Intended for healthcare professionals


Covid-19: GPs opt to prioritise all patients with learning disabilities for vaccination

BMJ 2021; 372 doi: (Published 19 February 2021) Cite this as: BMJ 2021;372:n510

Linked BMJ Opinion

People with an intellectual disability should be prioritised for vaccination

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  1. Gareth Iacobucci
  1. The BMJ

Local groups of GPs have decided to prioritise all patients with learning disabilities for covid-19 vaccination, after fresh evidence showed that disabled patients were at much higher risk from the disease.

Latest figures from the Office for National Statistics1 showed that 60% of people in England who died from covid-19 from January to November 2020 (30?296 of 50?888) had a disability.

This week an extra 1.7 million people in England2—including some with severe learning disabilities—are being added to the list of people identified as clinically extremely vulnerable to covid-19, although this does not include people with mild or moderate learning disabilities. But some clinical commissioning groups (CCGs) have deviated from national guidance and said that they will prioritise all patients with learning disabilities for vaccination given the disproportionate impact on them.

In a statement published on its website Kent and Medway CCG3 said that it had decided to include all adults with learning disabilities in the current priority phase for vaccination delivery. “Given the evidence of covid-19 inequalities increasing deaths amongst people with learning disabilities, the NHS in Kent and Medway has agreed to prioritise vaccinating the 9500 people on GP learning disability registers,” it said.

Oxfordshire CCG was also praised by local campaigners4 for adjusting its priority list so that everybody with a learning disability is included in priority group 6, regardless of its severity.

Lower life expectancy

The Office for National Statistics’ data showed that the risk of death involving covid-19 was 3.1 times greater in men who were more disabled and 1.9 times greater in less disabled men than in non-disabled men. The risk of death was 3.5 times greater in women who were more disabled and 2.0 times greater in less disabled women than in non-disabled women.

Helen Salisbury, an Oxford GP, said that she would “wholeheartedly support” adding all patients with learning disabilities to the priority list given the increased risk that they faced.

“It makes total sense, and I’m fully behind Oxford doing it,” she said. “The Green Book5 refers to those with severe and profound learning disabilities [as being in the age 16-65 at-risk group]. But one of the features of learning disabilities is being less able to follow all the rules and keep yourself safe, which puts you at increased risk of catching covid.”

Joe McManners, a GP in Oxford and clinical director of a local primary care network, also backed the move. “It is a very specific group who have lower life expectancy and a much higher risk of serious illness, so it’s the right decision,” he told The BMJ.

Edel Harris, chief executive of the learning disability charity Mencap, called for everyone in England with a learning disability in group 6 to have priority for vaccination.

She said, “It’s unacceptable that within a group of people hit so hard by the pandemic, and who even before covid died on average over 20 years younger than the general population, many are left feeling scared and wondering why they have been left out.

“The Joint Committee on Vaccination and Immunisation and government must act now to help save the lives of some of society’s most vulnerable people by urgently prioritising all people with a learning disability for the vaccine.”

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