Petition Update

[Lyndzi1]

Had an email today telling me that this petition has been rejected as it's not something UK Government or Parliament are responsible for. Thank you to all of you who supported it and got it as far as it did.

 

[Pumper_Sue]

The only reason people with diabetes have a bad outcome is if they are badly controlled or have complications.

If this is the case then shielding letters would have been issued at the 1st lockdown. Which in turn moves you up the list for vaccination.
The only people not on the priority list are shop workers, which imho is not right as they are sitting ducks.

 

[Hardy]

I don't think people with underlying health conditions (uhc) are low on the list. I read that there are 9 priority groups and those with uhc are in group 6.

1. residents in a care home for older adults and their carers
2. all those 80 years of age and over and frontline health and social care workers
3. all those 75 years of age and over
4. all those 70 years of age and over and clinically extremely vulnerable individuals[footnote 1]
5. all those 65 years of age and over
6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7. all those 60 years of age and over
8. all those 55 years of age and over
9. all those 50 years of age and over

 

[Lyndzi1]

That is one reason but not the only one. It is also a fact that coronavirus makes blood sugar levels impossible to control which is also why the outcome is worse for diabetics. As we know when we get any normal viruses or infections it is harder to control bs levels.

As I said, diabetics were originally on the shielding list but mysteriously taken off it so if anyone has better luck at finding out why please post an answer if you find one

 

[Sally71]

Under 16s with type 1 like my daughter aren’t on the list at all. And her doctors have all said that because she's well controlled she's at no greater risk than anyone else. Which must count for something surely? Yes having a virus makes it harder to control blood sugar levels but so does having a simple cold, or being female and having a period every month, and she doesn’t end up in hospital every time that happens. We just have to work a bit harder to keep things under control, c'est la vie!

 

[Inka]

That is one reason but not the only one. It is also a fact that coronavirus makes blood sugar levels impossible to control which is also why the outcome is worse for diabetics. As we know when we get any normal viruses or infections it is harder to control bs levels.

As I said, diabetics were originally on the shielding list but mysteriously taken off it so if anyone has better luck at finding out why please post an answer if you find one

I thought the reason was the sheer number of people with diabetes?

What I’m wondering is how they’ll organise the people with underlying conditions group. It’s one of the largest groups and comprises many people from young to older. Will they be prioritising people by age in the group? That would make sense eg split it into two or three groups and do those as sub-groups starting with the oldest first. Eg Clinically Vulnerable 50-64yrs, 30-49yrs, 16-29yrs.

When you look at the data about diabetes, it seems that age is a contributing risk so it would make sense to do us in age groups, especially as there’s talk about vaccine production problems.

 

[Kaylz]

It is also a fact that coronavirus makes blood sugar levels impossible to control which is also why the outcome is worse for diabetics

Not true, there are many that have had in range levels while suffering from it

 

[Pumper_Sue]

It is also a fact that coronavirus makes blood sugar levels impossible to control which is also why the outcome is worse for diabetics

I think you will find that it's the steroids causing a problem if they are needed as the dose is so high.

The vaccinations will happen sooner rather than later so a little more patience wont harm anyone 🙂
Personally I do not begrudge our VIP's (very important pensioners) being first on the list with all our carers and other HCP's and shop workers 🙂

 

[Sally71]

Yes I wouldn’t want to try to jump my daughter up the queue when there are so many people who obviously need the vaccine more urgently than she does.

 

[Stitch147]

I think you will find that it's the steroids causing a problem if they are needed as the dose is so high.

The vaccinations will happen sooner rather than later so a little more patience wont harm anyone 🙂
Personally I do not begrudge our VIP's (very important pensioners) being first on the list with all our carers and other HCP's and shop workers 🙂

I wish shop workers would be eligible sooner, would make work less stressful.

 

[ukjohn]

Well, I am 82 next month, yet I haven't heard a thing yet about vaccination, not even an invite, so I'm not sure where the priority is or works.🙄

 

[Amigo]

In an ideal world, everyone would be high up the priority list but it’s clearly a logistical nightmare to obtain and vaccinate the sheer numbers of people in each group so prioritisation based on serious vulnerability has to be established.
I‘m in group 4 as a clinically extremely vulnerable person with cancer of the immune system as well as diabetes. I wouldn’t expect my diabetes to confer any greater priority to be honest and there are so many millions of diabetics in the U.K. population (3.9 million), that some other group would have to be pushed back to push us forward.
I do understand and appreciate the issues and know diabetes isn’t created equal (some have more serious health issues and added clinical risk) but sorry, I couldn’t support the petition.

 

[grovesy]

Well, I am 82 next month, yet I haven't heard a thing yet about vaccination, not even an invite, so I'm not sure where the priority is or works.🙄

The roll out seems to be very patchy. In my area the Hospital 20 miles away was a hub, one group practice out in sticks here doing, my own Surgery have still not heard when they will be a participant.

 

[KARNAK]

Sorry can`t support it, diabetes.org.uk is a great campaigner on our behalf.
I`m sure extra donations would help them to obtain the same result as you
wish for diabetics eventually.

 

[trophywench]

The weird thing to me is that for about 10 days after testing positive my BG was fine but then just before Xmas and still now, I've been mega high and have increased some early morning basal rates plus put a 24hr TBR on. I was hypo this morning - but there again I hit a gin bottle last night, didn't hit it very hard cos I don't often do it - September was the last time I tasted any gin in fact! But at least a treble and a double, so we'll have to see what occurs overnight tonight stone cold sober!

 

[Steve_H]

The government, NHS and Oxford University created a QCOVID Risk calculator that the government stated it would use to access individual risk should a further lockdown be required, when it happened this was completely forgotten about (conveniently). Diabetes UK & the NHS National Adviser on Diabetes issued a statement that something like this should be used as peoples risk as even with Diabetes peoples risk will be different. Again why hasn't this been used to 1) access if people in Tier 4 should be having to go to work and 2) where people should be on the vaccine priority list.

 

[trophywench]

Well we're both in Group 4 being 70 and 70+ and both being clinically extremely vulnerable, so sorry all, it's really not in our interests to add shedloads of other folk for us to have to compete with to get our jabs.

Come on - as long as you stick to the rules of being masked as often as possible, not touching anyone else with a bargepole and not going out ANYwhere same as we're having to do - and have had to do already for 9 months you potentially have a good many more years of life ahead of you - whereas us old and knackered folk, simply do not.

I miss my family and the pleasure they bring when they're little. There's one who for definite hasn't met us since he was a babe in arms, and he's already toddling about now. Poor little B will be terrified of us when he meets us now. His big sis is a very good socialiser and talker at 3+ ish, so hopefully she'll accept us back again as long as we all do it steadily in well known company. It's just so hard being separated for so long. I mean I always think, well none of them are 'mine' cos I'm only their grandma's step mother - but if I feel like this - how does their real Greatgrandad feel? It's utterly alien for him cos he's the only grandad their mothers have ever known cos although their dad's dad was also alive 20+ years ago, he had very advanced Parkinson's so Grandad Dave just wasn't around in any meaningful way for any of them all in all.

 

[danielmg]

I've managed to have my first vaccine dose last week. I was offered this as I work within the NHS as well.

To be honest, as a few others have mentioned, I strongly believe staff in supermarkets/food stores are certainly 'key' workers and should be just as high on the list as NHS staff. My mum works in a large supermarket, with anyone being able to walk past on the checkouts without first checking if they have COVID-19 symptoms, or as she had last week, people behaving inappropriately and increase risk to staff and other customers. I'm more worried about my Mum who still has to visit my grandparents each week, and I would happily have given up my invite if it meant her, on someone else in a similar position, receiving the vaccine instead.

 

[Lyndzi1]

Please take the time to read the part in my first post where I said that quite rightly the most at risk take priority in the vaccination roll out.
I certainly do not begrudge any of these groups getting their jabs and I too believe many others should be up there as well. No one should feel bad for having theirs first.We all have many of them to thank for battling on through all this without a choice and risking their health and lives. I didnt say I think diabetics should take priority over these groups.

This terrible virus has impacted so many people in so many different ways and it breaks my heart to hear everyone's stories, even the good ones have me in tears.

My own Mum is 83, lives on her own and has had cancer twice and she hasn't heard a thing about getting her jab. I keep trying to find out when she'll get it but no one has a clue. I have visited her regularly all the way through with meals, shopping etc to the doorstep, celebrated her December birthday while trying to light candles on a cake in the wind and rain on the doorstep.Cried with her on my Dads anniversary... on the doorstep, when all she wants is the great big hug I can't give her. It's heart breaking but know it's what I have to do to protect her.

Sadly some of our stories prove that even some of those most at risk aren't even getting it yet so it will be a very, very long time before other groups get theirs.

 

[Becka]

Figures below are taken from O.N.S. estimates for the population of England (56,286,961) and of the number of people classed as Clinically Extremely Vulnerable (2,237,000)

5.1% of the population are 80+
3.4% of the population are 75–79
8.7% of the population are 70–74 (4.9%) or clinically extremely vulnerable and under 70 (3.8%)
5% of the population are 65–69

I do not know how many people are frontline health and care workers, but I will generously assume one million (in addition to those are 65 and over or clinically extremely vulnerable) which would be 1.8% of the population.

N.B. There are 1,164,729 full-time equivalent hospital and community health staff according to N.H.S. workforce data for September 2020. Of these 618,858 are professional qualified clinical staff.

That would make 23.1% (13,010,282) of the country prioritized ahead of those who are clinically vulnerable, which includes those with diabetes who are under 65 and not clinically extremely vulnerable.

N.B. 40.7% of those diagnosed with diabetes are aged 65 or older according to figures published by Public Health England in 2015. That proportion as well as though with co-morbidities which make them clinically extremely vulnerable will have already been included in the higher priority levels

To put it another way, of the remaining 76.9% (43,276,679) of the population, the least vulnerable diabetics are classed in the highest priority.

If being atop of over three-quarters of the population is "low on the list," what should the correct position be?

Also, diabetes has never been on the shielding list. As someone with then (and now, for that matter) out of control diabetes and who is both immunosuppressed and has a rare lung disease I obviously did a lot of research before the lockdown began to confirm my status.

For reference, this is the original list sent to primary care clinicians ahead of the introduction of shielding (and before the term clinically extremely vulnerable had even been introduced):

List of diseases and conditions considered to be very high risk (Group 1):

1. Solid organ transplant recipients

2. People with specific cancers

• People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer
• People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
• People having immunotherapy or other continuing antibody treatments for cancer
• People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
• People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe COPD

4. People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID, homozygous sickle cell disease)

5. People on immunosuppression therapies sufficient to significantly increase risk of infection

6. People who are pregnant with significant heart disease, congenital or acquired A copy of the letter sent to patients can be found in Annex 3. The patients of your practice that have been contacted can be identified through an “at high risk” indicator code that has been applied to each patient record by your clinical system supplier. Your supplier will inform you of the code they have used, which should be treated as temporary until a definitive list of COVID-19 ‘at risk’ SNOMED codes is released.

Your GP System supplier will also provide a report that will list those patients that have been centrally identified as being at high risk. You should have this by 23 March. We ask that you review this report for accuracy and, where any of these patients have dementia, a learning disability or autism, that you provide appropriate additional support to them to ensure they continue receiving access to care.

We have taken a two-pronged approach to identification of people on immunosuppression therapies sufficient to significantly increase the risk of infection (category 5). All patients on the following medications have been centrally identified and will be contacted via the letter:

• Azathioprine
• Mycophenolate (both types)
• Cyclosporin
• Sirolimus
• Tacrolimus

As for the rationale of the vaccine priority list, this is the reasoning given by the Joint Committee on Vaccination and Immunisation on how they have prioritize access to vaccines to provide the best pubic health outcomes.

JCVI has considered a number of different vaccination strategies, including those targeting transmission and those targeted at providing direct protection to persons most at risk.

In order to interrupt transmission, mathematical modelling indicates that we would need to vaccinate a large proportion of the population with a vaccine which is highly effective at preventing infection (transmission). At the start of the vaccination programme, good evidence on the effects of vaccination on transmission will not be available, and vaccine availability will be more limited. The best use of available vaccine will also, in part, be dependent on the point in the pandemic the UK is at.

Given the current epidemiological situation in the UK, the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality.

Age

Current evidence strongly indicates that the single greatest risk of mortality from COVID-19 is increasing age and that the risk increases exponentially with age. Mathematical modelling indicates that the optimal strategy for minimising future deaths or quality adjusted life year (QALY) losses is to offer vaccination to older age groups first. These models assume an available vaccine is both safe and effective in older adults. Data also indicates that the absolute risk of mortality is higher in those over 65 years than that seen in the majority of younger adults with an underlying health condition (see below). Accordingly, the committee’s advice largely prioritises based on age.

Age-based programmes are usually easier to implement and therefore achieve higher vaccine uptake. An age-based programme is also likely to increase uptake in those with clinical risk factors as the prevalence of these increases with age.

Older adults resident in care homes

There is clear evidence that those living in residential care homes for older adults have been disproportionately affected by COVID-19 as they have had a high risk of exposure to infection and are at higher clinical risk of severe disease and mortality. Given the increased risk of outbreaks, morbidity and mortality in these closed settings, these adults are considered to be at very high risk. The committee’s advice is that this group should be the highest priority for vaccination. Vaccination of residents and staff at the same time is considered to be a highly efficient strategy within a mass vaccination programme with the greatest potential impact (see below).

Health and social care workers

Frontline health and social care workers are at increased personal risk of exposure to infection with COVID-19 and of transmitting that infection to susceptible and vulnerable patients in health and social care settings. The committee considers frontline health and social care workers who provide care to vulnerable people a high priority for vaccination. Protecting them protects the health and social care service and recognises the risks that they face in this service. Even a small reduction in transmission arising from vaccination would add to the benefits of vaccinating this population, by reducing transmission from health and social care workers to multiple vulnerable patients and other staff members. This group includes those working in hospice care and those working temporarily in the COVID-19 vaccination programme who provide face-to-face clinical care.

There is evidence that infection rates are higher in residential care home staff than in those providing domiciliary care or in healthcare workers. Care home workers are therefore considered a very high priority for vaccination.

Prioritisation among health and social care workers

Frontline health and social care workers at high risk of acquiring infection, at high individual risk of developing serious disease, or at risk of transmitting infection to multiple vulnerable persons or other staff in a healthcare environment, are considered of higher priority for vaccination than those at lower risk. This prioritisation should be taken into account during vaccine deployment.

Clinically extremely vulnerable (shielding patients)

Individuals considered extremely clinically vulnerable have been shielding for much of the pandemic. This means that available data is likely to underestimate the risk in this group. Many of those who are clinically extremely vulnerable are in the oldest age groups and will be among the first to receive vaccine. Considering data from the first wave in the UK, the overall risk of mortality for clinically extremely vulnerable younger adults is estimated to be roughly the same as the risk to persons aged 70 to 74 years. Given the level of risk seen in this group as a whole, JCVI advises that persons aged less than 70 years who are clinically extremely vulnerable should be offered vaccine alongside those aged 70 to 74 years of age. There are 2 key exceptions to this, pregnant women with heart disease and children (see below).

Many individuals who are clinically extremely vulnerable will have some degree of immunosuppression or be immunocompromised and may not respond as well to the vaccine. Therefore, those who are clinically extremely vulnerable should continue to follow government advice on reducing their risk of infection. Consideration has been given to vaccination of household contacts of immunosuppressed individuals. However, at this time there is no data on the size of the effect of COVID-19 vaccines on transmission. Evidence is expected to accrue during the course of the vaccine programme, and until that time the committee is not in a position to advise vaccination solely on the basis of indirect protection. Once sufficient evidence becomes available the committee will consider options for a cocooning strategy for immunosuppressed individuals, including whether any specific vaccine is preferred in this population.

Persons with underlying health conditions

There is good evidence that certain underlying health conditions increase the risk of morbidity and mortality from COVID-19. When compared to persons without underlying health conditions, the absolute increased risk in those with underlying health conditions is considered generally to be lower than the increased risk in persons over the age of 65 years (with the exception of the clinically extremely vulnerable – see above). The committee’s advice is to offer vaccination to those aged 65 years and over followed by those in clinical risk groups aged 16 years and over. The main risk groups identified by the committee are set out below:

• chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and
• severe asthma
• chronic heart disease (and vascular disease)
• chronic kidney disease
• chronic liver disease
• chronic neurological disease including epilepsy
• Down’s syndrome
• severe and profound learning disability
• diabetes
• solid organ, bone marrow and stem cell transplant recipients
• people with specific cancers
• immunosuppression due to disease or treatment
• asplenia and splenic dysfunction
• morbid obesity
• severe mental illness

Other groups at higher risk, including those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill, should also be offered vaccination alongside these groups.

Joint Committee on Vaccination and Immunisation: advice on priority groups for COVID-19 vaccination, 30 December 2020

www.gov.uk