The gaps between posts are getting gradually longer and I have little excuse as I've been at home since March save for a brief, COVID-secure, sojourn to Dorset (UK, South Coast) in September. Fortunately my day-job is intact for the moment and I've avoided COVID (except possibly last Easter - see previous post). So now in the UK we are fortunate to have a vaccine roll-out in progress although who gets which vaccine and when is hard to predict. Broadly speaking, the elderly and those who look after them in a care-setting are high up the list. I haven't been contacted to get a jab yet - the so-called "clinically extremely vulnerable" are in the fourth priority group of nine in recent advice which I notice has just been withdrawn. (In case there is any doubt, yes I will be getting the vaccine at the earliest opportunity.)
Hot off the press is some updated advice to the UK government on vaccine priorities. The full document is here: advice on priority groups for COVID-19 vaccination, 30 December 2020. Some interesting extracts for "clinically extremely vulnerable" people i.e. including CLIPPERS patients being treated with steroids and/or steroid-sparing immunosuppressants include:
"the overall risk of mortality for clinically extremely vulnerable younger adults is estimated to be roughly the same as the risk to persons aged 70 to 74 years"
"Many individuals who are clinically extremely vulnerable will have some degree of immunosuppression or be immunocompromised and may not respond as well to the vaccine. Therefore, those who are clinically extremely vulnerable should continue to follow government advice on reducing their risk of infection."
"Consideration has been given to vaccination of household contacts of immunosuppressed individuals ..." (but until evidence is accrued ) "... the committee is not in a position to advise vaccination solely on the basis of indirect protection."
"Once sufficient evidence becomes available the committee will consider options for a cocooning strategy for immunosuppressed individuals, including whether any specific vaccine is preferred in this population."
So it sounds like the case for vaccinating immuno-suppressed people early is being strengthened and they are considering whether to also vaccinate other members of those households if there is evidence that the vaccines also reduce transmission. They also don't know which vaccine if any is a better fit for vulnerable groups. So no magic bullets yet and of course the UK government does not have a brilliant record for "following the science" whatever they may say publicly. Fingers-crossed for 2021.
Read other articles in this series at Living With CLIPPERS.
Living With CLIPPERS by Bill Crum is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
