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Pregnant women are being turned away from UK Covid vaccine clinics

Pregnant women

Pregnant women are being turned away from UK Covid vaccine clinics, experts warn

Pregnant women are being turned away from Covid vaccine clinics despite clinical advice, experts have warned as they urged ministers to ramp up efforts to reach unvaccinated groups.

Members of the Joint Committee on Vaccination and Immunisation (JCVI) told the Guardian that efforts to increase booster jab uptake will not be sufficient to prevent more deaths and hospitalisations, and that ministers must prioritise reaching those who have had no jabs. In particular they urged a focus on pregnant women as only about 15% in the UK have been fully vaccinated. Among all over-12s, the figure is 79%.

On Tuesday the NHS said pregnant women should never be turned away from clinics and said vaccines could save the lives of women and their babies.

New data from Oxford University’s MBRRACE-UK study on maternal health, seen by the Guardian, shows that at least 13 pregnant women died with Covid between July and September this year, with 85% of them believed to have been unvaccinated. The figure is higher than in the first and second waves of the pandemic, when nine and 11 pregnant women died but when jabs were not available.

Prof Marian Knight, the lead for the MBRRACE-UK programme, said there was still no joined-up messaging across the health service. “Women are being turned away from clinics and now there are some trusts offering it as part of the maternity service, but it is not universal so there are still barriers,” she said.

“It is important we start to see data on outcomes in vaccinated women so we can show evidence that vaccines are safe, rather than say there’s no evidence they cause harm. These are very small numbers, but the point is that women could have been saved; children have been orphaned.”

Joeli Brearley, the founder of the charity Pregnant Then Screwed, said old leaflets advising against the jab were still in circulation at some healthcare centres. Some professionals were giving conflicting advice on safety, with hesitancy also driven by the fact that pregnant women were not yet included in the booster jab drive, she added. “It sends out the message: we are not sure about pregnant women and the vaccination.”

Covid in pregnancy is linked to a raised risk of premature delivery, while pregnant women are more likely to become seriously ill than non-pregnant women of the same age. A previous study found that one in six of 118 Covid patients requiring the most intensive ventilation treatment were unvaccinated pregnant women.

Other research suggests the Delta variant poses a greater threat to pregnant women than previous variants. In July the UK Obstetric Surveillance System found that one in four pregnant women admitted to hospital with Covid in the first wave had moderate to severe disease compared with 45% of recent admissions. Between March and July, one in three pregnant women in hospital with Covid required respiratory support, and one in seven required intensive care.

Pregnant women are among those that some members of the JCVI, which advises the government on vaccine policy, are most concerned about. However, some scientists have privately accused the JCVI itself of being slow to advise that the vaccine was safe for pregnant women.

An NHS spokesperson said: “Pregnant women should not be turned away from NHS vaccination centres and women should continue to come forward for the lifesaving Covid vaccine – they can make a booking through the national booking service online or by calling 119 anytime between 7am and 11pm seven days a week.

“The NHS has advised midwifery staff to give pregnant women the information they need to make the right decision for them and their baby so if you are pregnant and have any concerns, please come forward and discuss them with a healthcare professional.”

Adam Finn, a professor of paediatrics at the University of Bristol and a member of the JCVI, said: “It does now seem clear that not only does Covid in pregnancy bring an increased risk of premature delivery but also pregnant women are more likely to get seriously ill than non-pregnant women of the same age. So there’s a need to communicate that effectively and that can probably most effectively be done by midwives.

“The people who benefit most from vaccines, whether or not they are pregnant, are those who have had no doses so far. Explaining to people why this makes sense and is important for them is, perhaps, the most worthwhile thing we could be doing at present.”

Another member of the JCVI, Maggie Wearmouth, said: “The message is just not reaching many pregnant women … Saving lives and reducing admissions needs more active outreach to the 4 million people not yet vaccinated at all, particularly pregnant women and young black men.”

Amid criticism of the pace of the booster rollout, the government has pledged to intensify efforts to improve take-up of the third jab offered to those over 50 and the clinically vulnerable. Last week, government sources said they would examine whether to cut the period that must elapse before a booster jab from six months to five.

Members of the JCVI are understood to be sceptical about the effects of such a move. Finn said: “Getting the booster programme done as quickly as possible is only one aspect of a complex situation.

“It’s important to immunise the right people – those who actually need a booster – at the right time, when their response to it will be substantial and as long-lasting as possible. It’s also important not to overestimate what the booster programme is capable of – after all it is simply increasing the level of protection against serious illness in people whose protection from the first two doses is still pretty good.

“Finally, the booster programme will not do much to reduce the circulation of the virus more generally or any time soon – other precautions would be needed to achieve that.”

Wearmouth said it was highly unlikely there would be any clinical benefit to speeding up the booster jabs. “The sooner a booster is given, the sooner it may have to be given yet again,” she said. “We are clearly losing the battle by depending on vaccinations alone. It is time for a serious review of wider aspects. We need politicians and known faces to be seen to have their boosters as well as observing social distancing, masks, etc.”

Prof Anthony Harnden, deputy chairman of the JCVI, told Sky News: “Vaccines do a lot of the heavy lifting, but they can’t do everything, so social distancing, mask wearing in crowded spaces and being sensible is all part of what we ought to be doing as a society.”

Health

Lagos to convert General Hospital to eye centre

The Lagos State Commissioner for Health, Prof. Akin Abayomi, says the state government will designate one of its general hospitals as a centre for ophthalmic specialty to improve care for patients with eye conditions.

Abayomi said this during the 4th Annual General Meeting and Scientific Conference of the Africa Retina Society on Thursday in Lagos.

The News Agency of Nigeria (NAN) reports that the event was themed, “Upscaling Retinal Services in a Resource-Constrained Economy.”

Abayomi said the centre would provide a world-class diagnostic, medical, surgical and ophthalmic services in Lagos and Nigeria.

He stressed that the state would prioritise eye health, noting that the state was working on developing screening capacity of all its primary healthcare facilities to detect eye diseases early.

“The conditions that affect the eyes very much reflect the conditions of the community in which you live. HIV, for example, was a major problem in South Africa, and I certainly experienced the impact of HIV on our day-to-day medicine and practice.

“Here in Nigeria, we have other things. We have hypertension, diabetes, sickle cell, and lots of trauma. These are the kinds of things that we see in our clinics here in Lagos and in Nigeria.

“We need to be able to understand how these prevailing conditions really affect us,” he said.

The commissioner further said that efforts are ongoing to promote eye screening, especially in schools, starting with the training of teachers to detect students exhibiting challenges with their vision.

He added that the state would leverage the social health insurance to screen, detect and treat eye diseases as patients presents at health facilities.

The commissioner further said the state would strengthen public awareness and understanding on eye health, especially glaucoma and visual acuity.

Abayomi disclosed that the state through its Ministry of Health had forged a partnership with the Chagoury Group
to develop a specialist eye hospital in Lagos to boost access to eye services.

He acknowledged that ophthalmology was equipment-intensive, stressing that government would pay attention to that and human resources to enable practitioners make appropriate diagnosis, and treatment to reverse medical tourism.

Earlier, Prof. Linda Visser, Head, Division of Ophthalmology Stellenbosch University, South Africa, called on policy makers to formulate policies that would integrate eye screening into diabetes care from the primary healthcare level, noting that cases of diabetic retinopathy was on the increase among Africans.

Diabetic retinopathy (DR) is a chronic progressive disease of the retinal capillaries (small blood vessels) associated with prolonged raised blood glucose levels in people with diabetes.

Visser cited data from International Diabetes Foundation that showed that 537 million adults aged 20 to 79 years are living with diabetes globally, a number that was predicted to reach 1.3 billion in 50 years.

“The high prevalence of type 2 diabetes continues to rise worldwide and is particularly rapid in low- and middle income countries.

“Most of these countries have limited availability and affordability of healthcare services for screening and treating diabetes-related complications, such as retinopathy, to prevent vision loss,”

According to her, all persons with diabetes are at risk of developing DR, however, those with poor blood glucose and blood pressure management and hyperlipidaemia are most at risk.

Visser, Past President, Vitreoretinal Society of South Africa, emphasised that early detection would lead to timely treatment of DR, which could prevent 95 per cent of vision impairment and blindness.

Also, Dr Asiwome Seneadza, Chairman, Africa Retina Society, said that the theme was timely and critical as efforts are made to navigate the complexities and challenges in delivering advanced retinal care across the continent.

Seneadza said, “That’s why we are advocating for improved diabetes care and regular retinal screening made available and accessible for every individual living with diabetes,” he said.

Similarly, Prof. Bassey Fiebai, Chairman, Vitreo Retinal Society of Nigeria, said the meeting was critical to proffering solutions to the challenge of offering standard retina care, improving outcomes and reducing visual loss from retina related disorders among low to medium income countries.

Fiebai said that the government plays a critical role in providing funding, training of personnel, provision of equipment to improve screening, detection and treatment of retinopathy disease.

The professor noted that retina specialists are few in Nigeria, placing the figure at about 100, stressing that it was inadequate to cater to the teeming population who require eye care.

“Right now in the country, we have just a little over 100 retina specialists. And we know that the population of Nigeria is about 230 million.

“So we’re looking at a situation in which one retina specialist is supposed to cater for 2.3 million people. How does anyone cope?” she queried.

NAN reports that the Annual General Meeting and Scientific Conference of the Africa Retina Society which began on June 26 to June 28, had participants from various African countries brainstorm on enhancing retinal care.

(NAN)

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Health

Cholera outbreak: Tinubu sets up presidential committee to oversee emergency operation centre

President Bola Tinubu has directed the setting up of a presidential committee to oversee the Cholera Emergency Operation Centre, operated by the National Centre For Disease Control.

The Minister of Health, Ali Pate, made this known on Tuesday after the Federal Executive Council meeting chaired by President Tinubu at the State House, Abuja.

He added that the committee’s effort is in addition to state government support to ensure Nigeria makes progress in reducing open defecation.

“The Council then approved a cabinet committee comprising the federal ministries of Health, Finance,Water Resources, Environment, Youth, Aviation, Education because some of our children will be returning to school . In addition to this, the state government, we will co-opt, so that Nigeria makes progress in reducing open defecation because cholera is a developmental issue that requires a multi-sectoral approach.

“The President directed that a cabinet committee be set up to oversee what the emergency operation centre led by NCDC is doing and for the resources to be provided complemented by the state government,” he said.

Pate further disclosed: “At the moment about 31 states have recorded 1528 cases and 53 deaths in Nigeria. That is what we are working through the Emergency Operation Centre that was activated by NCDC on Monday.

“Now we have a cholera outbreak and we discussed extensively in the Council in addition to a new emergence of Yellow Fever specifically in Bayelsa State.

“On cholera we are in the middle of the 7th pandemic globally which is decades in the making. In 2022, the world had almost 500,000 cases of cholera so it is not only peculiar to Nigeria. In 2023 almost 700,000 cases of cholera were reported by the World Health Organization.

“This year more than 200,000 cases have occurred in five regions of the World.”

He emphasised that a multi sectoral approach is required to tackle the outbreak .

“Resources were deployed to 21 states to help them respond to cholera. We are improving awareness of population, handwashing, hygiene sanitation, in addition to treatment with drugs, and intravenous fluids,” he added.

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Health

NCDC reports 1,598 cases of cholera across the country

The Nigeria Centre for Disease Control and Prevention, NCDC, has reported 1,598 suspected cases of cholera across 107 local government areas.

The cholera outbreak is characterised by a case fatality rate of 3.5 per cent, significantly higher than the national expected average of one per cent, underscoring the severity of the situation.

The Director-General of NCDC, Dr Jide Idris, disclosed this on Monday in Abuja while providing an update on the cholera epidemiological situation in Nigeria and ongoing prevention and response efforts at the national and sub-national levels.

Cholera is a severe diarrheal illness caused by the bacterium Vibrio cholerae. The disease remains a significant health challenge, especially in regions with inadequate sanitation and clean water access.

Understanding the transmission mechanism of cholera is crucial to curbing its spread and implementing effective prevention measures.

Idris said: “Government is deeply concerned about the rapid spread and higher-than-expected mortality rate, indicating a more lethal outbreak.”

He emphasised that the fatalities represented significant personal losses, including those of family members, spouses, parents and healthcare workers.

“This situation can be compounded as the rainy season intensifies,” he added.

He disclosed that Lagos State accounted for the highest number of deaths with 29, followed by Rivers with eight, Abia and Delta with four each, Katsina with three, Bayelsa with two and Kano, Nasarawa and Cross River with one each.

He added: “This alarming trend highlights the urgent need for coordinated response to prevent further escalation of the crisis. Sixteen states accounted for 90 per cent of the confirmed cases, with Lagos being the epicentre of the outbreak. Lagos State, having the highest number of cases, has received significant focus, with ongoing support and resources directed to manage the outbreak effectively.”

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