Covid 19 Vaccination Programme in Shropshire
04/02/2021
Currently there is a considerable focus on who is eligible for a Covid 19 vaccine amongst our community. This is a particular issue for those families who support children and young people who are vulnerable due to a specific health condition or have a learning disability. Recent reports have shared some frightening data about the increased risk from Covid 19 for those with learning disabilities, which is understandably worrying families.
Nationally there have been a number of concerns raised specifically about the vulnerability of the learning-disabled community and how they have been included in the vaccination programme. How the vaccine programme is rolled out in local areas is based on guidance from the Joint Committee of Vaccination and Immunisation and the advice outlined in the Green Book – Immunisation against infectious disease - chapter 14a - see links below
https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a
Mencap is currently hosting a campaign asking that this guidance, which only references those who are severe or profoundly learning disabled, should be changed and all individuals with a learning disability should be offered a vaccination. See the link below for more information and how to get involved.
https://secure.mencap.org.uk/en-gb/prioritise-all-learning-disabilities-coronavirus-vaccine
PACC has been involved in ongoing discussion locally about how we can ensure that all children and young people with a learning disability or medical vulnerability are appropriately included in the local role out. We have had discussions with the Director of Adult Social Care and the Head of Medicines Management, Shropshire, Telford & Wrekin CCGs and are waiting for an urgent follow up meeting to address these issues.
We have been told the following about the current situation in Shropshire;
Cohort 1: older people aged over 65 in residential care settings: All Learning Disability homes with people aged over 65 have now been visited. All residents will have been offered a vaccine whilst there unless there are clinical reasons this could not be done, homes that could not be completed e.g. due to active or recent Covid outbreaks are being revisited.
Residential care settings for 16-64year olds are also being planned for visits over the next few weeks. 12-15year old in residential settings will need an individual assessment of risk vs benefits of vaccine, and how this can be delivered this is being worked through at present. ( NB. The vaccine is not currently licenced for use in children. PACC has been told that those young people and adults in supported living placements will also be offerred the vacination)
Parents of older children aged 12-15 year olds, with severe or profound learning disabilities who are prone to repeat respiratory infections, who are not in full time residential care but spend significant periods of time in these settings for respite care, will need to discuss their child with their GP for an individual decision. All GP practices have access to vaccine and can arrange to vaccinate these children where clinically appropriate in line with green book recommendations. These children are unlikely to be called automatically. (PACC suggests families should also speak to any specialists involved in their child’s care, before speaking to their GP, to inform this discussion.)
Cohort 4: All patients aged 16 years or older who have received a shielding letter will be called for vaccination. The aim is to complete this in Shropshire before 15th Feb. These patients are being called at present.
This will include a small number of people with severe or profound learning disabilities. People with Downs Syndrome are specifically included in this cohort, but it may also include other people with other co-morbidities or assessed as extremely clinically vulnerable by their specialist and were added to the shielding patient lists. Specialists should have communicated any such assessment to the patients GP to be coded on their clinical system.
Cohort 6: Clinical risk group 16-64 years of age (by this point all patients over 65 will be eligible on an age criteria). We have not yet started to vaccinate these patients nationally, but would expect to begin after 15th Feb.
This cohort is called based on the GP clinical records. This includes individuals with cerebral palsy, severe or profound learning disabilities, multiple sclerosis, epilepsy, dementia, Parkinson’s disease, motor neurone disease and related or similar conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.
PACC has raised concerns that recent work on the GP learning disability registers in Shropshire, related to Annual Health Checks update, has shown very few young people with a learning disability (16-25 year) are registered in this way with GP’s. We have raised this concern both at the Learning Disability and Autism Programme Board and with senior leaders within the CCG and Local Authority. If the GP learning disability registers are inaccurate, it means a significant number of young people with a learning disability will be disadvantaged and will not receive the vaccination as they should. We have also highlighted the concerns that there is no clear way of identifying those with a severe or profound learning disability from the data collected on the register and that families often face barriers when trying to register their learning disabled son or daughter, due to GP’s lack of understanding of this cohort and the current pressures in surgeries and practices.
In response to these concerns, we have received the following;
There has been a lot of work on Learning Disabilities registers recently in GP practices to ensure patients with severe or profound Learning disabilities are up to date, but we acknowledge they may not be 100% accurate. As a guide, if patients are usually called for a routine flu vaccine and are aged 16 plus then they will be included in this cohort and will be called by their GP practice when we reach cohort 6. If parents/ carers believe that their child or young person is eligible in this cohort, but they do not routinely receive flu vaccine invitations to their GP practice, then they should discuss this with their GP and/or specialist.
GPs will be asked to review LD registers and reminded of the eligibility criteria for people with severe or profound learning disabilities as per the green book chapter 14. We would ask that parents and carers only contact GP practices if they have genuine concerns that their child / relatives’ condition is not known to the practice or they are not recorded on their LD registers.
PACC will continue to have these discussions at the upcoming urgent meeting now being arranged and we will keep you updated on any progress. In the meantime, we would encourage any families of young people with any level of learning disability and who aren’t on their GP’s learning disability register to contact their local GP surgery asap. If you face any difficulties in getting your child or young person with a learning disability registered please do let PACC know at enquiries@paccshropshire.org.uk or by Facebook messenger https://www.facebook.com/ShropsPACC
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