The World Health Organisation (WHO) estimates that vaccination prevents between 3.5 million and 5 million deaths across the world every year. Therefore it is evident that vaccination is one of the most successful and cost-effective interventions; savinge lives and improving health outcomes.
A study conducted by Edinburgh University and Health Data Research UK on vaccine coverage has recently been published in the Lancet. One of the largest surveys of its kind, involving data from 67 million people across the UK revealed that between 33-50% of the UK population had not received the recommended number of COVID vaccinations and boosters by summer 2022. Moreover, this “vaccine deficit” resulted in a higher risk of severe COVID-19 symptoms across all age groups compared to those who had received the recommended number of vaccine doses.
Could this be why we are still hearing reports that 1.5 million people’s day to day activities are adversely affected by Long Covid symptoms, and experiencing or witnessing the unrelenting pressure on our already overburdened and under resourced NHS, where hospitalisations are still happening due to Covid?
Is the prevalence of long COVID compounded by under vaccination?
These findings are frightening and since NHS estimates suggest that 40% of its budget is spent on treating preventable conditions, we need to find ways of reducing pressure on our healthcare services. Reform of the NHS has thus far been piecemeal and preventative health initiatives have been subject to budget constraints. Some excellent preventative schemes have been abandoned all together or postponed because of the fallout from the COVID pandemic particularly due to increases in hospital waiting lists.
In a previous article I outlined the advances in vaccine research, technology and treatment regimens which were given a significant boost as a result of the need for a suitable vaccine to be developed to prevent disease spread and deaths due to the Covid pandemic. If we could tackle the causes and drivers to low confidence and vaccine hesitancy, such as socioeconomic and healthcare inequalities, misinformation, concerns about long-term effects, their importance, safety and efficacy, previous Covid infection, we could develop and deploy a new strategy in disease prevention and treatment, which would reduce pressure on our health services.
Where politics meets healthcare expertise
Whilst it is obvious that politicians need to be involved in any proposed reforms, the expertise of those in the NHS needs to inform the entire process. There is no substitute for the knowledge and insight gleaned from years on the frontline of our health services. Various initiatives including one from Labour, ‘4 nation approach’, as the solution to the current problems within the NHS and healthcare throughout the UK, and another from Tony Blair, one of the initial architects of stealth privatisation of the NHS, have been proposed.
The latter is promoting the adoption of a new organisation called Protect Britain which will use artificial intelligence (AI) to determine those at risk from preventable disease and build on the ‘ success’ of the vaccine roll-out and operate alongside the NHS. Whilst being sold on the basis that the new organisation would save the NHS billions and the promotion of preventative vaccine programs is laudable, the scheme also promotes the use of weight reduction medication and other pharmaceuticals. It would also involve everyone’s health data being potentially exposed to nefarious actors or vested interests. The claim that Protect Britain would save billions may well fall by the wayside, given the propensity of pharmaceutical companies to put profits before people.
Current disease prevention initiatives in Scotland
Aside from the ongoing programme of Covid vaccination and childhood illness vaccinations there are other vaccines which are routinely made available. Some are targeted at specific age groups following research into their effectiveness.
A vaccination success story – Cervical cancer prevention
Cervical cancer is the fourth most common cancer in women and a major cause of morbidity and mortality worldwide. In Scotland, a national programme of routine immunisation of girls aged 12-13 against the primary causative agent of cervical cancer Human Papilloma Virus (HPV) begun in 2008 using the bivalent HPV vaccine.
The immunisation programme was expanded to include boys.
Research completed in 2019 concluded that vaccination resulted in a significant reduction in pre invasive cervical disease.
A study involving the analysis of data collected from 195 countries, concluded that HPV vaccination is cost saving in every country where the vaccine roll-out was successful and HPV vaccination programmes were recommended globally to reduce, and ultimately eliminate the healthcare burden of this disease. To comply with a call from the WHO to scale up cervical cancer interventions, a target of 90% coverage of HPV vaccine for girls was set.
In Scotland, uptake of the HPV is very encouraging. According to Public Health Scotland that 87.2% of S3 pupils in 2021/22 had received a single dose, rising to 87.9% in S4 2022/23.
To achieve the WHO target of 90% vaccine coverage there needs to be sufficient availability of affordable high quality HPV vaccines with coordinated and regulated programmes of vaccine delivery.
The global demand for HPV vaccine through to 2030 was forecast to outstrip current supply with insufficient stocks to meet demand by 2024! Thankfully, recent analysis shows
that the risk of HPV vaccine shortages has decreased markedly and under normal circumstances, there will be sufficient HPV to meet global demand. However, vigilance on vaccine programme policy and careful management of demand and supply will be needed to secure the long-term sustainability of all vaccine interventions and disease prevention programmes.
Vaccine Manufacturing in Scotland
It’s noteworthy that SNP party policy (not SNP government policy) supports the establishment of regional vaccine manufacturing hubs, which as well as producing vaccines would have facility to store and deliver vaccines to the Scottish population. As part of a future foreign policy in an independent Scotland these manufacturing facilities could potentially supply, surplus vaccine not required domestically, to other countries to help them achieve WHO vaccine coverage targets. This resolution was passed into party policy because the ongoing Covid-19 pandemic had highlighted both the current worldwide lack of vaccine manufacturing capacity and Scotland’s lack of preparedness and reliance on UK government policy to deliver. The only vaccine manufacturing plant in Scotland suspended manufacture of COVID vaccines in August 2022. The facility was subsequently sold to a Swedish company involved in clinical trials manufacturing.
Vaccines for the future
A Scottish Government Cancer plan completed in March 2023 established the Scottish Genetics Leadership in May 2022. One of its many aims is to consider the impact on services of new and emerging treatments and medicines to reduce the need for labour intensive and expensive invasive interventions. A previous article which I wrote outlines the potential role that vaccines will play in the treatment of disease as well as disease prevention and the opportunity to personalise medicines for individual patients.
Vaccines will increasingly be used in the treatment of, as well as prevention of disease. Since the outcomes of the various strategies being developed by the Scottish government are, as mentioned earlier, subject to budget constraints, the need for a more comprehensive economic plan that embraces the concepts of a well-being economy is urgent. The current neoliberal ideology-driven economic policy of the UK government is incompatible with the desired goal of a Scottish Government of a well-being economy. A paradigm shift in economic policy is required to achieve a well-being economy. For that to happen, people, including current government ministers, need to understand how current monetary and fiscal policy operates.
Healthcare personnel in many instances, made the ultimate sacrifice in their heroic efforts to save others, during the pandemic. We owe it to them and to future generations to safeguard our nation’s health and establish stronger foundations, exploring all options to deliver preventative healthcare and secure an independent future.
More on vaccines
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