So why the inconsistency then? Why am I being told I’m definitely not getting in group 6

Because: Humans. As a PCN we’ve all agreed to use the same imported searches (Ours are from Ardens, the group that provides searches for EMIS and System One which are our in house systems for pat management), so there’s consistency. I know other GP practices who’re aren’t using the same searches, or it’s some-ones job in the Practice to do the searches manually.  so there’s always going to be inconsistencies.

And if you were in our shoes, what can we do about it?

we have a list of folk who have asked for a call should there be any spaces. Perhaps your surgery has something similar? As for that tweet, we’ve also had to cancel clinics through lack of staff (esp on a Sunday) we don’t look through the list an cancel folks if they have Asthma

My 24 year old daughter got hers in Chester this week. She has mild seasonal asthma but has been prescribed medication for it within the last year so I guess that’s how she qualified. I’m 60 with no health issues and I’ve got my vaccination appointment next week. Guess they are smashing through the lists in our area.

My 24 year old daughter got hers in Chester this week. She has mild seasonal asthma but has been prescribed medication for it within the last year so I guess that’s how she qualified. I’m 60 with no health issues and I’ve got my vaccination appointment next week.

I’m very envious of this sort of thing. I’ve got asthma but I’m 65 so moving asthmatics to group 6 makes no difference to me, but our PCN says:

We will be moving to priority group 5, 65-70 years old, as soon as vaccination slots are available to us.
We are expecting vaccine supplies to fall nationally in the coming weeks so are not able to provide any further information on when this will be

Mrs R has a condition more serious than asthma but doesn’t know if she’s in group 6 or 7 – it’s not just asthmatics that have unclear guidance – so I’m assuming I may get a vaccine by the end of March and she’s assuming April. Got to manage your expectations and all that…

we have a list of folk who have asked for a call should there be any spaces. Perhaps your surgery has something similar?

Worth a shot, need to call them about some blood tests next week so can ask then. Thanks.

@tpbiker – saw this and thought of you…

https://www.bbc.co.uk/news/health-56069455

Looks like my wife might be prioritised as she spent a week in hospital about 3/4 years ago due to an asthma attack.

Yep that reflects exactly what everyone found out at the weekend. Tbh it reflects what was always in the jcvi so not a surprise to me. But it was very surprising to alot of folks judging by the outrage on Twitter.

Whilst the data the decision has been based on (deaths) is fundamentally flawed for asthma (as it doesn’t take into account severity and social distancing), the focus now should be on getting us all priority in the next phase. The government themselves have identified that the only medical condition associated with long covid are lung conditions including asthma, so hopefully they will take this into account, along side the key workers who I fully expect to also (rightly) get priority.

Just had the email which includes the official letter from nhs England advising only asthmatic patients with previous admissions or continuous oral steroids should be in group 6. Unlike nickc and lots of other practices we don’t use ardens for our searches so I expect someone at the medicines management team at our ccg will construct a search which will only invite these patients. However our clinical system (emis) is still telling me that patients with any regular meds for asthma are in group 6. So you can see why there is confusion. All caused by lack of clarity from the centre. Someone on R4 this morning trying spin that it was good news for all those millions of asthmatics under 50 who now are at the back of the queue.
They do like to make things difficult for us all!

Someone on R4 this morning trying spin that it was good news for all those millions of asthmatics under 50 who now are at the back of the queue

Asthma uk tried to put that spin on it to us to. It did not go down well with their supporters as you can imagine!

Frustrating, especially as from what I’ve seen loads of asthmatics no worse than me are getting the jab, but it is what it is. Certainly not the practices fault, clearly you guys are getting mixed messages as well.

Asthma UK have certainly dropped a bollock with their ‘anyone asked to shield will get one’ tweet over the weekend. Poor comms from them, they should have got it in writing before spouting off. But generally just poor comms overall from NHS England to both the public and practices, as usual.
One other issue is what qualifies as a hospital admission – normally there is some kind of trigger for a massive asthma exacerbation – a chest infection or allergic reaction. I was hospitalised for pneumonia about 10 years ago, does that count?

getting mixed messages

We get no messages other than what’s already been leaked to the press. Hence I found out this was an issue here on STW

At our regular meeting here our PCN clinical director saw no reason to exclude asthma suffers from Group 6. His reasoning was (to my mind) pretty sound, group 6 are those folk who’d normally get a flu jab in winter, it seems counter productive therefore to exclude them from a different respiratory disease just on the grounds of severity. We’ll continue to invite all asthma suffers in our PCN  for a COVID vaccine. Any official instruction to change that better come in the next few days otherwise we’ll have jabbed them already!

I’ve just had my vaccination offer cancelled, i’m quite pleased as it means i am too young at this stage.

His reasoning was (to my mind) pretty sound, group 6 are those folk who’d normally get a flu jab in winter, it seems counter productive therefore to exclude them from a different respiratory disease

Exactly, although it looks like you guys are in the minority taking this approach….and I wonder how many asthmatics will be thinking why bother getting a flu jab next year if I’m apparently not severe enough to get a covid vaccination.

I’ve just had my vaccination offer cancelled, i’m quite pleased as it means i am too young

I’ve heard of a few folks this has happened to. I think if you’ve been offered one already it’s pretty poor to be rescinding the invite.

Ffs..

Someone asks the vaccine minister why the change. He categorically states that if you have an inhaler you are in group 6..completely contradicting advice of last 24 hrs

At 56 min

This despite the likes of @docrobster receiving guidance to the contrary from nhs england only today

They really need to get their act in order here, the mix messages are completely unfair.

I’ve just booked in for a vaccination, had anyone else been offered one?

I’m 34, take steroid inhaler twice a day and was hospitalised when I was a small child a couple of times. Last asthma attack was 10 years ago now, since then I’ve followed the now wife’s advice to actually take my inhaler.

I half expect to have been scammed or to be turned away at the door.

Oh based in Greater Manchester too.

That should qualify you if you’ve been in hospital, as it’s not date limited.

Vaccine minister apparently just on tv now, backtracking on his advice from yesterday and saying he got it wrong and most asthmatics aren’t included.

You couldn’t make it up really..

I’ve had a call from my doctor this morning booking me in for a vaccine on Friday. I’ve never been hospitalized due to asthma. I’ve had steroids, the last time was 3 weeks ago, but never 3 lots in 3 months. Very pleased to be offered it.

Got an appointment for next Friday morning for my jab. Surprised been offered one so soon.

Got notification today & Vaccine booked for Monday – long term asthma but no oral steroids or hospitalisation. Asthma managed very well with Symbicort 🤷‍♂️
I had a different long term illness but that was fully cured two years ago and wasn’t something that was effecting my day to day health – it was a long term issue. Wife says that might have been flagged as well (she’s a clinical commissioner).

Meanwhile over on Twitter the asthma uk followers are going ballistic.

Take for example my pal, numerous a&e visits in last ten years, numerous steroid tablet prescriptions. But as the a&e didn’t lead to hospital admission, and because the steroids weren’t 3 times in 3 months, she isn’t prioritised

Meanwhile half a dozen folks on this thread announce that they have well controlled asthma, haven’t met any of the new criteria, and yet already have a jab date.

Don’t begrudge any asthmatic getting it obviously, but it’s pot luck if you get invited or not which is total bullsh*t. It should be all or none.

I agree, it’s not right that some are being offered and some not. Also, a past hospital admission doesn’t necessarily reflect the current state of someone’s asthma. My brother’s ex was admitted to hospital with breathing difficulties and was diagnosed with asthma. As soon as she was prescribed an inhaler, she was fine. Under the new guidelines she qualifies, but your friend doesn’t. I hope your friend’s GP decides she should be included.

Mine certainly didn’t feel well controlled 3 weeks ago, but I’ve been ok since the steroids.

MrsF just had email, 49, slight asthma, but is also registered as a carer for her mum – she also beat me to it for the flu and I’m 51. Good news.

I haven’t had notification, but NHS site just let me in to book – 51 with probably moderate to severe asthma under the current description (asked to shield in lockdown 1). Yay!

I’m having to schlep to Bradford for it, but I can manage that.

Worth other people popping their details just in case if they believe they have anything tending towards severe asthma.

https://www.nhs.uk/book-a-coronavirus-vaccination/

My wife was offered hers last week by the GP (37 mild asthma but a bad hospitalisation 3 years ago). They didn’t know what criteria had meant she was offered it but told her she was on the list so get it done.

Ironically she also started her job as a marshall at the Derby Arena which is the mass vaccination site so was offered one through that as well so had lots of opportunities last week. I am just glad she has had it. I am the only one in the immediate family who hasn’t had it now (I am the only person who doesn’t work in the NHS, emergency services or the care industry!).

37 mild asthma but a bad hospitalisation 3 years ago

An asthma related hospital admission qualifies her, although it surely can’t be that mild if she ended up needing an admission!

It’s pretty annoying that officials keep referring to those asthma sufferers excluded from the criteria as having ‘mild’ asthma. There is a whole spectrum of asthma between the severity required to be in the priority groups, and those that use ventolin one in a blue moon during exercise.

Worry for me is that all evidence points to asthmatics being more succeptable to both long covid and more severe disease. The fact that learning disabilities and others managed to reverse the decision to be excluded, and asthma didn’t, is reflective of how absolutely ineffective asthma uk were, eventually kicking up a fuss 2 days before the under 50s group was announced.

I’m lucky enough to be in group 10, but if I was a 25 year old key worker with asthma id be furious.

Worry for me is that all evidence points to asthmatics being more succeptable to both long covid and more severe disease.

CEBM’s recent rapid review seems not to agree with this –

Whether PWA increases risk of infection or severe outcomes from COVID-19 remains unclear. There is no consensus from systematic reviews, and high quality primary studies report conflicting results in some areas.

Will people stop using “sufferers” Its really annoys me

People who have asthma or people living with asthma please or even asthmatics! 😉

Wheezy **** is the clinically appropriate term, TJ.

tjagain
Will people stop using “sufferers” Its really annoys me

Why? I do suffer with it. I have done for most of my life. It is for some a debilitating lifelong condition.

seems not to agree with this –

Kings study disagrees ..as do numerous others

It should be pointed out that the studies used to define priority groups is fundamentally flawed as there is no differentiation in asthma severity or type. The data is taken from first half of 2020, when many folks with severe asthma were shielding. So when they say ‘people who had asthma didn’t die from covid ‘ , that study group will have been massively skewed towards the folks with asthma who weren’t taking as much care to avoid getting it. Those guys tend to not be the population with severe asthma. The study paper even calls this out as a limitation of its findings.

Will people stop using “sufferers” Its really annoys me

Why..I suffer from asthma, hence I’m an asthma sufferer.

Why..I suffer from asthma, hence I’m an asthma sufferer.

Because it’s annoying TJ. How about ‘airway impaired’?

Its a flip point and its about the social definition of disability rather than the medical one.

Its not a turn of phrase used in the medical world anymore

But as I said its a flippant point.

As a PWA (not come across that term before but it’s what Oxford CEBM use – “person/people with asthma”, and given the discussion above I can perhaps see why they came up with it) who has had the jab I no longer have any skin in the game but I still follow the research when I can find it. And Mrs R has also had the jab (she has a condition that’s rare enough to not even come up in studies, shielding or priority lists; the doctor vaccinating her said “gosh, you really need this don’t you”) so I no longer need to be cross with the people trying to push ahead of her in the queue. But:

Kings study disagrees ..as do numerous others

By Kings study I guess you mean the analysis from the Zoe app results. This says:

While asthma was not reported as a factor of risk for hospitalisation in ¹¹, its association with Long-COVID warrants further investigation.

which contrary to the view of the PWA lobbyists (who knew there was such a thing) is not a smoking gun supporting their prioritisation in the vaccine queue, it just suggests more research needs to be done. And the aim of the CEBM meta review is to avoid cherry picking results that support any particular view. My advice – just go by what your GP says, they probably know better than anyone.

its association with Long-COVID warrants further investigation.

And whilst we are investigating maybe a good idea to err on side of caution no?

Simple fact is covid attacks the lungs. In those with moderate to severe asthma the lungs are already compromised. It doesn’t take a genius to work out that could be an issue.

Any study I’ve seen that suggests asthma isn’t a risk factor doesn’t stratify the risk by severity of disease. I don’t think for a second that if you only have to use your ventolin every other week you are at greater risk. However there are numerous degrees of the severity between that and group 6 qualification. I know folks who have been to a&e multiple times, the common cold leaves them struggling to breath, and who regularly take 4 meds on a daily basis just to breath normally. Yet they don’t qualify for the jab against a disease that affects the lungs?

It’s also interesting to note that their are not such strict criteria on any other ailment that was previously called out as a risk factor. Take LD for example..Even mild cases qualify for group 6.

Anyway..as mentioned I’m in group 10 and my asthma isn’t as bad as many so I should be good

Still a crappy desicion imo though..

And whilst we are investigating maybe a good idea to err on side of caution no?

Not necessarily – don’t forget, for everyone that’s pushed up in the priority someone else is getting pushed down, and if that’s every PWA it’s nearly 5M people being pushed down, so someone has to decide if it’s increasing or reducing overall risk/pressure on ICU etc. Thankfully vaccination rates now appear to be sufficient that this isn’t quite the issue it was.

Not necessarily – don’t forget, for everyone that’s pushed up in the priority someone else is getting pushed down, and if that’s every PWA it’s nearly 5M people being pushed down,

So you were against all folks with learning disabilities getting it then I take it?

Besides it’s not 5 million. That would include all children plus those older folks who qualify in groups 1-9 already. It would be about 2mil based on steroid inhaler use. And personally if that means a healthy 40 year old has to wait a week longer to ensure a 25 year-old who requires multiple drugs for their asthma gets it as a priority, then I’m ok with that. As it is that 25 year old will be waiting until July for a jab.

Furthermore, the issue is not that asthmatics wanted pushed up in the priority list. The issue was they were told since day one they were at clinical risk, indeed many had been told to shield for most of last year. If you know anything about the subject you’ll also know that for some reason group 4 and group 6 for asthmatics has exactly the same criteria..why’s that do you think?

The ommision of most of the others from group 6 was a decision based on death stats which I’ve already pointed out are fundamentally flawed.

And personally if that means a healthy 40 year old has to wait a week longer to ensure a 25 year-old who requires multiple drugs for their asthma gets it as a priority, then I’m ok with that.

If I were making these decisions at a population level, it’s quite possible that I’d look at the evidence for increased risk in PWA and say it’s not visible whereas the increase in risk with age is clear. So I would prioritise the 40 year old. If the 25 year old has multiple drugs that control their asthma I’d be happy for their GP to make a judgement at an individual level, they may want to put them in group 6.

Edit: Asthma UK seems to agree with me.

Asthma UK seems to agree with me.

So why then have Asthma uk have publicly come out and said that there is evidence asthma is a risk factor for more severe disease and that they think all asthmatics should be prioritised before the under 50s? They even started a petition on the matter.

I’d look at the evidence for increased risk in PWA and say it’s not visible

Well the risk for long covid was visible and required further investigation. The risk for death wasn’t, but you keep skipping over the point that they didn’t stratify asthmatics by severity, so the data used for ommision is flawed.

You also keep saying ‘it’s down to the individual gp’ but this is totally ignoring the fact some take a hard line and some show flexibility. Hence why some folks on here have had the jab despite, by their own admission, having mild asthma. Yet my friend hasnt despite being told to shield in March last year, plus requiring a fairly high strength inhaler, daily montelukast tablets plus numerous visits to a&e and occasional oral steroid prescriptions.

Btw..

And Mrs R has also had the jab (she has a condition that’s rare enough to not even come up in studies, shielding or priority lists; the doctor vaccinating her said “gosh, you really need this don’t you”

So vaccinated through an abundance of caution rather than because of any hard evidence of increased risk? All I’m doing is suggesting we do the same for all severe asthmatics.

Well the risk for long covid was visible and required further investigation.

Tim Spector and co were careful with their words. They said “association”, not “risk” ; it may just be a spurious correlation. Anyway, that Asthma UK blog I linked to above explains everything better than I can. Your friend with the asthma maybe wants to be a bit more forthright with her GP.

Oh, and Mrs R was very much vaccinated on the basis of increased risk.

Will people stop using “sufferers” Its really annoys me

Sufferer: A person who is affected by an illness or ailment. Strange thing to say from someone who is in the medical profession.