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    The pharmacists’ defence association and trade union, PDA, is to urge the NHS to develop its strategy for the delivery of the second vaccination in good time and to give the role of the second vaccination of the Astra Zeneca vaccine to the national community pharmacy network as part of a collaborative and integrated NHS process.

    The decision to delay the second dose of the Covid-19 vaccination to twelve weeks so that the current efforts can concentrate on giving as many people as possible a first dose of the vaccine has already resulted in more than 6 million first vaccinations being successfully delivered in one of the UK’s designated vaccinating hospitals, primary care GP hubs or in one of the large regional centres.

    However, this means that in just over two months time, a large and ever-increasing cohort of the population will be due to receive its second vaccination and this will create logistical challenges to the current vaccination programme and risks slowing down the rollout of the critical first doses.

    PDA to launch “A thousand little ships” policy

    Individual pharmacies will never be able to deliver the high-volume vaccination operations seen in the large regional centres or the primary care hubs. However, like the large number of privately owned little ships that supported the larger Royal Navy carriers to save the lives of more than 330,000 allied soldiers from the Dunkirk beaches, they have the capacity to deliver smaller numbers that add up to a significant amount.

    With the potential of vaccinations across more than 13,500 locations in the UK, this mathematical capacity, even if providing an average of only 25 vaccinations per day, per pharmacy, would be able to deliver more than 2 million vaccinations each week. This would represent a very substantial component of the overall national vaccination programme.

    Working in a collaborative way and integrated within the wider NHS vaccination delivery pathway, pharmacists located in all community pharmacies delivering the second dose of the Astra Zeneca vaccine would protect the NHS by maintaining the capacity of the purpose-built, high volume hubs.

    This would enable the hubs to continue at pace with the successful first vaccination programme, as well as enabling them to deliver the second more operationally complex Pfizer Biontech vaccines.

    According to PDA Chairman, Mark Koziol:

    “The system needs to be dynamic and the number of vaccinations delivered in each pharmacy will depend on demand and location. Some pharmacies may be able to deliver more than 80 a day, while others may only be required to deliver 8 vaccinations on two afternoons a week. This would depend on how many patients booked appointments at the pharmacy of their choice. Appointments could be organised to ensure that no vaccine was ever wasted or left unaccounted for and in a way that enables the local community pharmacy to organise the right staffing levels for their vaccine clinics.”

    The PDA envisages that the community pharmacy vaccination programme could easily be built upon the existing Covid-19 vaccination service where the NHS local vaccination centres or primary care organisations would continue to be in control of the vials. The local centres would ensure that only the requisite number of vials were distributed to participating pharmacies on the specific days they were needed based on the number of appointments booked via the NHS vaccination booking system. This distribution and governance system would operate much in the same way that it currently does with the local care and residential homes.

    Mark continued:

    “The current GP vaccination hubs are successful because they rely on dedicated vaccinators. This means that the existing GP practice patients continue to enjoy access to their wider GP service. In our proposal, just as in the GP practice setting, the public would expect the wider community pharmacy service to continue and be delivered safely with full-time access to the community pharmacist to discuss their wider healthcare issues on an opportunistic basis. For this reason and also because the movement of the vials requires the vaccination service to be carefully structured and managed to avoid waste of vaccine, the vaccinations would have to be delivered in planned clinic sessions by a second dedicated pharmacist who comes in specifically to support the vaccination programme.” 

    The PDA’s “A thousand little ships” policy will be presented to governments in all four UK countries over the next few days.

    You can download the England version here:  PDA-Little-Ships-Initiative-ENGLAND-FINAL

    1 Comment

    HIV i-Base continue to report on COVID-19 vaccination and treatment. The Q&A service on the i-Base website has been answering many questions about coronavirus vaccinations.

    Please see this new question:

    Are animal products in the COVID vaccines? Are they Halal? https://i-base.info/qa/16668

    Answer:

    The vaccines are safe and recommended if you are Muslim.

    • There are no animal products in the Pfizer, Moderna or Oxford vaccines.
    • There are also no traces of pig products or egg products.
    • These vaccines are all Halal safe.

    The video in the i-Base link above is from Imam Yunus having the vaccine at Newham Hospital in East London.

    As chaplain of St Barts, Imam Yunus talks about how the vaccine is safe, effective and Halal.

    Please note this video is included as an information resource. It is not directly liked to HIV and i-Base was not involved in producing it.

    This is one of more than 45 questions about COVID vaccines. It was produced by and for people living with HIV.
    Q&A on COVID vaccines: are they safe and effective?
    https://i-base.info/qa/16330

    Copying and distribution of i-Base infomation is encouraged – and free – but please credit HIV i-Base as source.

    Comments Off on Are animal products in the COVID vaccines? Are they Halal?

    HIV i-Base continue to report on COVID-19 research and treatment as a supplement to HIV treatment research and information.

    Copying and distribution of i-Base infomation is encouraged – and free – but please credit HIV i-Base as source. You can see this Q&A here or read it below:

    Q&A on COVID vaccines: are they safe and effective?

    The following questions were for a community UK-CAB workshop on COVID vaccines. Answers by Angelina Namiba and Simon Collins.

    Are vaccines against COVID-19 effective?

    Yes, any approved vaccine has been very carefully studied in  a wide range of people.

    These first vaccines are highly effective. Both the Pfizer and Moderna vaccines prevent COVID symptoms in 95% of people. They also prevent severe COVID-19.

    These vaccines are much better than first thought possible. Early in 2020, a vaccine would have been approved if it was only 50% effective.

    Which vaccines are being used in the UK?

    The only vaccine that is currently approved in the UK is called BNT162b2.

    It is made by Pfizer/BioNTech. It was approved in the UK on 2 December and in the US on 12 December 2020. A second similar vaccine, developed by Moderna/NIH has just been approved in the US. It will also be approved in other countries too. The EU plans to approve these two vaccines within the next few weeks.

    However, other vaccines are being used in UK studies (see below). These include a vaccine from Oxford University and Astra-Zeneca called ChAdOx1. Another study using a Janssen vaccine is just starting. As new vaccines are approved we will add them to this page.

    Why should I get a vaccine?

    The main reason to get the vaccine is to protect yourself against COVID-19.

    COVID-19 can be deadly – it is much better to be protected. Even people who recover from COVID-19 often have symptoms that last for many months. This is called long COVID and is still being studied.

    If you have been offered the vaccine it is because of your personal level of risk. The vaccine may also protect your friends, family and contacts at work.

    Is my risk high enough to need the vaccine?

    Yes, there is only a limited supply of these vaccines. In the UK, for at least the next few months, you will only be offered the vaccine if your personal risk is high.

    This will be because of your age and your health or because you work in a high risk job.

    Do I have to get the vaccine?

    If the vaccine is for your own health, then this is always still your choice. You do not have to have the vaccine.

    Please talk to your doctor if you have any worries or concerns. Or if you’re unsure about having the vaccine.

    If you are offered the vaccine because of your job, not having the vaccine might affect the work you can do.

    Are vaccines against COVID-19 safe?

    Yes, based on the results from large studies, any approved vaccine will also be very safe.

    For example. the Pfizer vaccine was studied in more than 44,000 people without any serious side effects.

    There are only a few situations when this vaccine needs to been given more carefully. This includes people who have a history of serious allergy reactions to different foods or medicines – as with other vaccines. In this case the vaccine should only be given where there is medical support in case this reaction occurs.

    How do we know the vaccine is safe?

    Technically, no medicine or vaccine can be proved to be safe! This is because we can’t measure safety, we can only measure risk.

    So instead of saying something is safe, it is more accurate to describe the risk. With COVID vaccines we can say there is a very low risk of side effects.

    Compared to the very real risks from COVID-19, using the vaccine is much safer than not using it. This is known from research studies in tens of thousands of people. The studies recorded every side effect or any potential side effect.

    Additional safety data comes after the vaccines are used outside of studies. This will include from people who were not included in the main studies. This led to a caution in people with history of serious allergic reactions (see next Q).

    What if I have a history of allergy reactions?

    As in the question above, even people with a history of serious reactions can still use the vaccine. This includes people who have reactions to vaccines, medicines or foods.

    However, if you currently need to carry an anti-allergy syringe, you need to be vaccinated in a clinic in case a reaction occurs.

    Two health workers in the UK with a history of severe reactions did react to the vaccine. Both people have now recovered. More information will be collected on cases like this.

    Can I develop an allergic reaction to the vaccine?

    Yes, although the risk is small and relates to your history of allergies.

    For the Pfizer vaccine, anyone with a history of severe allergy reactions should have the vaccines in a setting that can safely manage reactions.

    What about if I have immune suppression from HIV or cancer treatment?

    Yes, the vaccine is still recommended if you are HIV positive or if you have cancer. This is because of the high risk from COVID-19.

    Although the leaflet that comes with the vaccine includes talking to your doctor first if you have a reduced immune system, this is not related to a safety of the vaccine. It is because the protection from the vaccine might not be as strong.

    This means that even after both doses of the vaccine, it will still be important to be careful, for example by wearing a mask and social distancing.

    As more people are vaccinated, researchers will look at responses in people who were not widely included in studies.

    What if I have other inflammatory or autoimmune conditions?

    As above, the vaccine is still recommended for people living with inflammatory or autoimmune conditions.

    In this, it is very similar to getting a flu vaccine. Anyone who can use the flu vaccine can use a vaccine against COVID-19.

    These include:

    • Inflammatory rheumatic diseases (rheumatoid arthritis, axial spondyloarthritis, lupus).
    • Inflammatory bowel disease (Crohn’s disease and ulcerative colitis).
    • Psoriasis.
    • Multiple sclerosis.
    • Organ transplant recipients.
    • People on chemotherapy.

    This is because of the high risks from COVID-19.

    Although many people with these and other complications were not directly studied in vaccine studies, there is no safety concern. As above, the caution is that the vaccine might not be quite as effective.

    Ongoing research though will be looking at this.

    Does the vaccine interact with other medicines?

    No. There are no medicines that can not be used with these vaccines. If you are taking other treatment, there is no need to stop this to have a vaccine.

    Although it is good to ask about interactions with current medicines, there are no interactions with the vaccines. If you are worried, it is easy to double-check this with your doctor.

    Your doctor will also know your medical history and whether one type of vaccine might be better for you than another.

    Could the vaccine interact with my HIV meds?

    There are no interactions between the COVID-19 vaccines and HIV meds.

    Will my HIV viral load blip when I have the vaccine?

    Technically though, there is not enough results from HIV positive people in the first vaccine studies to report this yet, though this will be reported later.

    However, based on other vaccines this is unlikely to happen.

    Any vaccine has the potential to increase viral load for a short time. This is the same as to any active infection (including flu and colds).  As with the answer to other questions here, it is okay to approach the COVID vaccination as if it was the annual flu vaccine – which is widely recommended for people living with HIV.

    If your viral load is generally undetectable any increase is likely to be very small. For example, with the flu vaccine, it might increase from less than 50 to maybe 80 or 100 copies/mL – and only for a few days or a week. This is too low to affect the risk of transmission.

    Other vaccines, for example for hepatitis B, don’t cause HIV viral load to blip.

    As a guide, unless you get symptoms from the vaccine, your HIV viral load is likely to stay undetectable. If you get symptoms, any small blip is likely to be undetectable again within a week.

    Can the vaccine interact with estrogen and/or testosterone treatment?

    There are no interactions between the COVID-19 vaccines and estrogen and testosterone.

    Are the vaccines safe in pregnancy?

    Great question. So far there is little data because pregnancy was an exclusion for the main studies. But if you are pregnant, the vaccine is still recommended.

    Also, women will still have become pregnant during these studies – and certainly afterwards. These data will all be collected during the study.

    When these data are available they will be widely publicised.

    Other studies are looking at vaccine responses during pregnancy.

    Are the vaccines safe in children?

    So far vaccines have only been studied in people who are aged 16 and over.

    Further research is planned to look at younger people.

    What is in the vaccine that they are going to offer me?

    None of the COVID vaccines in the UK contain any live viruses. There is no risk of catching coronavirus from the vaccine.

    The active parts of a vaccine though only use a protein from the outside of the coronavirus. Or they tell your boby how to make these proteins.

    This will not cause an infection though.

    Vaccines also include other ingredients that help the vaccine work. For example the Pfizer vaccine contains traces of sodium and potassium. This is sufficiently low to still be called sodium-free and potassium-free.

    It also contains sucrose and this, together with all other ingredients, is listed on the patient leaflet that you get before the injection. This is also online now if you want to check first (see fruther information in the final question).

    How is the vaccine given?

    The Pfizer vaccine is given as an injection into your upper arm. A second booster dose is given again, three weeks later. You reach the best protection seven days after the second dose.

    Do I still need to social distance after the vaccine?

    Yes, so far, it is still better to reduce the risk of catching coronavirus.

    A few people might not be protected by the vaccine. We also don’t know how long protection will last. You might also still become infected without symptoms. You could then pass this to other people.

    Even after the vaccine, please continue wearing a mask. Please continue recommendations for social distancing.

    Can I get COVID-19 from the vaccine?

    No. This is easy to answer.

    There is zero risk of getting COVID-19 from the vaccine.

    The vaccines do not contain coronavirus itself.

    What are the symptoms/side effects from the vaccine?

    Most side effects to the Pfizer vaccine were mild or moderate.

    Very common side effects were similar to getting the flu vaccine. They generally got better within a few days. These were reported by more than 1 in 10 people.

    • Pain at injection site.
    • Tiredness.
    • Headache.
    • Muscle pain.
    • Chills.
    • Joint pain.
    • Fever.

    Common side effects included injection site swelling, redness at injection site, and nausea. These were reported in less than 1 in 10 people.

    Uncommon side effects, in less than 1 in 100 people included enlarged lymph glands or just generally feeling unwell.

    Am I going to get sick with the COVID-19 vaccine like the flu jab?

    No necessarily, but maybe. So far the COVID vaccine is similar to getting a flu vaccine. And just like the flu vaccine, the response will vary for different people.

    The question above shows that symptoms are similar to the flu vaccine and are nearly always mild.

    Should I wait to see how people similar to me react first?

    This is a good question – and sounds very reasonable. But within a week or two another 500,000 people will have used the vaccine in the UK.

    Any serious concerns will be reported long before you are likely to be offered the vaccine.

    However, if you are okay leading a very isolated life, then waiting is a choice. But if you still want to interact with people, then waiting will be more risky than having the vaccine now.

    How long will protection last?

    This will only be known with more time. Protection should last for at least a year and hopefully a lot longer. Some vaccines, for example hepatitis B and tetanus only need a boost every ten years.

    Which vaccine is best?

    So far, all the leading vaccines look very good. Getting access to any vaccine now is more important than which vaccine you use.

    What if I already had COVID-19? Does it matter where this was severe or mild?

    People who already had COVID-19 are still recommended to use the vaccine. It doesn’t matter how severe or mild this was.

    Will my GP or HIV doctor give me the vaccine? Can I choose?

    Who gives you the vaccine will depend on which vaccine is being used.

    The Pfizer vaccine will generally be given at health centres or hospitals. This is because of limits in how it can be stored.

    If you are offered a different vaccine in the next month or two, this might be given by your GP. This is early stage for the vaccines but it is unlikely to be your HIV doctor. You are not likely to be able to choose.

    Why should I get the vaccine if the person giving me the vaccines hasn’t had it yet?

    The decision on who gets the vaccine first are decided by an expert advisory group.

    If this group recommends you get the vaccine, then this is because your individual risk makes this important.

    Will the vaccine stop me catching COVID-19? Or just from getting ill? Or maybe both?

    The vaccine will definitely reduce risk of getting ill, but the answer is “probably both”.

    The vaccines are approved because they reduce symptoms of COVID-19.

    The first studies didn’t measure whether people caught coronavirus, just whether they had symptoms of COVID-19.

    Most mild symptoms later confirmed as COVID-19 were in people who didn’t get the vaccine. Importantly, nearly all the most serious cases of COVID-19 were also in people who got the placebo (inactive) injections.

    Technically, some people might still catch coronavirus and be infectious but without symptoms. This is still an ongoing research question.

    Studies with the Moderna and Oxford vaccines include some results showing that the risk of catching coronavirus is also reduced.

    Is the vaccine safe if I have other health problems as well as HIV?

    Yes, vaccines are recommended in people living with HIV and other health problems.

    The more serious your other health problems, the more important it will be to be protected from COVID-19.

    Can I get the vaccine if I have or have had hepatitis C?

    Yes, vaccines are recommended in people living with hepatitis C or who previously had hepC.

    Is the vaccine safe if I use chems like crystal meth, GHB or mephedrone?

    Yes, the vaccines do not interact with drugs used for chemsex.

    However, taking a break from the chems for the week of the vaccine will make it easier to know whether you get any side effects.

    If the social context for using chems means you are having more partners, the protection from the vaccine will be especially important.

    Is the vaccine affected by ethnicity? Will it affect me differently because I’m black/brown?

    No, vaccines studies include people of different ethnicities. They are created for everyone.

    Ethnicity does not affect immune responses or risk of side effects.

    Are black and brown people more at risk of getting side effects?

    No, as with the question above, ethnicity has not been linked to any better or worse outcomes.

    Have vaccine trials included black and brown men and women living with HIV? Or do the findings just relate to the experiences of HIV positive white gay men?

    Unfortunately, most vaccine studies only included very small numbers of people living with HIV. So far, the ethnicity breakdown of the HIV positive group has not been presented. All the HIV positive participants might be black and brown women.

    For example, the Pfizer study with more than 44,000 people only included about 120 people living with HIV. The results did not show that HIV as any impact on how the vaccines work.

    However, there is a lot more data about ethnicity.

    About 10% of the people in the US sites were black or African American. There were no differences in how well the vaccine worked or in side effects compared to the rest of the study population.

    Who approved these vaccines? Were the interests of my community represented?

    Vaccine are approved by the same organisations that approve medicines. They were approved for all people.

    • This is the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK.
    • In Europe it is  the European Medicine Agency (EMA)
    • In the US it is the Food and Drug Administration (FDA).
    • Other countries and regions have similar organisations.

    Each of these groups is made up of expert advisors who are mainly scientists and doctors but that sometime include community voices.

    The panels are responsible for representing interests of all people who are going to be using these products.

    The FDA is especially open as it publishes the detailed study results online for everyone to read. It also webcasts the meeting that decide on where a vaccine or medicine is approved.

    How do I know I’m being treated equally? How do I know this isn’t experimentation in black people?

    These concerns are very real. Nearly all countries still have structures that are not equal. Many have a history where people were treated differently.

    In the UK, this still affects access to important services that include education and medical care. This is even when there are policies to make access fair.

    However, ethnicity has been linked to higher risk of COVID-19 in black, Asian and minority ethnic (BAME) communities. This actually makes access to the vaccines even more important.

    As all the studies included people from all ethnicities. There is good data to show they are at least as safe and effective.

    COVID vaccines will be offered to people of all ethnicities. As has been seen in the news all ethnicities have the choice to use the vaccine.

    If the government didn’t protect me from coronavirus, why should I trust them with the vaccine?

    Perhaps luckily, the government are not directly involved in either producing the vaccines or in running the studies that look at how well they work.

    The government is also not directly involved in deciding which vaccines are approved.

    Whether or not you use any medicine or vaccine is a decision that you make with your doctor as an individual.

    I’ve experienced racism in the health system and receiving HIV care. How can you tell me this won’t be the same?

    I am sorry for any previous experiences within the NHS. I am also sorry if you have not been treated fairly in the past.

    Although I can not guarantee this will not happen again, there is a lot of information about how to deal with this.

    I can however provide information on COVID-19 and the vaccines. This shows that the benefits of the vaccine so far are much greater than the risks from not getting the vaccine.

    Why did we get a COVID-19 vaccine so quickly, but there is still no vaccine for HIV?

    There are two answers here.

    The practical answer is that the threat from COVID-19 were so serious that many more resources became available. The urgency of COVID-19 led to a larger budget – and luckily, this has been more effective than anyone first hoped.

    A more technical scientific answer is coronavirus is relatively stable. Unlike HIV the structure of the proteins doesn’t change and so a vaccine based on these proteins with continue to work.

    HIV is still a more difficult virus to overcome because it makes small changes every day. So HIV vaccines that might work very well on Monday will be out-of-date on Friday because of these small changes.

    HIV does have at least 30 approved treatments. These enable to lead long and health lives.

    There are many other infections where we also need new vaccines. Hopefully the advances for COVID-19 will help for other vaccines.

    If vaccines are now available, should I still join a study?

    This is an important question because other vaccines are still being studied.

    In the UK this includes a vaccine from Oxford University and Astra-Zeneca called ChAdOx1.

    Another study is due to start using a vaccine from Janssen.

    Joining one of these studies might let you get a vaccine before you are offered on from the NHS.

    If you do get offered an NHS vaccine after joining a study, you can still use the approved one. The study will tell you whether or not you got the active vaccine. The researchers can also study your response to the second vaccine.

    In practice, new studies will hopefully look at switching between different vaccines.

    If the vaccine is lifesaving, why is not available to everyone in the world?

    You are right, for a vaccine to be really effective, everyone will need to use it. This includes in all countries.

    Many organisations, including the World Health Organization (WHO), have been working all year to also make access fair.

    For example, the international COVAX programme is aiming to vaccinate two billion people during 2021. This includes more than 100 low and middle income countries including across Africa, Asia and South America.

    So optimistically, at some point, everyone will have access.

    In practice, high income countries that could afford the first commercial vaccines have bought most of the first stock.

    But some of the next stock during 2021 – and more importantly newer vaccines – will be available for the COVAX programme. This might not be until later in 2021 and 2022 though.

    Where can I get more information?

    The following links are to different sources for more information.

    i-Base run an information service if you have individual questions that you would like answered.
    https://i-base.info/qa

    i-Base report news about COVID-19 treatment and vaccines in a monthly bulletin.
    https://i-base.info/htb

    British HIV Association (for information about HIV and COVID-19).
    https://www.bhiva.org/Coronavirus-COVID-19

    UK patient information leaflet for the Pfizer/BioNTech vaccine
    (PDF)

    FDA 50-page document with detailed results on Pfizer vaccine.
    https://www.fda.gov/media/144245/download

    YouTube website to watch the US CDC hearings for COVID vaccines
    https://www.youtube.com/playlist?list=PLvrp9iOILTQYiZunwmtiIRt52poVP8D02

    Article on why vaccine is recommended for people with immune suppression and autoimmune conditions.
    https://www.medscape.com/viewarticle/942853

    Website for WHO COVAX programme for global access.
    https://www.who.int/initiatives/act-accelerator/covax

    The People’s Vaccine – a collaboration of large charities including Oxfam.
    https://www.oxfam.org/en/tags/peoples-vaccine

    Comments Off on Q&A on COVID vaccines: are they safe and effective?

    Issue: 111 – 10 November 2020

    Pfizer Covid-19 Vaccine

    This could be the only good Covid-19 news we have had in a very long time. Regulators have still not approved the vaccine though, but allegedly this will happen soon. According to DHSC guidelines issued in September 2020, the top priority list for those being given the vaccine is older adults resident in care homes and care home workers, 80 years of age and over and health and social care workers, 75+, 70+. 65+, and high risk adults under 65.

    The Government has an agreement with Pfizer to buy 30 million doses, with 10 million due by the end of December 2020.

    Very Steep Rise in Secondary School Covid-19 Infection Rates

    The National Education Union (NEU) has analysed Covid-19 infection data published by the Office for National Statistics. The NEU states that Infection rates in Secondary schools in England are an astonishing 50 times higher since September 2020. In Primary schools the rise is nine times. The NEU maintains these figures clearly show that schools are engines for virus transmission.

    The NEU recommends schools staying open only for children of key workers and for vulnerable children during Covid-19 lockdown. The NEU membership is 450,000 teachers, lecturers, educational support staff and leaders. More at:

    https://neu.org.uk

    As a postscript to this, when I researched infection rates across many Ealing neighbourhoods on 9 November 2020 the three highest rates were in neighbourhoods containing secondary schools – Northolt South (349 cases/100,000), Southall Green (310.1) and Cuckoo Park, Hanwell (280.9).

    Hospitals are Breeding Grounds for Covid-19 Infections

    On 9 November 2020, ‘ITV’ reported that of the 12,903 new Covid-19 cases between 18 September and 18 October 2020. 1,772 were acquired in hospital. Of the 700 new hospital cases in south east England, 23% were contracted in hospital.

    It seems for all kinds of reasons hospital staff and patients are not being tested on a regular basis. By 20 November 2020, allegedly, all patient-facing NHS staff will be asked to test themselves at home twice a week with results available before coming to work.

    Covid-19 Lockdowns Impacting the Mental and Emotional Health of Young People

    The NSPCC AND Childline are both reporting increasing telephone and counselling sessions. Young people are increasingly presenting with feelings of isolation, anxiety, insecurity and eating and body image disorders. More at:

    www.nspcc.org.uk

    www.childline.org.uk

    Is Covid-19 Population Testing (Mass-Screening of Asymptomatic People) in Liverpool Simply the Wrong Thing to Do?

    80 test centres and 2,000 troops involved. This sounds expensive. But will it ‘work’? Professor Allyson Pollock, a recognised Public Health expert, has her doubts. On 3 November 2020, as part of the Government’s £100 billion ‘Operation Moonshot’, population-wide Covid-19 testing of asymptomatic people in Liverpool was announced. Eight test centres opened on 6 November 2020.

    Professor Pollock has pointed out that this initiative is at odds with the SAGE advice of 10 September 2020 and with the current World Health Organisation (WHO) guidance. SAGE and WHO favour prioritising the rapid testing of symptomatic people, contact tracing and identification of infection clusters. Her concerns about the Liverpool pilot include:

    • a diversion of public money and resources. The OptiGene tests have cost £323 million.

    • the use of inadequately evaluated Covid-19 tests (direct LAMP test (OptiGene) and a lateral flow assay (Innova)

    • WHO evaluations of similar tests suggest between 1% and 5% of people without infection may get false positive readings. (With 392,000 adults in Liverpool these false positives could number anything between 3,920 to 19,600 adults)

    • there is no evidence demonstrating that Covid-19 mass screening can achieve benefit cost-efficiency

    • smaller pilot studies should have been carried out first before launching a massive pilot study of 498,000 people. (Allegedly a pilot was carried out in Manchester and it was found that half of the infections were missed).

    More at:

    https://allysonpollock.com

    The ‘Sunday Times‘ of 8 November 2020 leaked that three towns would be added to the mass-testing project. One is thought to be in The Midlands and one in the south of England. This would add another 100,000 people to be regularly tested.

    Reduced Support for the Homeless in Lockdown 2

    During Lockdown 1 many homeless people were put up in hotels, hostels and other forms of accommodation. This Government funded ‘Everyone In’ strategy was deemed to be successful in saving lives and reducing Covid-19 infections rates during Lockdown 1.

    Now it appears that money is running out to support the homeless and getting them off the street during Lockdown 2. Almost half of the night sleepers in London are foreign nationals and under the October 2020 post-Brexit legislation they could face deportation if found sleeping in the street.

    One week into Lockdown 2

    On day one of Covid-19 National Lockdown 2 (5 November 2020), I researched the following Ealing Covid-19 infection rates per 100,000 people. A week later I did this again:

    Southall Park: 265.3 became 244.1

    Ealing Broadway: 247.6 became 281.4

    Acton Central: 147.8 became 113.7

    West Ealing: 132.9 became 122.9

    A very small sample I know, but in three out of the four neighbourhoods the rate had fallen.

    Government’s Vaccine Taskforce Chair Spends £670,000 on Public Relations

    Kate Bingham, Chair of the Government’s Vaccine Taskforce, has allegedly hired eight Admiral Associates public relations consultants at £167,000/year each. Ms Bingham, a qualified biochemist and venture capitalist, was hired by the Government in May 2020. She is married to Jesse Norman MP. Bizarrely she reports directly to Prime Minister Johnson.

    Town/Hospital Based NHS Activist Groups Slowly Being Marginalised

    Three main factors at work here. Firstly the demolition of local CCGs. In 2018/19 there were 195 of them. By 1 April 2021 they will all have been closed down and ‘replaced’ be some 42 regional CCGs. Secondly, the Covid-19 response National Lockdown 2 has shifted commissioning from local, through regional, to a national undertaking. Thirdly, Covid-19 has allowed NHS bodies and Local Authorities to remove citizens from any effective, real time involvement in statutory body public meetings. In Ealing, for example, virtual, public Council care meetings employ MS-Teams software in a restricted, unhelpful fashion.

    NHS NWL EPIC

    On 17 December 2019 In NHS North West London (NWL) a public engagement initiative called ‘EPIC’ was launched at a workshop. 80 people attended of whom 34 were ‘patients’. EPIC is being used ‘to gather public opinion about local and NHS activities, involving ‘local residents in shaping and co-producing our services’. NHS NWL EPIC has built a ‘Citizen’s Panel’ of 4,000 north west London residents. The make up of the panel is allegedly representative of the 2.5 million residents in the region. I applied to join this panel but my application was ignored. Another EPIC Citizen’s panel meeting – this time a virtual one – was held 27 October 2020. In this meeting the idea of a ’Patient Forum in each borough’ was floated. The local Healthwatch, the local Council and the local voluntary sector would be invited. No timescale was set and it’s obvious that the forums would have no statutory significance whatsoever.

    Public Involvement Charter (PIC)

    EPIC is also developing its own ‘Public Involvement Charter’ (PIC). The PIC has admirable intentions and ‘core values’ – ‘the right to be involved, influence, improving outcomes, inclusion, engagement as residents want, information and transparency’. And all this as ‘we move more towards the (non-statutory) Integrated Core System (ICS)’.

    With all the generosity I can muster, I find the non-statutory EPIC, Citizen’s Panel and the Public Involvement Charter to be underwhelming, likely to be expensive and probably a complete waste of NHS and citizen’s time.

    Eric Leach

    Comments Off on Our NHS in Crisis

    The BMA is urging the Government to ensure more people take advantage of routine vaccinations after a concerning fall in coverage rates in recent years.

    In a report published today, the Association says that many immunisation programmes have been disrupted because of the pandemic as the NHS focused on responding to immediate health concerns and now it’s imperative that they are re-started and that people are encouraged to be immunised.

    It also notes that childhood vaccination in particular has plummeted during this time – dropping by around a fifth in total – despite advice that childhood immunisation should continue during Covid-19.

    According to NHS Digital, and highlighted in this report, coverage for the first dose of the MMR vaccine in England was at 94.5% in 2018-19, down from 94.9% in 2017-18 and below the 95% target set by the World Health Organisation (WHO).

    The BMA’s report says that making people aware of the benefits of routine vaccinations, such as the MMR vaccine, is vital. This is not just for their wellbeing, but also when we consider worrying reports about a lack of confidence in a potential Covid-19 vaccine and the implications that could have for general uptake.

    Altogether, the BMA is calling for action to:

    • widen vaccine availability and target specific populations
    • ensure adequate funding to deliver fully resourced immunisation services
    • raise public awareness and understanding of immunisation programmes
    • ensure health service IT supports vaccine uptake
    • increase vaccine uptake among NHS workers

    Dr Peter English, BMA public health medicine committee chair, said: “It’s been incredibly worrying to watch the decline in vaccine rates in the UK over the past few years –  for example, we lost our ‘measles-free’ status in 2019 and the pandemic has of course meant even fewer vaccinations have been carried out as the NHS battled on all fronts to keep the virus at bay.

    “Routine vaccination is so important, and many doctors can remember a time without it. Vaccination against common but often serious ailments has changed the face of public health and are rightly ranked by WHO, alongside clean water, as the public health intervention which has had the greatest impact on the world’s health.

    “That’s why, as we recover from this pandemic, everything must be done to increase vaccine uptake – particularly as we head into flu season and vulnerable people are at greater risk of becoming ill.

    “This means not only making sure the public understands the importance of getting vaccinated, but also resourcing the health service with what it needs to deliver this; adequate funding for immunisation programmes, IT services, and encouraging staff to protect themselves too.

    “Health has never been more at the forefront of people’s minds, and the Government needs to utilise this as a matter of urgency – not just for the sake of the population now, but the generations that follow.”

    Oliver Fry

    The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.

    Posted on behalf of the BMA by Jean Hardiman Smith

    Comments Off on More people need to be encouraged to take up routine vaccinations as we recover from Covid-19, BMA warns