Despite rhetoric on #healthinequalities, the current UK #vaccination strategy discriminates against poorer people.

🧵 below on why.

Immediate action needs to be allowing vacc sites to move down cohorts (& providing supply to do so)

@CdsPcn @NikkiKF @CMO_England @Jeremy_Hunt
With the exception of HCWs, the top JCVI cohorts are based on biological age.

But poverty affects life expectancy. In poor areas people don't live so long.
Our #PCN covers a highly deprived area. Most people don't live to be over 80. Or > 75 for that matter. Our first cohorts are tiny.

BUT we have huge numbers of patients in cohort 4 (over 70, and clinically extremely vulnerable). That's b/c we have LOADS of ppl w multimorbidity
We got through our over 80's cohort on day 1 of vaccinating. We're desperate to be able to vaccinate the bulk of our eligible patients (i.e cohort 4) but @NHSEngland say 'no'.

We can vaccinate, and we want to, but we're having 2 weeks with no deliveries.
Poverty is a risk factor for death from #COVID19 , but it's overlooked by the JCVI.

Many of my clinically extremely vulnerable patients live in overcrowded, inter-generational households where relatives still have to work outside the home.

They can't shield properly.
They're at much higher risk of exposure to/death from COVID than a spritely>80 year old who can effectively isolate, and get online shopping from Occado (aka my elderly relatives). Brutal to have to make those arguments, but true.
We desperately need flexibility of vaccine delivery to match local factors and #PCN vaccine delivery capacity.

If we have capacity (we do) and huge numbers of deprived, vulnerable people please please let us 💉
Also, unless we're allowed to crack on, we'll be having to vaccinate our massive cohorts (4,5,6) at the same time as doing second doses for first cohorts.

And then we really will run out of capacity.

For equity and efficiency we need to be allowed to move through the cohorts
Nb. I realise that this argument makes it harder for the PM to reach the Feb cohort 1&2 target. But that's a political goal, and IMHO not the right one.

@doctor_oxford @ADMBriggs @CharlesTTHF @fhussain73 @JennieJoyce6 @sarahwollaston @PaulWilliamsLAB

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