Phase 1 – direct prevention of mortality and supporting the NHS and social care system
JCVI advises that the first priorities for the COVID-19 vaccination programme should be the prevention of mortality and the maintenance of the health and social care systems. As the risk of mortality from COVID-19 increases with age, prioritisation is primarily based on age. The order of priority for each group in the population corresponds with data on the number of individuals who would need to be vaccinated to prevent one death, estimated from UK data obtained from March to June 2020.
1 Residents in a care home for older adults and their carers
2 All those 80 years of age and over Frontline health and social care workers
3 All those 75 years of age and over
4 All those 70 years of age and over Clinically extremely vulnerable individuals*
5 All those 65 years of age and over
6 All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7 All those 60 years of age and over
8 All those 55 years of age and over
9 All those 50 years of age and over
* Clinically extremely vulnerable individuals are described
here. This advice on vaccination does not include pregnant women and those under the age of 16 years (see above)
It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19.
JCVI advises that implementation of the COVID-19 vaccine programme should aim to achieve high vaccine uptake. An age-based programme will likely result in faster delivery and better uptake in those at the highest risk. Implementation should also involve flexibility in vaccine deployment at a local level with due attention to:
• mitigating health inequalities, such as might occur in relation to access to healthcare and ethnicity;
• vaccine product storage, transport and administration constraints;
• exceptional individualised circumstances; and
• availability of suitable approved vaccines e.g. for specific age cohorts.
JCVI appreciates that operational considerations, such as minimising wastage, may require a flexible approach, where decisions are taken in consultation with national or local public health experts. To be assured that outcome is maximised however, JCVI would like to see early and regular comprehensive vaccine coverage data so that the Committee can respond if high priority risk groups are unable to access vaccination in a reasonable time frame.