We are publishing a guest post today by Dr. Peter Hayes, a Senior Lecturer in Politics at the University of Sunderland, pointing out that when it comes to vaccinating healthy 12-15 year-olds the Government can no longer claim to be following the science.
“Follow The Science” has been the defining slogan of Covid policymaking for the past year and a half. However, we may now be at turning point. On September 3rd, that august and scientific body The Joint Committee on Vaccination and Immunisation (JCVI) advised not to start vaccinating otherwise healthy 12-15 year-olds. The Government, however, seems likely to set about vaccinating them anyway.
In his letter to chief medical officers, Health Secretary Sajid Javid says that the JCVI is against vaccination of 12-15 year olds because its margin of benefit against harm is “too small” and tacitly suggests that the officers come up with something to enable him to override this advice. However, Javid’s spin on the committee’s advice is misleading. It is not only the marginal benefits of the vaccine but also the unknown extent of its harms that has led the JCVI to recommend against it.
(1) The JCVI states that in advising whether or not to vaccinate it has focused on “the benefit to children and young people themselves, weighed against any potential harms from vaccination”, and that it has done this to the exclusion of other issues such as cost.
(2) It states that overall “the benefits from vaccination are marginally greater than the potential known harms” [emphasis added].
If the benefits are greater, albeit only marginally, it might seem logical for the JCVI to approve of extending the vaccination program. The reason it does not is because of an important proviso. There is uncertainty, the JCVI says, about what the harms the vaccine might have in the medium to long term. There is, therefore, an asymmetry between our knowledge of the extent of the benefits of the vaccine and the extent of its harms. It is known perfectly well that the maximum benefit is small because even if it is assumed to protect every healthy child aged 12-15 from serious illness, very few become seriously ill anyway. The question of maximum harm is more open ended. In particular, the JCVI expresses concern over the very rare side effect of myocarditis. In the short term, the JCVI states, patients recover, but in the medium to longer term there is “the possibility of persistence of tissue damage resulting from inflammation”. Therefore, the JCVI argument is not simply that the marginal benefits are too small to recommend vaccination. It is that the benefits at best are small, and that while the known harms are marginally smaller, the unknowns might change this balance for the worse.
The JCVI also comments that while the effect of the vaccine on transition rates is uncertain, in its view any impact “may be relatively small”. This is significant when it comes to efforts to justify the vaccination of 12-15 year-olds on social and educational grounds. Although rather vague, such justifications implicitly assume a significant reduction in rates of transition.
The willingness of the JCVI to engage in critical scrutiny of the vaccination rollout has not been all that much in evidence in the past. No wonder the Government was unpleasantly surprised by its refusal to rubber stamp an extension to 12-15 year-olds. Perhaps the committee is heading out in a new direction. But more to the point, we are left with the question of the new direction taken by the Government.
If it is no longer following ‘the Science’, who is it following?
Stop Press: A senior panjandrum at the British Medical Association has said 12 year-olds should be able to overrule their parents to get a Covid vaccine because they’re “mature enough” – but admits jabbing teens will only cut infections by 20%.
