Poor Covid vaccine access for children in England ‘likely to widen inqualities’ | Coronavirus

Concerns have been raised around access to Covid jabs for young children after it was suggested they are unlikely to be offered as part of school vaccination programs in England.

On Tuesday, it was announced that all children aged five to 11 in England will be offered a Covid vaccine, following advice from the Joint Committee for Vaccination and Immunization (JCVI). Similar announcements have been made for Wales and Scotland, with Northern Ireland having confirmed it will do the same.

The Guardian understands that details of the vaccine rollout are still being finalized but, in England at least, a schools-based program is not likely to be the primary route.

Instead, the jabs will be offered from April at pharmacies, vaccination centers and, where appropriate, at GP surgeries.

The plans appear to be rooted in concerns that provision of the jabs in schools could disrupt other vaccination programs.

“School-based deployment will draw on many of the same resources required for the delivery of other routine immunization programmes, including for HPV, MenACWY (meningitis) and MMR (measles, mumps and rubella), coverage of which was affected over the last two years because of the pandemic,” the JCVI has noted.

There may also be other considerations.

“In principle school programs would represent an excellent opportunity to reach the target group, but I am not sure how comfortable, especially the younger children – and their parents – would be to receive an injection without (a) parent being present, and this needs to be explored with families,” said Beate Kampmann, professor of pediatric infection and immunity, and director of the vaccine center at the London School of Hygiene & Tropical Medicine.

Dr Simon Williams, a behavioral scientist at Swansea University, said he supported plans not to offer Covid vaccinations to five- to 11-year-olds in schools, noting a survey from the Office for National Statistics which found only six in 10 parents of children in that age bracket said they were likely to have their child vaccinated.

“The downside to it being offered through schools is that some parents might feel like this puts undue pressure on their decision, or might feel that it is less optional that way,” he said, adding having to book an appointment outside of school was less likely to create a sense of division or difference between those children and parents who decided to have the vaccine and those who did not.

But the plans have also raised concerns.

The JCVI itself has noted that offering vaccines to children at school has previously been associated with “higher levels of vaccine coverage with less inequality as measured by ethnicity and indices of deprivation”.

“[The challenge] is to make sure that those parents and children who do want the vaccine, but might find it harder to access or travel to other vaccination locations, or find time outside existing work and other commitments, are able to get it,” said Williams. “As such, making the vaccination appointments easy to book and making sure there are enough opportunities, including local and mobile sites and walk-ins, will help.”

Dr Helen Salisbury, a GP in Oxford and a member of the Independent Sage Committee, also raised concerns.

“If we hope to make vaccines easily accessible to all families who want them, it makes sense to do the vaccination in schools which is where the children already are,” she said, although she added the school health service would need extra support to do so given vaccine programs for older children need to continue at the same time.

Salisbury added that while some GP surgeries may be able to put on further clinics for young children to be vaccinated, others may not feel they have the capacity.

“The further option of mass vaccination centers is likely to limit the vaccination uptake to the most motivated families who also have access to transport, and is likely to widen inequalities,” she said.

“In other age groups, we can see that the least advantaged in our society have the lowest vaccine coverage: the mode of delivery of children’s vaccines needs to be considered carefully to prevent this being duplicated in this age group.”

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