RCGP: why aren’t BAME patients on vaccination priority list?

The Royal College of GPs is calling on secretary of state for health and social xare, Matt Hancock, for a more detailed rationale for not including people from Black, Asian, and minority ethnic communities on the initial prioritisation list for a COVID-19 vaccination

The initial list, devised by the Joint Committee on Vaccinations Immunisations (JCVI), does not specifically include people from Black, Asian and minority ethnic communities, despite data showing that death rates from COVID-19 are amongst the highest in patients from these groups. The list currently takes an age-based approach to prioritisation, also specifically including care home residents and staff, health and social care workers, and high and moderate-risk adults – for example, those with underlying health conditions.

In a letter to the health secretary, RCGP chair Professor Martin Marshall writes: “Throughout the pandemic the RCGP has raised significant concerns about the extent to which GPs, their practice staff, and patients from Black, Asian and minority ethnic communities are disproportionately affected by COVID-19…yet we note that they are not included on the initial JCVI prioritisation list ahead of roll-out of the vaccines. 

“It is important that GPs and their patients are aware of the rationale for the decisions made, particularly as data clearly indicates that patients from ethnic minority backgrounds are more susceptible to contracting and dying from the virus.  While some of this may be due to the higher prevalence of pre-existing conditions within the BAME communities, a recent study by the Office of National Statistics suggested that is not sufficient to explain the disparity in mortality rates from COVID-19, and emphasises the importance of demographic and socio-economic factors, such as place of residence and occupational exposure.”

The letter recognises the need to keep the criteria ‘as simple as possible’, and that there may be ‘legitimate reasons’ why it is not possible to reflect ethnicity in the list. However, the College is also asking whether a risk score that accounts for ethnicity, geographical socio-economic indicators, and other related factors has been considered by government to ensure that this vaccination strategy is ‘appropriate for the entire population’ and those most vulnerable are prioritised.

Continuing his letter, Prof Marshall writes: “We would therefore like to ask for clarification of the rationale for people from Black, Asian and minority ethnic communities not being included on the initial JCVI prioritisation list and to be able to communicate this clearly to our members. We would additionally like to know whether using a risk score that accounts for ethnicity, geographical socio-economic indicators, and other related factors has been considered.

“I do appreciate the complexities and difficulties of the decisions that are having to be taken and can assure you of the support of the RCGP and the profession in the national effort to vaccinate the population against COVID-19.”

Read the letter from RCGP