UK Covid efforts should target unvaccinated, says expert

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Efforts to increase uptake of Covid jabs in the UK should be concentrated on reducing the number of unvaccinated people rather than booster jabs, a leading expert has said.

As Omicron spread rapidly around the country towards the end of 2021, health advisers and government ministers stressed that two doses “are not enough” to protect against the new variant, urging those eligible to take up a booster dose as soon as possible.

The message hit home: in an attempt to avert another dismal Christmas and protect their loved ones people dashed to get jabbed, with 968,665 booster or third vaccinations reported on 21 December alone. But uptake subsequently fell dramatically, with booster doses now bobbing about 50,000 a day.

Now a leading vaccine expert has said the focus should be placed on reducing the numbers of those who have yet to have even their first jab.

“I think the booster programme might have reached saturation and [it is] best to concentrate on those who had no vaccine at all – as their chance of dying is 11 times higher than vaccinated folks,” said Prof Beate Kampmann, director of the vaccine centre at the London School of Hygiene & Tropical Medicine.

When the booster slowdown first became apparent, the government’s vaccine minister, Maggie Throup said the Christmas break and public holidays were key factors. But the ongoing slump suggests there is more at play.

Dr Simon Williams, a behavioural scientist at Swansea University, said one reason could be that people needed to wait 28 days after testing positive for Covid before they could have a booster.

“At the start of January, cases were astronomically high, with Omicron at its peak, so we might in theory see an increase in booster uptake now, as more people become eligible,” he said.

But he said hesitancy or complacency around booster jabs might also play a role, adding his own research had found many people have “variant fatigue” – the view that Omicron is just another variant and it is just time to get on with life.

“This has been compounded by a common perception that Omicron is a ‘milder’ variant,” Williams said, adding that, in fact, it is in large part thanks to vaccinations, including boosters, that Omicron has not lead to as many hospitalisations as initially feared.

Williams suggested falling levels of infection might also reduce the sense of urgency around getting boosted – despite boosters being one of the factors behind the decline.

But Kampmann said another reason was the perception of vaccine effectiveness. “I suspect it all has to do with people feeling less confident that the vaccine is going to protect them from Omicron infection, and the observation that despite vaccination people still had contracted this variant,” she said, adding people forget why the booster programme existed.

“Primarily [it is] to keep individuals out of hospital and protecting those who are the most vulnerable from progressing to severe disease. And for that the booster is definitely needed and has been shown to work very well,” she said.

The latest figures from the UK Health Security Agency reveal more than 90% of those aged 70 and over in England have now had a booster.

While Williams said he agreed a priority should be to continue to attempt to engage and encourage the unvaccinated to get vaccinated, particularly those who are vulnerable, he added boosters remained important, noting while the jabs did not fully prevent transmission, they helped. “To keep rates and illness going down, booster uptake is still needed,” he said.

While efforts are to understand the reasons for hesitancy in some communities and to counter misinformation are needed to encourage uptake of all Covid jabs, Williams said there was another issue to tackle to increase booster uptake.

“For some there might be a bit of a conflict or confusion between the message that boosters are important to help protect against the ongoing threat posed by Omicron, and the message that is sent out by the quite sudden removal of pretty much all policy protections and the reduction of the self-isolation period, coupled with the message of ‘getting on with it’,” he said.

Not for the first time in the pandemic, the message appears to be that when it comes to jabs, communication is key.

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