'Why aren’t ethnic minorities on priority list?’

By Professor Kailash Chand

British Medical Association

BRITAIN is the first country to authorise emergency use of a vac­cine for Sars-CoV-2, the virus that causes Cov­id-19. This vaccine is the first of its type.

Traditional vaccines are made up of small or inactivated doses of the whole disease-causing organism, or the pro­teins that it produces, which are introduced into the body to provoke the immune system in­to mounting a response. The new vaccine called mRNA vaccines, in con­trast, tricks the body in­to producing some of the viral proteins itself. And by getting the body to produce the viral proteins itself, mRNA vaccines cut out some of the manufacturing process and should be easier and quicker to produce than tradition­al vaccines.

To generate a good immune response, two doses of the vaccine will be given 21 days apart, with recipients protect­ed from about a week after their second dose.

The UK has already purchased 40 million doses of the vaccine, with 800,000 due to be rolled out to some of the most vulnerable people in society through a network of 1,000 prima­ry care hubs and more than 50 hospitals.

The Pfizer vaccine is the first of several Cov­id-19 vaccines to be ap­proved for use, but it al­so presents the greatest logistical challenges in terms of storage, trans­portation and dilution. It is 95 per cent effective and worked in all the groups who were given the vaccine, irrespective of age, sex, race or the country they lived in.

Knowing the com­plexities, it is unlikely that a wide-scale vacci­nation campaign will begin in full force until the new year. Inevitably, some may have to wait a little longer for a vac­cine that is easier to transport in small quantities to be available.

The practice of im­munisation dates back hundreds of years. Bud­dhist monks drank snake venom to confer immunity to snake bite. Variolation – smearing of a skin tear with cow­pox to confer immunity to smallpox – was prac­tised in 17th century China. Edward Jenner is considered the founder of vaccinology in the West in 1796, when he demonstrated immuni­ty to smallpox.

The NHS now routinely, effectively and safe­ly vaccinates the popu­lation against diphthe­ria, tetanus, pertussis, measles, mumps, rubel­la, polio (IPV), hib, hep­atitis B, varicella, hepa­titis A, pneumococcal, influenza and rotavirus.

We know from trials that more than 80,000 people worldwide have already been vaccinat­ed. The safety of the vaccine is ‘similar to other vaccines’ and ‘most of the side effects are very mild and usu­ally last for a day or so’, officials have said.

The government’s Joint Committee on Vaccination and Immu­nisation (JCVI) has pri­oritised nine groups of at-risk people to have the vaccine in the first phase, with care home residents and workers at the top and frontline health workers and the over-80s. However, it excludes the BAME com­munity in that priority.

Even though Covid has laid bare the gross inequalities in society through a disproportionate impact on BAME communities, there ap­pears to be little pro­gress made to ensure that we learned our les­sons in time. It seems hypocritical that politi­cians applaud the con­tribution of BAME healthcare staff, key workers and these com­munities in general, but no steps have been taken to ensure that they are protected from the threat of Covid.

It is despicable that BAME communities have been not consid­ered as a priority group for the imminent Covid vaccination, even though that would seem to be the logical approach, which is to protect those at higher risk.

The single paragraph in the guidance around BAME healthcare work­ers is also very vague and frankly, carries no weight. This is utterly disappointing when we have seen hundreds of them losing their lives. It would seem the pow­ers are happy for these communities to be de­ployed and to continue to work in high-risk en­vironments, but then treat them as second-class citizens when it comes to safety and protecting their lives. The BAME are good enough to work on the at-risk frontline services, good enough to die dispro­portionately, but not good enough to be pri­oritised for vaccination.

I sincerely hope that the JCVI urgently priori­tises BAME communities along with our elderly at highest risk, so that precious lives are saved.

The roll-out of the vaccine is the begin­ning, not the end, to de­feat this virus. It will take six to 12 months before enough people have been vaccinated to make a return to life as we knew it possible. To avoid any further increase in infections, and to save lives, it’s vital that the public remain vigi­lant and continue to ad­here to existing rules on hygiene, travel and so­cial mixing.

A word of caution. For political gains, don’t create unrealistic ex­pectations of timescale while the NHS prepares to administer the mil­lions of vaccinations so critical to the health of the nation, and to getting the economy back on track. Mistakes and con­sequent delays would be inexcusable when the stakes are this high.