This article examines data for the Spring 2024 Covid booster campaign in England to see what progress has been made to improve coverage amongst the eligible groups.
Interesting data. Perhaps I can offer some perspective on the immunocompromised group. I received a donor stem cell transplant in February 2020, and knew that I would have no immunity for at least a year. In the event I did not mount an antibody response to vaccination until my 7th vaccination. Since then my response has continued to improve. I have been part of the 'forgotten lives' group for immunocompromised people and am aware that a substantial portion of the group are permanently immunocompromised due to their primary pathology or to medication taken to control their illness. Many have been advised/ have realised that they have no chance of mounting a useful antibody response to COVID vaccination and have therefore declined further boosters. Indeed I believe that some have been advised against further vaccination by their consultants. The push for this group is for pre-exposure prophylaxis which is available in other countries but does not seem to be a priority for the JCVI.
It's interesting to see this breakdown of the areas where improvement is needed. Here in Northern Ireland we're also told that there has once again been low coverage for immunosuppressed people, but unfortunately the media reports tend to pass quickly over it in tones that veer from vague bafflement to victim-blaming. They always say we are "not taking them up" but never ask why.
The reality - and maybe immunosuppressed people in England have a parallel experience - is that the system has aggressively complicated the process of even finding out a booster is available, much less accessing one: and that's just my experience as someone eager to receive it. I'll tell you my story, because I feel that few commentators realise how torturous the process has become...
After three years of not receiving booster letters from my GP despite my eligibility, I was finally told that some immunosuppressants, despite being on the Green Book list, are not programmed into the algorithm my surgery's computer uses to flag up patients to receive a booster clinic letter. Ustekinumab/Stelara, a biologic used in the NHS for nearly a decade, is one such drug.
So now I have to judge when to contact my GP surgery based on increasingly vague word-of-mouth re: clinics. I used to gauge it based on my mum getting her letter: her age band got the primary vaccines about a month before immunosuppressed under-50s. But now the surgery gets a smaller supply and has stopped writing to patients, even elderly ones.
This spring, it turned out they'd printed an easily missed note on prescriptions to say patients would receive a text message. But my pharmacy collects my prescriptions and delivers my meds, so I don't always receive the paper scrip. And Mum - like many older and disabled people - didn't get the text message as she wasn't using a mobile at the time.
Rang my surgery; it took days to get through as you can no longer reach a person once their daily GP call limit is reached. Due to my age (40s) I got the usual skeptical interrogation re: my eligibility by reception staff, and they said a GP would have to ring me back. He told me both their vaccine clinics had ended: no supply left, and we both googled to figure out where to find a Trust vaccine clinic while he agreed to write me a letter proving my eligibility.
I booked for a clinic at one of our major teaching hospitals via the automated system, and received two confirmations, including one the night before my appointment. But on arrival, I found the ground floor like the Marie Celeste: no staff, just many computers. I explored the building, getting more and more anxious, until upstairs I found an admin clerk who'd been about to leave for the day.
She was baffled too and called a colleague: they eventually worked out that I'd passed a confusing, hastily printed sign downstairs. I'd been told in the email to follow the purple signage, and being autistic and literal, I'd gone past the printout and entered the building, because a more permanent-looking and purple sign had said "Vaccination Clinic". Nobody seemed to have considered that when printing signs, one ought to use clear, unambiguous language, a large font, and the colour patients have been told to look for.
It turned out that, without contacting patients with booked appointments, the vaccine clinic had packed up that very morning and moved to a different hospital on the other side of town. This was because the Encompass team (the NI Health and Social Care system's new integrated computer system, which was rolling out that month), based at the other hospital, had demanded and got the Vaccination Clinic building for their use instead.
I should mention here that at no point had I been given any contact phone number or named person to speak to about the vaccine clinic: there was no such information on the booster clinic booking website, in either of the emails I received confirming my appointment and giving directions to it, or on the poster directing me to the other hospital. If anything, it felt like the Trust actively preferred patients not to have a way of contacting them.
So I'd had an expensive taxi journey to one hospital and now had to have an even more expensive journey to another, on a Saturday, as that was now the only remaining option left - like many disabled people, I don't drive, and I don't know many people who can just ferry me places. As it turned out, taxi access was very difficult, and once I'd got the booster I got distressingly lost trying to find my way back to city landmarks I knew, and ended up in an unsafe situation.
The whole experience was overwhelming, confusing and distressing for me, as an autistic person with medical trauma and a complex medical history that makes avoiding further COVID infection vital (I've already had it once and been unable to access treatment due to poor official communication re: testing). I've done a lot of work a patient advocate, and am normally adept at researching questions of healthcare access and policy, but the situation I found myself in absolutely beat me. I'm dreading what the autumn booster process will be like.
But in the minds of the powerd that be, it's all the fault of immunosuppressed patients for not taking up the offer of a booster...
What happens to the vaccines that haven't been taken up? Presumably they'll be used in the Autumn when they will of course be even further distant from whatever the latest subvariant is by then.
As I understand it the Autumn 2024 booster campaign will be the last campaign that uses vaccines contracted and funded by the Covid vaccine task force who had a separate and protected budget for Covid vaccines. Unfortunately, these are not the vaccines developed for the latest variants.
The vaccine task force has now been disbanded, so Covid vaccines now come fully under the management of the NHS, including funding. It will be interesting to see what happens in Spring 2025 when it comes under the full control of the NHS.
Unfortunately, there has not been any data on Spring 2024 booster coverage for health workers published yet.
However, there was data published by NHS England (NHSE) for the Autumn 2023 booster campaign which I covered in a previous article. For England coverage was only 31% with the lowest coverage in the London region (25%). This is about the same as coverage for the 2023 Flu vaccination campaign. Worryingly, vaccine coverage in the NHSE for both Covid and Flu are declining with each successive year.
With just over 1 in 20 sickness days in NHS England attributed to Covid over Dec 2023/Jan 2024 you would hope for a higher take up,
Is there any data on the scope of people who bought vaccines because they want the protection but weren’t eligible? Given the current wave maybe it’s insignificant from a community protection point of view.
Interesting data. Perhaps I can offer some perspective on the immunocompromised group. I received a donor stem cell transplant in February 2020, and knew that I would have no immunity for at least a year. In the event I did not mount an antibody response to vaccination until my 7th vaccination. Since then my response has continued to improve. I have been part of the 'forgotten lives' group for immunocompromised people and am aware that a substantial portion of the group are permanently immunocompromised due to their primary pathology or to medication taken to control their illness. Many have been advised/ have realised that they have no chance of mounting a useful antibody response to COVID vaccination and have therefore declined further boosters. Indeed I believe that some have been advised against further vaccination by their consultants. The push for this group is for pre-exposure prophylaxis which is available in other countries but does not seem to be a priority for the JCVI.
It's interesting to see this breakdown of the areas where improvement is needed. Here in Northern Ireland we're also told that there has once again been low coverage for immunosuppressed people, but unfortunately the media reports tend to pass quickly over it in tones that veer from vague bafflement to victim-blaming. They always say we are "not taking them up" but never ask why.
The reality - and maybe immunosuppressed people in England have a parallel experience - is that the system has aggressively complicated the process of even finding out a booster is available, much less accessing one: and that's just my experience as someone eager to receive it. I'll tell you my story, because I feel that few commentators realise how torturous the process has become...
After three years of not receiving booster letters from my GP despite my eligibility, I was finally told that some immunosuppressants, despite being on the Green Book list, are not programmed into the algorithm my surgery's computer uses to flag up patients to receive a booster clinic letter. Ustekinumab/Stelara, a biologic used in the NHS for nearly a decade, is one such drug.
So now I have to judge when to contact my GP surgery based on increasingly vague word-of-mouth re: clinics. I used to gauge it based on my mum getting her letter: her age band got the primary vaccines about a month before immunosuppressed under-50s. But now the surgery gets a smaller supply and has stopped writing to patients, even elderly ones.
This spring, it turned out they'd printed an easily missed note on prescriptions to say patients would receive a text message. But my pharmacy collects my prescriptions and delivers my meds, so I don't always receive the paper scrip. And Mum - like many older and disabled people - didn't get the text message as she wasn't using a mobile at the time.
Rang my surgery; it took days to get through as you can no longer reach a person once their daily GP call limit is reached. Due to my age (40s) I got the usual skeptical interrogation re: my eligibility by reception staff, and they said a GP would have to ring me back. He told me both their vaccine clinics had ended: no supply left, and we both googled to figure out where to find a Trust vaccine clinic while he agreed to write me a letter proving my eligibility.
I booked for a clinic at one of our major teaching hospitals via the automated system, and received two confirmations, including one the night before my appointment. But on arrival, I found the ground floor like the Marie Celeste: no staff, just many computers. I explored the building, getting more and more anxious, until upstairs I found an admin clerk who'd been about to leave for the day.
She was baffled too and called a colleague: they eventually worked out that I'd passed a confusing, hastily printed sign downstairs. I'd been told in the email to follow the purple signage, and being autistic and literal, I'd gone past the printout and entered the building, because a more permanent-looking and purple sign had said "Vaccination Clinic". Nobody seemed to have considered that when printing signs, one ought to use clear, unambiguous language, a large font, and the colour patients have been told to look for.
It turned out that, without contacting patients with booked appointments, the vaccine clinic had packed up that very morning and moved to a different hospital on the other side of town. This was because the Encompass team (the NI Health and Social Care system's new integrated computer system, which was rolling out that month), based at the other hospital, had demanded and got the Vaccination Clinic building for their use instead.
I should mention here that at no point had I been given any contact phone number or named person to speak to about the vaccine clinic: there was no such information on the booster clinic booking website, in either of the emails I received confirming my appointment and giving directions to it, or on the poster directing me to the other hospital. If anything, it felt like the Trust actively preferred patients not to have a way of contacting them.
So I'd had an expensive taxi journey to one hospital and now had to have an even more expensive journey to another, on a Saturday, as that was now the only remaining option left - like many disabled people, I don't drive, and I don't know many people who can just ferry me places. As it turned out, taxi access was very difficult, and once I'd got the booster I got distressingly lost trying to find my way back to city landmarks I knew, and ended up in an unsafe situation.
The whole experience was overwhelming, confusing and distressing for me, as an autistic person with medical trauma and a complex medical history that makes avoiding further COVID infection vital (I've already had it once and been unable to access treatment due to poor official communication re: testing). I've done a lot of work a patient advocate, and am normally adept at researching questions of healthcare access and policy, but the situation I found myself in absolutely beat me. I'm dreading what the autumn booster process will be like.
But in the minds of the powerd that be, it's all the fault of immunosuppressed patients for not taking up the offer of a booster...
What happens to the vaccines that haven't been taken up? Presumably they'll be used in the Autumn when they will of course be even further distant from whatever the latest subvariant is by then.
Kate,
As I understand it the Autumn 2024 booster campaign will be the last campaign that uses vaccines contracted and funded by the Covid vaccine task force who had a separate and protected budget for Covid vaccines. Unfortunately, these are not the vaccines developed for the latest variants.
The vaccine task force has now been disbanded, so Covid vaccines now come fully under the management of the NHS, including funding. It will be interesting to see what happens in Spring 2025 when it comes under the full control of the NHS.
Is there any data on coverage for Health Care Workers?
Julian,
Unfortunately, there has not been any data on Spring 2024 booster coverage for health workers published yet.
However, there was data published by NHS England (NHSE) for the Autumn 2023 booster campaign which I covered in a previous article. For England coverage was only 31% with the lowest coverage in the London region (25%). This is about the same as coverage for the 2023 Flu vaccination campaign. Worryingly, vaccine coverage in the NHSE for both Covid and Flu are declining with each successive year.
With just over 1 in 20 sickness days in NHS England attributed to Covid over Dec 2023/Jan 2024 you would hope for a higher take up,
Is there any data on the scope of people who bought vaccines because they want the protection but weren’t eligible? Given the current wave maybe it’s insignificant from a community protection point of view.
Annette -- Unfortunately vaccinations bought privately do not appear on the NHS databases so we do not have this information.