{"id":50750,"date":"2021-07-30T15:07:29","date_gmt":"2021-07-30T14:07:29","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50750"},"modified":"2021-08-11T10:51:34","modified_gmt":"2021-08-11T09:51:34","slug":"simon-hodes-mixed-messages-on-covid-19-childhood-vaccination-leave-gps-on-the-backfoot","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/07\/30\/simon-hodes-mixed-messages-on-covid-19-childhood-vaccination-leave-gps-on-the-backfoot\/","title":{"rendered":"Simon Hodes: Mixed messages on covid-19 childhood vaccination leave patients confused and GPs on the back foot"},"content":{"rendered":"<p><span style=\"font-weight: 400\">After much <\/span><a href=\"https:\/\/www.bmj.com\/content\/374\/bmj.n1866\"><span style=\"font-weight: 400\">discussion and debate<\/span><\/a><span style=\"font-weight: 400\">, on 19 July 2021, we finally heard <a href=\"https:\/\/www.gov.uk\/government\/news\/jcvi-issues-advice-on-covid-19-vaccination-of-children-and-young-people\">the Joint Committee on Vaccination and Immunisation<\/a>\u2019s <\/span><span style=\"font-weight: 400\">(JCVI) decision<\/span><span style=\"font-weight: 400\"> that the UK will now start vaccinating some at risk children against covid-19. The JCVI announced that \u201cchildren aged 12 to 15 with severe neurodisabilities, Down\u2019s syndrome, immunosuppression, and multiple or severe learning disabilities,&#8221; will receive the vaccine. The JCVI also recommends that \u201cchildren and young people aged 12 to 17 who live with an immunosuppressed person should be offered the vaccine,\u201d to protect their immunosuppressed household contacts.<\/span><\/p>\n<p><span style=\"font-weight: 400\">However, the decision to vaccinate children <\/span><a href=\"https:\/\/www.telegraph.co.uk\/politics\/2021\/07\/17\/children-will-get-covid-vaccines-vulnerable\/\"><span style=\"font-weight: 400\">was first released by the press <\/span><\/a><span style=\"font-weight: 400\">on 17 July, meaning that anxious parents were already calling GP surgeries asking about this before GPs had received any official communication.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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\u2019s vaccines be done at <\/span><a href=\"https:\/\/www.bmj.com\/content\/373\/bmj.n1578\"><span style=\"font-weight: 400\">mass vaccination sites or at GP led sites<\/span><\/a><span style=\"font-weight: 400\"> (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 (<\/span><a href=\"https:\/\/www.gov.uk\/government\/publications\/patient-group-directions-pgds\/patient-group-directions-who-can-use-them\"><span style=\"font-weight: 400\">Patient Group Directions<\/span><\/a><span style=\"font-weight: 400\">) are not yet in place.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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. \u201cIt is important that PCN Groupings do not begin to vaccinate eligible 12\u201315-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,\u201d said the bulletin. <\/span><a href=\"https:\/\/future.nhs.uk\/system\/login?nextURL=%2Fconnect%2Eti%2FP%5FC%5FN%2Fview%3FobjectId%3D108655941\"><span style=\"font-weight: 400\">An FAQ document<\/span><\/a><span style=\"font-weight: 400\"> on the covid-19 vaccination programme said it was \u201cimportant PCN groupings do not begin to vaccinate eligible 12\u201315-year-olds until we have confirmed details and revised the service specification.\u201d <\/span><span style=\"font-weight: 400\">The document added: \u201cWe will write soon with further information about the implementation of the JCVI\u2019s advice on the vaccination of 12-15-year-olds with specific underlying health conditions that put them at risk of serious covid-19.\u201d\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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, <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/14\/if-general-practice-fails-the-nhs-fails\/\"><span style=\"font-weight: 400\">already at or beyond breaking point<\/span><\/a><span style=\"font-weight: 400\">, 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\u2014and of course before the next school year.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">In his regular column in <em>The BMJ<\/em> a few months ago, <\/span><a href=\"https:\/\/www.bmj.com\/content\/371\/bmj.m3986\"><span style=\"font-weight: 400\">David Oliver called out<\/span><\/a><span style=\"font-weight: 400\"> the confused messaging that has characterised official communications during the pandemic.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">&#8220;<\/span><span style=\"font-weight: 400\">If you\u2019re going to announce a new policy, don\u2019t do it by leaking it to selected media outlets in advance of announcements. This has happened repeatedly throughout the pandemic. And don\u2019t give long advance notice of possible behaviour change relaxations,<\/span><span style=\"font-weight: 400\">\u201d he said.<\/span><\/p>\n<p><span style=\"font-weight: 400\">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.\u00a0<\/span><\/p>\n<p><em><span style=\"font-weight: 400\"><strong>Simon Hodes<\/strong>, <\/span><span style=\"font-weight: 400\">GP Partner Watford, Twitter: <\/span><a href=\"https:\/\/twitter.com\/DrSimonHodes?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor\"><span style=\"font-weight: 400\">@DrSimonHodes<\/span><\/a><\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: none declared.\u00a0<\/em><\/p>\n<p><em><span style=\"font-weight: 400\">All views expressed are my own.\u00a0<\/span><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>After much discussion and debate, on 19 July 2021, we finally heard the Joint Committee on Vaccination and Immunisation\u2019s (JCVI) decision that the UK will now start vaccinating some at [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/07\/30\/simon-hodes-mixed-messages-on-covid-19-childhood-vaccination-leave-gps-on-the-backfoot\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":66,"featured_media":50751,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-50750","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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