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Covid-19: Are high rates of B.1.617.2 linked to vaccine hesitancy?

BMJ 2021; 373 doi: (Published 25 May 2021) Cite this as: BMJ 2021;373:n1345

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  1. Gareth Iacobucci
  1. The BMJ

Last week England’s health and social care secretary, Matt Hancock, linked high rates of infection and hospital admissions of people with the B.1.617.2 variant of covid-19 first identified in India to vaccine hesitancy. Giving an update to the House of Commons on 17 May Hancock said that most of the 19 people admitted to hospital with the variant in the hotspot area of Bolton, Greater Manchester, were eligible for a covid-19 vaccine but had not had it.1

Hancock said, “In Bolton, 19 people are now in hospital with coronavirus, the majority of whom are eligible for a vaccine but have not yet had one. That shows that the new variant is not tending to penetrate into older vaccinated groups and underlines again the importance of getting the jab—especially, but not only, among the vulnerable age groups.”

He added, “The majority of people in [the Royal Bolton] hospital with coronavirus were eligible for the jab but had chosen not yet to have it and have ended up in hospital—some of them in intensive care. Vaccines save lives. They protect you, they protect your loved ones, and they will help us all get out of this pandemic.”

Was Hancock right to frame the situation in this way?

Bolton NHS Foundation Trust, which runs Royal Bolton Hospital, said it could not issue any information about individual patients and could only refer The BMJ to national data on vaccination uptake. These data show that, while Bolton has the highest covid-19 case rate in England (424 cases per 100 000 people as at 18 May],2 its vaccine uptake (67.6% of adults had received a first dose as at 24 May) is broadly similar to the average for the rest of England.3

Similarly, in Blackburn with Darwen, the area of England with the second highest prevalence of B.1.617.2 (215.1 cases per 100 000 people on 18 May), 63.4% of first vaccine doses have been administered, again placing it close to the middle of the pack.

By comparison, Tower Hamlets in east London, which has the lowest percentage of first doses administered (36.6%) in England, has just 10.8 cases of the variant per 100 000 people. Hackney and the City of London combined, the next lowest borough area, with 39.1% of first doses given, has 10.7 cases per 100 000.

The Isle of Wight has the highest percentage of first doses administered in England (78.3%) and has 4.2 cases per 100 000.

Gabriel Scally, visiting professor of public health at the University of Bristol and a member of the Independent Scientific Advisory Group for Emergencies, believes it was wrong for Hancock to link Bolton’s vaccine uptake with hospital admissions, for several reasons.

Writing in the Guardian newspaper Scally wrote, “Hancock’s use of this information raises several important questions. How did the health secretary know such detailed clinical information about these individuals? How accurate were these numbers? And was it appropriate to suggest that a small number of people currently battling a deadly infectious disease in hospital had brought this illness upon themselves?”4

In a statement Bolton council’s director of public health, Helen Lowey, said, “There is no evidence these variants cause more severe illness; there is some evidence that the Indian variant spreads more easily than other covid-19 variants so it is the one that we want to stop and contain.”

Helen Wall, senior responsible officer of the covid-19 vaccination programme in Bolton, said, “We have a good track record of vaccination and a high level of confidence in the programme already in Bolton, and we aim to build on that with some targeted vaccination work to try to nip this in the bud to protect everyone in Bolton.”

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