Doctors are being given more discretion to add patients they deem at high risk of covid-19 to the priority vaccination list.

Scotland’s Chief Medical Officer Dr Gregor Smith wrote to medics to say the list of conditions for priority group six is not ‘exhaustive’ and clinicians can refer patients they believe are at-risk to be vaccinated ahead of where they would be placed by their age alone.

Jabs for priority group six, which is those with underlying health conditions under the age of 65 as well as unpaid carers, are currently underway.

Separately priority group seven – 60 to 64-year-olds – is also being inoculated.

As of yesterday 1.8m people in Scotland had received their first dose of one of the two vaccines currently available.

Of this total 141,000 had received their second dose, including nearly 20,000 care home residents.

New research has suggested that vaccination cuts transmission of the virus by at least 30%.

Public Health Scotland said the figure, which was revealed by looking at virus rates among people living with a vaccinated health and care worker, was likely an underestimate as these relatives and housemates could have been infected from others.

It represented some of the first real world evidence on the vaccines’ effectiveness in reducing – but not stopping – transmission.

Identifying all those eligible in lower-priority groups has proved more difficult as the programme moves on from care home residents, health and care staff and the oldest Scots.

Vaccinations of everyone with a learning disability were brought forward to group six after concerns that some could be missed out – despite being much more at risk of severe covid-19.

Meanwhile an online portal has been set up to allow unpaid carers who are not known to the Scottish Social Services Council to register for vaccination.

Now doctors have more discretion to add people they have assessed as being more vulnerable to covid-19.

A letter sent this week from Dr Gregor Smith to NHS boards states: ‘You will be aware that agreeing the inclusion of a variety of medical conditions and underlying health risks for group 6 has been highly complex.

‘There are of course many rare diseases and conditions, and guidance in the [vaccination guidelines] Green Book states that the group 6 list is not exhaustive.’

Clinicians who consider that some of their patients are at high risk of infection and severe illness from covid-19 can refer these individuals to NHS boards.

This will allow ‘case by case risk assessment to consider vaccination ahead of the age based call up timeline in the general vaccine delivery programme,’ the letter states.

 

Read more: Care group asked to re-think vaccinated-only visiting; Change to learning disability vaccine plans; Unpaid carers next in line for vaccinations

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