Maybe the JCVI decision does make sense. Thread.

I've revisited their terms of reference. They're all about cost-effectiveness.…
They appear to have framed the benefits of vaccinating 12-15-yos exclusively in terms of the short term healthcare costs that would be avoided.

They appear not to have considered the wider benefits to children's.

Such as a reduction in disruption to education.
Such as distress when parents or grandparents get ill, can't work/earn due to Long Covid, or die.

Or the harm to the 1 in 7 children who get Long Covid, or the minority with permanent organ damage.
By ignoring all these benefits and only looking at the short-term costs to the health service of treating the initial illness,
they're found that there is a benefit to vaccinating 12 to 15-year olds, but it doesn't meet the NICE cost-effectiveness threshold.
We've been here before. When a vaccine was introduced against Group B meningococcal disease it was expensive, and not initially thought to be cost-effective.
They subsequently revisited the costs, and included the long-term costs of the people who have the disease and survive, but with permanent impairments.

Deafness, blindness, intellectual impairment, amputations, and so on.
When they looked at the costs of caring for people with these conditions, and the loss of their contribution to the economy through employment and taxation, caring, and so on, they soon found that the benefits of vaccination were worth more than the costs of the vaccination…

In the meantime, however children, missed out on this meningococcal vaccine.
We are staring down the barrels of the highly transmissible delta variant gun, and of the other more virulent or more transmissible variants that may arise if we do not control the virus as quickly as possible.
We do not have time to specify the value of the benefits of vaccination the last few £100 before making her decision to implement the vaccine.

End of thread.
My apologies for the typos - tweeting and exercise don't go well together. The brain works; the typing fingers and proof-reading don't!
ps Initially I wasn't convinced the economic case for introducing so-called meningococcal group B vaccines had been made.…

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More from @petermbenglish

30 Aug
We know SARS-CoV-2 can infect the brain.

So can measles, which occasionally causes SSPE - a progressive and invariably fatal brain disease, which typically becomes apparent years after measles infection.…
About a century ago something - almost certainly virus - caused an epidemic of encephalitis lethargica.…

How do we know that SARS-CoV-2 won't do something similar, possibly years after infection?

The answer is that we don't. It might do this.
That's one reason why I worry so much about the "children aren't at risk" messaging. It will be years before we will be able to say this with confidence.
Read 4 tweets
21 Aug
1/ Like so many of us, I have been watching, aghast, as evil forces take over Afghanistan, and wondering "how can this be happening?"

It's not my area of expertise.

I think it's a proxy war.
2/ I think many of the Taliban fighters (and financial backers) are not Afghans, but extremists from other countries, who want to impose a misogynistic, illiberal culture on Afghanistan (initially). Probably ultimately on the world; but Afghanistan is weak and susceptible.
3/ But what do I know?

I hear people saying - "we cannot, indefinitely, hold the line with our military - eventually the local government must do this, and we must withdraw. We cannot continue to lose our own people's lives, and pay the vast costs."
Read 34 tweets
11 Aug
1/ Are we still at the point [genuine question] where a dose of Covid vaccine given in eg UK or USA deprives somebody in a poorer country from a dose?

And if so - is that because we haven't done enough to ramp up production?

What should be our priority now?
2/ Should we be boosting production in Africa, Asia, South America, and elsewhere?
3/ Will there come a point where the argument that we shouldn't vaccinate [lower risk groups] in rich countries until higher risk groups in poorer countries have been vaccinated becomes irrelevant, because there's enough manufacturing capacity everywhere?
Read 4 tweets
28 Jul
I was just told "my son went to the Latitude festival, and he and all the people he went with have Covid".

This begs so many questions!
Transmission is predominantly airborne, and mainly occurs when aerosolised respiratory droplets can accumulate, and you spend enough time in the space to breathe in an infectious dose.

That's what most of us believe.
An anecdote like this suggests so many hypotheses that could be tested by investigating transmission patterns at events like Latitude.

Who are the people the son went with? What did they do together? Can you identify clusters or chains of transmission?
Read 10 tweets
27 Jul
1/ There's been a lot of talk about Covid-19 becoming "endemic".

Which means it circulates normally.

It doesn't mean "trivial" or unimportant.

(Long thread.)
2/ (A version of this thread is available at my blog:… .)
3/ Polio was endemic in many countries in the mid-twentieth century. Smallpox ditto, for a much longer period. Both caused death and disability.

Populations which had been exposed to them had lower mortality rates; but that didn't mean the disease was trivial.
Read 51 tweets
27 Jul
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