Covid-19: MPs call for greater efforts to reach the unvaccinated and partially vaccinatedBMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o1743 (Published 13 July 2022) Cite this as: BMJ 2022;378:o1743
MPs have called on NHS England and the UK Health Security Agency (UKHSA) to redouble efforts to reach the almost three million adults in England who remain unvaccinated against covid-19 as well as those who are only partially vaccinated.
The Public Accounts Committee has challenged the government to reduce the overall number of unvaccinated people to 2.5 million and achieve an 80% uptake for first boosters within four months.
The committee’s report on the rollout of the covid-19 vaccine programme acknowledged its early success but said low vaccination rates persist in many vulnerable groups including pregnant women and minority ethnic groups.1
At the end of May 2022, 2.98 million adults in England remained unvaccinated with a further 1.5 million only having had one dose of a covid-19 vaccine. Although 90% of the adult population has received two doses of vaccine, the uptake for the first booster, for which all adults are eligible, is only 73%.
The report points out that by the end of May 2022 only 55% of young people aged 16 and 17 had received two doses and only 38% of 12 to 15 year olds. As of February 2022 only 58% of pregnant women had received two doses.
The committee said that NHS England and UKHSA should urgently evaluate which approaches are most effective for increasing uptake and communicate again with local areas about what works. It says there need to be fresh approaches to tackling the persistent low uptake observed in some ethnic groups. Compared with people of white British origin, people of black, black British, and Pakistani origins were less than half as likely to have had their boosters.
The committee’s chair Meg Hillier said, “Despite work to date, low vaccination rates persist in many vulnerable groups and fresh approaches are needed to reach them. It’s important that early success does not mean that the department and NHS England take their eye off the ball in tackling future challenges and getting vaccines to hard to reach groups.”
The committee said it is not yet clear how NHS England’s strategy of reducing vaccine sites and staffing for the rest of 2022 will strike the right balance between maintaining high vaccination levels and ensuring that demands on healthcare staff are sustainable. It called for clear costed plans by the end of October 2022 on how the programme will ensure both value for money and accessibility, including who it expects will administer vaccinations and in what locations.
The Department of Health and Social Care (DHSC) should also carry out a systematic exercise to identify successes and lessons from the vaccination programme and see how they can be applied to emergency response planning and other government programmes, the report recommends.
The committee also warned against over-reliance on two vaccines—Pfizer and Moderna. It said although the vaccine taskforce is confident that these two mRNA vaccines are the most effective choice for boosters there is still uncertainty about what might be needed in the future which the original portfolio strategy of seven candidate vaccines was designed to mitigate.
In the 2021 spending review, the DHSC received £9.6bn for all its key covid-19 programmes throughout the three year review period. The committee expressed concern, however, that the department has not finalised how this money will be allocated for 2022-23, creating uncertainty for the vaccine programme. It also has not finalised the 2022-23 budget for UKHSA, which has key roles in covid-19 vaccine storage and distribution as well as monitoring.
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