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Derek Maylor, NW BT Unions H&S Co-ord member and Health & Safety Officer (Telecom section) of the CWU's Grter Mersey Amal Branch; reports on a Royal Society Of Medicine webinar, looking at the vaccinatioin roll-out as it currently stands: The UK is currently undertaking its largest mass-vaccination program to protect millions from a virus that has already killed over 100,000 people in this country so we look at the roll-out, the strategic and immunological considerations. Victoria Macdonald, Channel 4 News Heath and Social Care Editor, chaired the session with Danny Mortimer, Chief Executive of the NHS Confederation, and Professor Sheena Cruickshank, immunologist and Professor in Biomedical Sciences and Public Engagement at the University of Manchester; considering the current status of the roll-out, the latest evidence on the one-shot strategy, offering insights into vaccine take-up among different population groups, immunity and the threat from mutations, and predictions for when we might start to see the impact of mass vaccination. The target date of 15th February for the over 70’s and most vulnerable will be met but there is still uncertainty about supply and major problems with ethnic reluctance for historical reasons. Trust is a major issue for some communities, people are disengaged with government, this can be seen in politics and very low turnout at elections etc. However this makes it easy to predict which estate or even which roads have an issue and address that with the local authority and community leaders. It has been a remarkable effort to get to this stage but there is not enough data on hesitancy and PHE are looking at ethnicity, there is even a difference in primary care colleagues in the take up of the vaccine in NHS staff. It is critical to get some protection for everyone ASAP and the initial jab clearly does that, delaying to help the majority get a high level of protection. One problem already seen is people’s behaviours changing as soon as they’ve had the vaccination but before it had time to give the protection, leaving them open to the virus, you are not protected as soon as the needle comes out of your arm; even when the B cell antibody response is high there is a period of time before these antibodies can kill the virus freshly entering the nose or throat. There is also a thought to consider workplace priorities, NHS staff and care workers have already been addressed and that was essential, but other key workers like postal staff and BT/Openreach engineers are customer facing, however taking this route could make it logistically very complicated and it could slow down the process of the national population vaccination. There are many variables and many trades that could claim to be a priority and full justify that, but the greatest good may be to rush on with targeting using the lowering age principle as soon as the most vulnerable are vaccinated. Going forward, the virus may return in some form regularly like flu, it may be possible to select a vaccine according to patient's specific immune disorder whether cellular or soluble immune deficiency or disorder. Before we went in to the pandemic we were already 1000’s of nurses short, there needs to be long term planning for the NHS as whole in every part of the service. Community immunity depends lots of variables, previously suggested that would require 80% of people to be vaccinated but that figure changes with who has been vaccinated for example, the vulnerable, ages etc. so that figure is nowhere near being written in ink and it could be well over 90%. Every country will come to their own decisions and we have seen a change with over 65’s in Germany, there is a difference in T cell response depending on age but we know the elderly are most vulnerable and also may have additional issues like diabetes, obesity etc. Finally, unless we can protect everybody we can’t protect ourselves and that includes the rest of the world, we cannot leave a reservoir for the virus to mutate and come back. Countries that are struggling must be helped and that means more than merely giving them the vaccine but in helping them with the logistics of getting it out to their population and completing their national programme. This is not just morally the right thing to do, though it certainly is that, but to eradicate the virus we must help others to do the same. Notes by Derek Maylor 4 February 2001
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