants all those age 50 and older — alongside all other risk groups — to be vaccinated by April. Then the government will tackle the rest of the population. Already, general practitioners are texting, calling and writing to those in their 60s to urge them to make appointments.
British regulators have approved three vaccines for emergency use, one from Pfizer-BioNTech and one from AstraZeneca-Oxford. A third, made by Moderna, has been approved but won’t begin to be delivered until the spring.
Although uptake has been higher than expected, there are concerns about disparities between White Britons and Black, Asian and minority ethnic (BAME) communities.
One study, not yet peer-reviewed, found significant ethnic disparities in vaccine uptake among health care staff at NHS University Hospitals of Leicester, where more than 19,000 staff members have been offered a vaccine. Leicester is one of the most ethnically diverse cities in the U.K. The study found that 71 percent of White staff had come forward to get the shot, 59 percent of South Asian staff and 37 percent of Black staff.
Kamlesh Khunti, a professor at the University of Leicester and one of the authors of the study, tweeted, “Urgently need to identify barriers & overcome these.”
Nadhim Zahawi, Britain’s vaccine minister, told Sky News that those adults who are not taking the vaccines “skew heavily toward BAME communities.” He said that “if one particular community remains unvaccinated, then the virus will seek them out and it will go through that community like wildfire.”
Public health experts said that uptake in some BAME communities, which include a number of immigrants, may be lower because of issues of trust and misinformation.
“It’s remarkable, given the best we ever achieved with flu was 75 percent, with the average closer to 60 percent. So we’ve had remarkable coverage rates — so far,” said Martin Marshall, chairman of Royal College of General Practitioners. “Older people are more likely to get the vaccine, partly because they are at high risk, and also because they have had a prolonged period of lockdown — many [have] not been out in a year, desperate to go out to see friends. Likely we’ll see a lower uptake in younger people, but we don’t know for sure yet.”
To beat the pandemic, large swaths of the population will need to take the vaccine. It’s not enough for the world’s top scientific brains to develop an effective coronavirus vaccine in record time — people need to take it.
“The more people who have vaccinated, the higher chance you have of the virus not circulating,” said Marshall. “If young people don’t accept the vaccine, it could potentially be a problem because there will be more people susceptible, and a larger reservoir for the virus to continue circulating.”
Azra Ghani, chair in infectious-disease epidemiology at Imperial College London, explained that there are two numbers to focus on: how effective are the vaccines and how many people take them. She said a country could have the best vaccines in the world, but they will be far less effective if only half the people take it.
“Uptake is as important as vaccine efficacy” in modeling how the virus will spread and how to slow it, Ghani said.
It is especially worrisome if the uptake is low in clusters in single communities, where the virus then has more freedom to spread quickly.
Paul Hunter, a professor of medicine at the University of East Anglia, said that even as the U.K. presses on with its vaccination program, it may not achieve “herd immunity” if the vaccine doesn’t stop actual transmission of the virus.
“If you’ve been vaccinated, and if you can still get infected and infect other people, then you will not achieve herd immunity.” But he said it was right for the U.K. to prioritize the most vulnerable, since the vaccines are effective at stopping people from getting severe illness and dying.
“The dangerous time for people is getting their first ever infection with no prior immunity and in a vulnerable category. The critical thing is protecting those people so they don’t die when they first get the infection.”
He said that the virus wasn’t likely to disappear but could become manageable. “Our grandchildren’s grandchildren will be getting covid, but by then, or probably a lot sooner, it won’t be much different than the common cold.”
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