Scientists who provide advice and guidance to the Welsh Government in response to Covid-19 have said it could be "extremely difficult" to achieve herd immunity in Wales.
The revelation comes in a nine-page report detailing advice from the Technical Advisory Group (TAG) - comprising scientific and technical experts from across Welsh Government, NHS Wales and academia - for the Welsh Government's review of restrictions on September 17.
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The group also warned that the median age of hospitalisations is increasing, with the balance of Covid-related admissions shifting towards vaccinated rather than unvaccinated patients.
The document explains that for the effects of population immunity to be observed, more than 80%, or possibly closer to 90%, of the Welsh population, spread evenly across Wales, must be immune to the virus.
Despite an an average vaccine first dose uptake of 89% in those aged 16 and over in Wales (74% of the total population), there are several factors that lessen the likelihood of achieving population immunity, according to the guidance.
These include:
- lower vaccine uptake in younger age groups
a significant proportion of under 18s being ineligible for vaccines
a non-uniform distribution of vaccination across Wales and across age groups
transmission rates of the dominant delta variant and other emerging variants
the proportion of individuals immune from natural infection
the possibility of waning immunity and the need for booster vaccines
the possibility of emerging variants with increased transmissibility or mortality risk or ability to escape immune responses
and evidence that vaccines are not 100% effective.
The report continues: "Waning immunity from natural infection and vaccination is a key uncertainty in population immunity estimates and is increasingly important."
It added: "Despite an average vaccine first dose uptake of 89% in those aged 16 and over in Wales (74% of the total population), it will be extremely difficult, if possible, to reach population immunity."
It cites recent studies from Israel which have reported higher infection rates in people who were vaccinated earliest compared to those who were vaccinated later.
The advice given by TAG for the Welsh Government also casts light on the potential harms of vaccine passports and other "immunity certification", such as those which prove you have had prior Covid-19 infection or a recent negative test result.
While the advice admits that passports could encourage vaccine uptake, it said that "evidence is limited".
Instead, the scientists are concerned that such certification could give people "unreasonable expectations about the level of protection they have" and urge that "even in the case of large events and hospitality, holding a certificate should not permit an individual to avoid of self-isolation if symptoms develop, nor be exempt from other measures used to protect high-risk individuals".
Other concerns include the "perverse incentives" (such as deliberate infection where certification includes proof of prior infection), complacency when it comes to other safety measures (such as social distancing or wearing masks), increased opposition to vaccination in some groups and increased mistrust in the vaccine in marginalised communities.
The report continues: "More recently (August 2021) a study involving 1300 adults in the UK and Israel explored willingness and motivation to get vaccinated as determined by psychological needs. The authors conclude that vaccine passports may have detrimental effects on people’s autonomy, motivation, and willingness to get vaccinated, and affect longer term relationships with local governments and health authorities (that are crucial for public health adherence and behaviour change to occur)."
The advice comes as First Minister Mark Drakeford announced at the briefing on September 17 that while the Welsh Government will not bring in full vaccine passports, it will insist on the NHS Covid pass for clubs and events.
The guidance also provides an update on coronavirus hospitalisations in Wales, and reveals more Covid-19 related admissions are made up of vaccinated rather than unvaccinated individuals.
It continues to say while "the ratio of cases to hospitalisations and deaths remains low", it says "the growth of cases, hospitalisations and deaths is on an exponential, rather than linear, curve" and that there is "evidence of a continued steady increase in hospital admissions and ICU admissions", as we approach 500 cases per 100,000, with the median age of hospital admissions increasing.
Announcing the outcome of the latest three-week review of the coronavirus regulations on September 17, First Minister Mark Drakeford encouraged everyone to work from home whenever possible and to make sure they are fully vaccinated.
The First Minister announced that anyone aged over 18 will need to have had two vaccinations or have done a lateral flow test within the previous 48 hours to be able to download the NHS Covid pass.
The requirement to show an NHS Covid Pass will come into force from 11 October. Adults will need to have a NHS pass to enter nightclubs, indoor non-seated events for more than 500 people, outdoor non-seated events for more than 4,000 people and any setting or event with more than 10,000 people in attendance.
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