Simon Hodes: Mixed messages on covid-19 childhood vaccination leave patients confused and GPs on the back foot

After much discussion and debate, on 19 July 2021, we finally heard the Joint Committee on Vaccination and Immunisation’s (JCVI) decision that the UK will now start vaccinating some at risk children against covid-19. The JCVI announced that “children aged 12 to 15 with severe neurodisabilities, Down’s syndrome, immunosuppression, and multiple or severe learning disabilities,” will receive the vaccine. The JCVI also recommends that “children and young people aged 12 to 17 who live with an immunosuppressed person should be offered the vaccine,” to protect their immunosuppressed household contacts.

However, the decision to vaccinate children was first released by the press on 17 July, meaning that anxious parents were already calling GP surgeries asking about this before GPs had received any official communication. 

In general practice we still have very little detail on how this will work. For example, who is expected to do the recalls for the children now eligible for the vaccine? Will it be centrally generated or via GP teams, and if so with what resource? Will children’s vaccines be done at mass vaccination sites or at GP led sites (who have delivered around 75% of vaccines thus far and are local with robust call/recall systems if needed). We cannot even start as the national agreed protocols (Patient Group Directions) are not yet in place.

Despite these questions still being unresolved, general practices have started to book appointments for the appropriate children, but we then received an NHS England bulletin late in the evening yesterday (29 July 2021), essentially advising a pause. “It is important that PCN Groupings do not begin to vaccinate eligible 12–15-year-olds until we have confirmed details and revised the service specification, because such vaccinations may not be covered by the general practice indemnity scheme,” said the bulletin. An FAQ document on the covid-19 vaccination programme said it was “important PCN groupings do not begin to vaccinate eligible 12–15-year-olds until we have confirmed details and revised the service specification.” The document added: “We will write soon with further information about the implementation of the JCVI’s advice on the vaccination of 12-15-year-olds with specific underlying health conditions that put them at risk of serious covid-19.”  

So once again, GPs find ourselves fielding queries from patients about a process released to the press ahead of any official guidance, then an official release several days later, yet no cohesive plan in place to deliver the vaccinations at the coal face. This is distressing for parents and embarrassing for GP teams, and is adding to our already unsustainable workload.

It would be really helpful for all concerned if NHS England could clarify when patients can be booked, how the recalls will work, and who will deliver the vaccines. GP teams, already at or beyond breaking point, need to be adequately resourced to deliver this next phase of the covid-19 vaccination rollout, as parents are naturally anxious to have their vulnerable children protected as soon as possible—and of course before the next school year. 

In his regular column in The BMJ a few months ago, David Oliver called out the confused messaging that has characterised official communications during the pandemic. 

If you’re going to announce a new policy, don’t do it by leaking it to selected media outlets in advance of announcements. This has happened repeatedly throughout the pandemic. And don’t give long advance notice of possible behaviour change relaxations,” he said.

These mixed messages sow seeds of confusion for the public, erode confidence in the already faltering vaccine rollout and leave GPs on the backfoot trying to quickly reorganise services, while patients are left worried and waiting to find out what will happen next. 

Simon Hodes, GP Partner Watford, Twitter: @DrSimonHodes

Competing interests: none declared. 

All views expressed are my own.