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Will non-severe asthmatics get a Covid-19 jab as part of Priorty Group 6?There is currently much confusion about the answer to this question. I've spent the last 24 hours trying to clarify things for @bmj_latest.
Article coming soon but here's a thread...
First, some pictures to share with you.
Exhibit A: NHS guidance on who is at moderate risk from Covid-19. People with *non-severe* asthma are defined as "clinically vulnerable". Severe asthma meanwhile = "clinically extremely vulnerable".
https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/
Exhibit A: NHS guidance on who is at moderate risk from Covid-19. People with *non-severe* asthma are defined as "clinically vulnerable". Severe asthma meanwhile = "clinically extremely vulnerable".
https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/whos-at-higher-risk-from-coronavirus/
Exhibit B: PHE guidance published 8 January that says people with asthma who use steroid inhalers - remember this bit - should be offered a vaccine. (They note the seriousness of one's condition will be a factor, though.)
https://www.gov.uk/government/publications/covid-19-vaccination-easy-read-resources/information-on-covid-19-vaccination-easy-read-guide
https://www.gov.uk/government/publications/covid-19-vaccination-easy-read-resources/information-on-covid-19-vaccination-easy-read-guide
Exhibit C: Asthma UK, a charity that has been calling for clarity on which asthmatics will receive a jab for months, tweeting in Dec that those using steroid inhalers and who get an annual flu jab, should get a vaccine.
With me so far? All seems clear, doesn't it?
With me so far? All seems clear, doesn't it?
But wait.
Exhibit D: The green book, which defines in more (but NOT exhaustive) detail which asthmatics are in line for the vaccine in Group 6. N.B. "systemic steroids" - this is NOT inhalers but rather oral steroid tablets taken by people with more severe asthma issues.
Exhibit D: The green book, which defines in more (but NOT exhaustive) detail which asthmatics are in line for the vaccine in Group 6. N.B. "systemic steroids" - this is NOT inhalers but rather oral steroid tablets taken by people with more severe asthma issues.
The long and short of it = there has long been a lack of clarity over what criteria, exactly, would make an asthmatic person eligible for Covid-19 vaccination. Asthma UK hoped to clear that up to some extent this week: https://twitter.com/asthmauk/status/1359106453135581184
That key line - that people with "well-controlled asthma" would NOT be eligible for the vaccine was news to some, including many asthmatics.
Some had previously seen Asthma UK's December messaging ("steroid inhalers / flu jab = you'll likely get Covid-19 jab").
Some had previously seen Asthma UK's December messaging ("steroid inhalers / flu jab = you'll likely get Covid-19 jab").
In a statement, Asthma UK said the information in December was based on communication with the Department of Health and Social Care.
I have asked the DHSC what happened here - am still waiting for their response.
I have asked the DHSC what happened here - am still waiting for their response.
I have also asked Public Health England if their advice mentioned above, that asthmatics using steroid inhalers will get the jab, is in fact incorrect.
I am still waiting for a response from them also.
I am still waiting for a response from them also.
It's not just asthmatics who have been left wondering what's going on. Many GPs had assumed that asthmatics using inhalers, those who get their flu jab annually, would also get a Covid-19 jab early - but some GPs have recently received guidance that this is NOT the case.
In fact I spoke to one GP yesterday who said that, until I contacted them, they still expected to vaccinate asthmatics on inhalers as part of Group 6.
The situation has not been helped by various media reports this morning suggesting that asthmatics who use inhalers / get a flu jab WOULD be in Group 6! Some of these stories have been edited / updated. Others have not.
The reason for not including asthmatics with well-controlled symptoms = there's now more evidence that they are not at higher risk of hospitalisation / death due to Covid-19.
If that is the thinking behind the green book (published in Nov), why is it not more widely understood?
If that is the thinking behind the green book (published in Nov), why is it not more widely understood?
As of this lunchtime, full clarity on which asthmatics will be part of Group 6 still appears to be lacking.
And I'm still not sure myself whether asthmatics using steroid inhalers only / who get a flu jab because of this definitely won't be in Group 6. https://twitter.com/swoolnough/status/1359808027210178563
And I'm still not sure myself whether asthmatics using steroid inhalers only / who get a flu jab because of this definitely won't be in Group 6. https://twitter.com/swoolnough/status/1359808027210178563
If I get any updates on the situation, I will post them here. I'll also link to my article when it goes live - should be soon!
An update - I asked the Department of Health in Northern Ireland (where I am based) which asthmatics would get an early jab as part of Group 6. They have referred me to the green book and made no reference to steroid inhalers / flu jabs.
NEW: A colleague gets in touch to say their GP offered them a vaccine recently - but this person is a young adult with *mild* asthma only, takes inhalers, no history of hospitalisation and no other conditions.
(The doc linked here btw mentions "severe asthma" only.)
(The doc linked here btw mentions "severe asthma" only.)
Imagine how much more complicated this gets if some GPs start giving jabs to mild asthmatics while others do not.
An update - am told PHE guidance I mentioned, here again below, is to be updated. But I am not told how, exactly.
I will keep asking.
Still no comment from DHSC on claim it previously informed Asthma UK that asthmatics who use steroid inhalers would get Covid-19 jab.
I will keep asking.
Still no comment from DHSC on claim it previously informed Asthma UK that asthmatics who use steroid inhalers would get Covid-19 jab.
If you are asthmatic without severe symptoms (e.g. no recent history of hospitalisation or oral steroid use but you do use inhalers / get annual free flu jab - or similar) and you get offered a vaccine soon (or have already), feel free to drop me a DM.
NEW: Statement from Sarah Woolnough, Chief Executive of Asthma UK + British Lung Foundation:“We have been urging the government for clarity on which priority group people with asthma will be in for the COVID vaccine and we have now been given further information. If you...
...were sent a shielding letter, you will be in group 4. If you have ever had an emergency hospital admission for your asthma, or ever been prescribed three courses of steroid tablets in a three-month period you will fall into priority group 6...
...If you do not fall into either of these groups and are under the age of 50, you will be vaccinated after the first 9 priority groups.
"We hope this makes things clearer for everyone now and that by sharing this information, people with asthma will be able to recognise...
"We hope this makes things clearer for everyone now and that by sharing this information, people with asthma will be able to recognise...
...from the criteria if they are eligible to have the vaccine in group 6."
An additional statement from @asthmauk "We have been told that if your records show both a diagnosis of asthma and an emergency hospital admission with asthma, you will be in priority group six."
In my opinion (and I'm not a doctor) this seems like a softening of this week's guidance that may broaden it slightly - but many asthmatics will still feel they won't be covered.
Having said that, I have had several reports 4rm asthmatics who say they have mild/moderate symptoms, r young, no other conditions, no history of hospitalisation - saying they are being offered a jab by their GP
It MAY be that, in reality, lots end up getting vaccinated anyway.
It MAY be that, in reality, lots end up getting vaccinated anyway.
Thing is, it's hard for someone to know for sure why they've been offered the jab by a GP unless they're told explicitly. Some people are just receiving automated texts.
If you're a GP and want to comment on this issue, drop me a DM.
If you're a GP and want to comment on this issue, drop me a DM.
