People with asthma have been left angry and confused by the government’s decision not to prioritise all asthmatics for the vaccine, meaning they’ll have their jabs later than originally thought.
Those with asthma have been deemed clinically vulnerable throughout the pandemic – people are at a higher risk of Covid if they have “a lung condition that’s not severe (such as asthma, COPD, emphysema or bronchitis)”, the NHS website states. Those with severe asthma are deemed clinically extremely vulnerable.
But many with moderate asthma are disappointed they won’t get the vaccine until their age group is called up. The hashtag #AsthmaticsAtRisk has gained traction on social media, with hundreds of people sharing their stories of struggling to breathe, but not being considered vulnerable enough for the jab.
Angela Stapleford, 46, from Dumfries in Scotland, was diagnosed with asthma in her mid-30s. She had attacks that left her with shortness of breath between coughing fits and now carries her reliever inhaler with her everywhere. She will not be prioritised for the vaccine.
When she found out, she was shocked and confused. “It felt like the light at the end of the tunnel that had been slowly growing had been pushed further back and had become only a tiny point of light overnight,” she tells HuffPost UK.
“Being in the clinically vulnerable category has led me to turn down work in a public environment. It made me feel anxious about going out in public spaces even when restrictions were lowered.”
It was previously thought people with severe asthma would be in priority group four as they are “clinically extremely vulnerable individuals” and the remainder of people with asthma would be in priority group six which described “all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality”.
All the people HuffPost UK spoke to believed all asthmatics using inhalers, or those eligible for the free flu vaccine, would be in group six. This belief was held by doctors, too. Dr Neil Bhatia, a GP in Hampshire, told The BMJ he had assumed those who regularly received a flu vaccination because of their asthma would be offered the jab.
However, this is not the case. While those with severe asthma, who would’ve been sent a shielding letter, remain in priority group four – the national medical director of NHS England, Professor Stephen Powis, explained “that’s those who require regular hospital admission or who take steroid tablets for asthma” – those who’ve had an emergency hospital admission for their asthma, or have been prescribed three courses of steroid tablets in a three-month period, fall into priority group six.
And anyone with asthma who does not fall into either of these groups, and is under the age of 50, will be vaccinated after the first nine priority groups.
In Scotland, the eligibility is slightly different: those who have a recorded hospital admission because of asthma, or have had three prescriptions of oral prednisolone in the last six months – or 168 tablets in the last six months if they use the Chronic Medication Service – are included in group six.
Eligibility for the vaccine is based on advice from experts on the Joint Committee on Vaccination and Immunisation (JCVI), whose aim is to prevent as many deaths from Covid-19 as possible.
It’s this shift away from the narrative that all people with asthma are at risk – to now just some people being at risk – that is causing a lot of confusion.
All the people with asthma that HuffPost UK spoke to don’t fall into either of the vaccine priority groups because they don’t fit the criteria detailed above. However, they still struggle with asthma attacks and have “waves” where they’ll struggle to breathe. Many of them are frightened and anxious to go about normal life after being told for so long that they’re at higher risk.
Megan Jane Lillie, 27, from Teesside, has lived with asthma since she was two. “All this time, we’ve been told that we’re more at risk due to our condition,” she says. “When the priority list came to light, severe asthmatics were in group four and the remaining in group six. I feel somewhat robbed.”
Lillie can go months, sometimes even years, with her asthma being well controlled. But there are times when the condition – which affects 5.4 million people in the UK – can leave her gasping for air. One episode a few years ago left her crawling into her parents’ room because she couldn’t breathe. “I don’t think people understand the full impact asthma can have on you,” she says.
The priority list confusion has caused a lot of anxiety for Lillie, who has heard nothing from her GP and is now in a state of limbo. “I rang my local hospital switchboard and they told me to wait until I get my letter. I have my yearly asthma review this week, so I’m hoping to get some further clarity.
“I feel completely lost. I feel like nobody is acknowledging this.”
I feel completely lost. I feel like nobody is acknowledging this.Megan Jane Lillie, 27, from Teesside
Karishma Champaneria, 26, from Leicestershire, is particularly concerned about the consequences of catching Covid-19 as she’s also from an ethnic minority – another high risk group.One study found adults with asthma specifically from Black and South Asian groups are at an increased risk of hospital admission for Covid.
Like Lillie, she has also lived with asthma her entire life and always carries a blue inhaler. “I feel like asthmatics are being discriminated against,” says Champaneria. “It’s worrying, especially as I’m from an ethnic minority.”
The 26-year-old was led to believe she’d be having the vaccine in the next few weeks, however now it’s looking like she won’t be vaccinated until July because of her age, with the second dose in flu season – another worry in itself.
Even medical professionals don’t appear clear on the guidelines. Sarah, from Lancashire, says her GP initially refused to place her in priority group six, despite the fact she was hospitalised with pneumonia and severe asthma five years ago, which led to her being placed on steroid medication for six months.
“I was disappointed and surprised I wasn’t being placed in the group by my GP,” the 33-year-old, who preferred not to share her surname, tells HuffPost UK. “I quoted the criteria from the JVCI and within an hour they U-turned their decision. I’m due my vaccine a week today.”
The science that directed the JCVI’s decision to not include millions of asthmatics on the priority list is also being questioned. It’s thought the JCVI used the findings of a study, published in the BMJ, that concluded those with asthma were no more likely to die from Covid than those without asthma.
The study looked at more than six million patient records during the spring and summer of 2020, of which 13% had a diagnosis of asthma. They tracked whether people got Covid and what their outcomes were.
On February 15, Prof Powis, from NHS England, said: “The good news is that mild asthma, inhaler-treated asthma, doesn’t carry that increased risk for coronavirus, so in fact that’s a good news story for mild asthma sufferers that evidence has shown that the risk is not there for them.”
Another study suggests women with asthma might represent a susceptible sub-group for severe Covid-19 requiring hospitalisation. Roughly 37-53% of all individuals hospitalised with SARS-CoV-2 are women. However, when you factor asthma into the mix, 56-71% of patients with asthma hospitalised for Covid-19 were women, the study found.
“It may not necessarily come out that asthmatics are more at risk from death, but certainly we are at increased risk of long Covid complications,” says Sarah. “We’re offered a flu vaccine due to being vulnerable, yet with Covid, which is also a virus that attacks the lungs, we’re told we are no more at risk than a healthy individual.”
The long-term health implications of having Covid and asthma shouldn’t be ignored. Gemma Gedling, 25, from Surrey, believes she came down with Covid-19 last year before testing was widely available and says it “knocked her sideways” for six months. The 25-year-old, who has had asthma since she was five, says it’s “terrifying” being on the NHS’s clinically vulnerable list for Covid, but not being prioritised for the vaccine.
“The idea of lockdown starting to lift from March 8 indicates I’m going to need to continue self-shielding wherever possible, because I’m too scared to go out into the general population right now unless absolutely necessary,” she says.
Some, like Gedling, are relying on the discretion of their doctors to get them fast-tracked for the vaccine, meaning it’s turning into a bit of a postcode lottery that depends on whether GPs are willing to put them forward. This, in itself, might depend on whether there’s enough vaccine supply in the area.
Asthma UK – and many asthmatics – are calling on the UK government and governments in Wales, Scotland and Northern Ireland to prioritise everyone with asthma for the next wave of the vaccine rollout. Sarah Woolnough, the charity’s chief executive, said: “The decision not to prioritise all people with asthma, who are not already in group four and six, ignores the evidence that they are more at risk of going to hospital with Covid and more at risk from long Covid.
“There are thousands of people with asthma who will rightly feel anxious, angry and ignored by government. We have been urging the government to ensure everyone with asthma is prioritised in the next vaccine roll out and more than 18,000 people with asthma have signed our petition in support of this.”
HuffPost UK understands that adults with mild asthma who do not meet the inclusion criteria will not be included within JCVI priority group six. But asthmatics don’t want to have to wait until their age group is called up before having the vaccine – compared to their peers who do not live asthma.
Stapleford, who spent years working with consultants to control her symptoms, says her attacks are under control – but she’ll still get breathless and wheezy. Being in her 40s, she should get the vaccine after the nine priority groups.
“I feel slightly relieved,” she says, “but this doesn’t stop me from worrying about younger people with asthma who will have a long wait while still being clinically vulnerable.”