COVID-19 vaccines: UK rollout and priority groups
21st April 2021 by Anna Gyarmati
Written by Dr. Mei Lee, Senior Scientific Advisor
When is it my turn?
Approximately 48% 1,2 of England’s population have acquired their first step towards freedom, otherwise known as their first dose of the COVID-19 vaccine. It’s also been great news to hear that 90% of care home residents and over-75-year-olds in England have received one dose of the vaccine 3 .
Deciding who should be first in line for their vaccine during a pandemic situation comes with economic and moral considerations. So who is tasked with that mammoth responsibility? That role lies with an independent group of experts who advise the Government health departments on immunisations and the prevention of infectious diseases, known as the Joint Committee on Vaccination and Immunisation (JCVI) 4 .
The UK COVID-19 vaccination strategy has prioritised the elderly, care home residents and staff followed by frontline health and social care workers. This decision was based on current evidence indicating that the single greatest risk of mortality from COVID-19 was increasing age and the risk of dying is higher in those over 65 years than that seen in the majority of younger adults with an underlying health condition5 .
What about protecting individuals delivering key public services?
Some have argued that the younger working population in occupations that put them at risk of constant exposure to COVID-19 should be given higher priority, for example, teachers, bus drivers or supermarket workers. These heroes have kept the country going whilst many of us have been able to work safely from home.
Interestingly, across the globe in Indonesia, the country is taking a markedly different vaccine strategic approach by targeting first their frontline workers; younger working people aged 18 to 59 with the rationale that those going to work may be getting exposed, returning to their families at home and potentially spreading the disease 6 .
Mum had her first dose but she’s still awaiting her second dose
When the efficacy of one of the COVID-19 vaccines deployed in the UK was initially assessed in clinical trials, patients were given 2 doses, 3 weeks apart. 7. However, the JCVI advised that for the UK roll out, a maximum interval between the first and second doses could be up to 12 weeks.
This decision has allowed more people to be vaccinated with at least one dose, which is critical when vaccine supply is limited. The JCVI stated that given the high level of protection afforded by the first dose (up to 70% protection)7, they predicted that initially vaccinating a greater number of people with a single dose will prevent more deaths and hospitalisations than vaccinating a smaller number of people with 2 doses.8 The second dose is key to providing longer lasting protection (up to 90% protection)7.
Is the UK vaccine strategy the right one?
Tough decisions based on assumptions and expert opinion has led us to where we are. Time will tell if we have got it completely right. However, early data suggests the UK vaccine roll out is working9.
At the time of publishing, the UK is moving into the next phase of the COVID-19 vaccination programme, with people aged 45 to 49 now invited to book their appointments.10 We’ll be monitoring the vaccine effectiveness closely. The world’s eyes are upon the UK as we were one of the first nations to roll out the COVID-19 vaccination campaign… Roll up!
 NHS COVID-19 Vaccination Statistics, COVID-19 daily announced vaccinations 15 April 2021.xlsxhttps://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-vaccinations/f
 UK COVID-19 vaccine uptake plan, 13th Feb 2021 https://www.gov.uk/government/publications/covid-19-vaccination-uptake-plan/uk-covid-19-vaccine-uptake-plan#conclusion
 Public Health England https://publichealthmatters.blog.gov.uk/2020/12/02/the-roles-of-the-mhra-and-jcvi-in-covid-19-vaccines/
 Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination, 30 December 2020 https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-30-december-2020/joint-committee-on-vaccination-and-immunisation-advice-on-priority-groups-for-covid-19-vaccination-30-december-2020
 Polack FP, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020 Dec 31;383(27):2603-2615.
 COVID-19: analysing first vaccine effectiveness in the UK https://publichealthmatters.blog.gov.uk/2021/02/23/covid-19-analysing-first-vaccine-effectiveness-in-the-uk/