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Homeless healthcare specialist nurses Helen Gee (left) and Liz Thomas giving Covid-19 vaccines to homeless people at their mobile clinic in Manchester.
Homeless healthcare specialist nurses Helen Gee (left) and Liz Thomas at their mobile clinic. Photograph: Christopher Thomond/The Guardian
Homeless healthcare specialist nurses Helen Gee (left) and Liz Thomas at their mobile clinic. Photograph: Christopher Thomond/The Guardian

Homeless and rough sleepers in England prioritised for vaccine

This article is more than 3 years old

Matt Hancock acts on official advice concerning segment of society more likely to be in poor health

The government has taken up official advice that homeless people and those sleeping rough should be prioritised for coronavirus vaccines, given they are more likely to have undiagnosed conditions and have less regular access to healthcare.

In a letter to the government’s Joint Committee on Vaccination and Immunisation, (JCVI), which has set out the timetable for the vaccination programme, Matt Hancock agreed that homeless people should be put in group six, designated as people with underlying health conditions that place them at greater risk of Covid.

The health secretary also agreed to a JCVI suggestion that prison officers could be vaccinated early if there were any doses left over in jails or other detention settings that were intended for use by prisoners eligible under health or age criteria.

The UK recorded 6,753 new coronavirus cases on Thursday, the highest daily figure for almost two weeks, although there has also been a significant rise in testing, as schools have fully returned in England.

Other data showed that in the week to 7 March, 7% of local authorities in England recorded a rise in case rates, with 92% seeing a fall and one area unchanged.

The JCVI and the government had opted not to offer early vaccinations to prison officers, or to other frontline staff such as police and teachers, and to base the rollout purely on age and health conditions, prompting objections from trade unions.

In a letter to Hancock this month, the JCVI noted that people who were homeless or sleeping rough had high rates of undiagnosed comorbidities, and that half of them in effect had no access to healthcare.

Many thousands of usual rough sleepers are currently in accommodation, giving “a unique opportunity to in-reach vaccination to a population that is otherwise often unable to access basic healthcare”, the letter said.

In his reply on Thursday, Hancock said he was happy for NHS England teams to treat homeless or rough-sleeping people alongside group 6, as part of a “pragmatic approach to the dosing schedule”.

Prof Wei Shen Lim, the chair of the JCVI’s Covid-19 programme, said: “This advice will help us to protect more people who are at greater risk, ensuring that fewer people become seriously ill or die from the virus.”

Hancock said on Thursday: “We know there are heightened risks for those who sleep rough and today I have accepted the advice of the independent experts at the JCVI to prioritise those experiencing rough sleeping or homelessness for vaccination alongside priority group 6.”

Quick Guide

Vaccines: how effective is each one?

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Pfizer/BioNTech

Country US/Germany

Efficacy 95% a week after the second shot. Pfizer says it is only 52% after the first dose but the UK’s Joint Committee on Vaccination and Immunisation (JCVI) says this may rise to 90% after 21 days.

Doses Clinical trials involved two doses 21 days apart. The UK is stretching this to 12 weeks.


Oxford/AstraZeneca

Country UK

Efficacy 70.4% 14 days after receiving the second dose. May have up to 90% efficacy when given as a half dose followed by a full dose. No severe disease or hospitalisations in anyone who received the vaccine. 

There have been concerns it is less effective against the South African variant of the coronavirus, and that a rare type of blood clot can be a side effect.

Doses Two, four to 12 weeks apart


Moderna

Country US

Efficacy Phase 3 trial results suggest 94.1%.

Doses Two, 28 days apart


Novavax

Country US

Efficacy Phase 3 trials suggest 89.3%.

Doses Two


Janssen (part of Johnson & Johnson)

Country US

Efficacy 72% in preventing mild to moderate cases in US trials but 66% efficacy observed in international trials. 85% efficacy against severe illness, and 100% protection against hospitalisation and death.

Doses: One, making it unique among Covid vaccines with phase 3 results so far


Sinovac

Country China

Efficacy Unclear. Researchers in Brazil have found the efficacy of the Chinese vaccine to be as low as 50.4%, whereas Turkish officials reported interim data from trials showing efficacy was 91%.

Photograph: Stéphane Mahé/X02520
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On prison officers, Hancock said in his letter that the vaccination programme was now reaching significant numbers of people in detention, but that NHS England should “bear the JCVI advice in mind for the future, considering its practicality, should current circumstances change”.

But in principle, Hancock said, he was happy for prison staff to be given any unused doses, and “this should be done wherever possible”.

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