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Found 452 results
  1. News Article
    The Covid-19 pandemic has entered its third year, with no end in sight, and the world is fed up to the gills. A new and even more highly transmissible variant, Omicron, has been scorching through holiday gatherings over the past couple of weeks. People who are thrice vaccinated are among the infected. STAT asks Mike Ryan, head of the health emergencies programme at the World Health Organization, if he expected the pandemic to last as long as it has, who should make the call on whether to update Covid vaccines, and what he thinks are the main mistakes the world has made. “What’s shocked me most in this pandemic has been that absence or loss of trust,” he said of people’s unwillingness to follow the advice of public health leaders and the containment policies set out by governments," says Ryan. Read full interview Source: STAT, 3 January 2022
  2. News Article
    Trusts will be told next week how they should go about dismissing potentially thousands of NHS staff who have decided not to be vaccinated against covid, HSJ has learned. Last year, the government decided all patient-facing NHS staff would need to have received their first dose of the covid vaccine by 3 February, and two doses by April 2022. The stipulation covers non-clinical staff who may have face-to-face contact with patients, such as receptionists, porters and cleaners. NHS England published the first part of its guidance for employers in December last year, which warned staff who have to be redeployed because of a refusal to have the covid vaccination could be forced to compete for their job and also have their pay and pension affected. HSJ understands NHSE will issue its ‘phase two’ guidance’ next week. To date, government and NHSE announcements or guidance have not mentioned what will happen to patient-facing staff who refuse to be redeployed or are exempt from the requirement. However, HSJ understands the new guidance will make it clear that — while redeployment remains the preferred outcome — some staff are likely to be dismissed and trusts should be prepared for taking that action next month. Read full story Source: HSJ, 6 January 2022
  3. News Article
    Entire hospital units could be forced to shut because of staff quitting in protest at the government’s order that they must all be vaccinated against COVID-19, a senior NHS leader has warned. Chris Hopson, the chief executive of NHS Providers, said that at one hospital trust in England, 40 midwives were refusing to get jabbed, raising fears that the maternity unit may have to close. “Trust leaders are acutely aware that, from April onwards, when Covid vaccinations will become mandatory, decisions by staff to remain unvaccinated could – in extreme circumstances – lead to patient services being put at risk,” said Hopson. “If sufficient numbers of unvaccinated staff in a particular service in a particular location choose not to get vaccinated, the viability and/or safety of that service could be at risk.” Hopson did not name the trust. But he cautioned that its maternity unit is “one representative example” of potential closures on grounds of patient safety that the government’s decision to compel NHS staff in England to be vaccinated or risk losing their job could lead to. Hopson said: “I was talking to a [trust] chief executive who said that 40 of the midwives on their midwifery service … were saying they were not prepared to be vaccinated. Those staff, given their skills and their expertise, are not easily redeployed but they’re also extremely difficult to replace." Read full story Source: The Guardian, 20 December 2021
  4. News Article
    The national chief for the Covid vaccination programme has warned that the NHS cannot become a vaccination service every few months. Emily Lawson also told healthcare staff in a briefing on Wednesday: “I have fed back to the Department of Health yesterday that I think realistically we don’t have the capacity to do anything else new over the next two-and-a-half weeks. “And that when we plan for things and have the right lead-up to them, we deliver them more effectively, which in the end is very critical for public confidence.” Her warning comes after the government announced plans on Sunday to rapidly accelerate the national Covid vaccination programme by offering all adults a booster jab by the new year. On Monday, NHS England sent letters to hospital chiefs, GPs and local healthcare leaders setting out plans to speed up the programme, and said the first priority for primary care would be delivering vaccines. Healthcare leaders were told they could drop non-urgent care in efforts to support the vaccine drive, however specific details on what treatments can be dropped are yet to be finalised. Read full story Source: The Independent, 15 December 2021
  5. News Article
    Pregnant women say they are queuing for hours at busy vaccination centres for a booster jab, despite being at greater risk from Covid-19 if seriously ill. All adults in England, Scotland and Wales have been offered a booster by the end of 2021. Pregnant women have not been prioritised, but doctors say they should be first in line to protect them and their babies against Omicron. The NHS is urging people to book a jab appointment to avoid waiting in queues. And the UK's vaccine advisory committee, the JCVI, said women who were pregnant and already had two vaccine doses were included in the accelerated booster programme. However, the charity Pregnant Then Screwed said thousands of pregnant women had "encountered unnecessary barriers" which had "left many without the protection they need". Read full story Source: BBC News, 16 December 2021
  6. News Article
    Everyone over the age of 18 in England has been promised they can book their coronavirus booster appointment by the end of this year. In a televised address on Sunday evening, Prime Minister Boris Johnson promised to deliver up to a million vaccine doses a day to ensure everyone eligible is offered a slot a month earlier than planned. As part of the "Omicron emergency national mission" he asked NHS staff "to make another extraordinary effort" to meet the new target. This will include more vaccine centres and walk-in sites with extended opening hours, "thousands" more volunteers to deliver jabs and help from the military to oversee operations. However, COVID ICU anaesthetist Dr Ed Patrick told Sky News there are already staff shortages "all over" the NHS, including intensive care, with boosters threatening to make them even worse. "It's a massive concern," he said. "You're taking a really scant resource and then you're pushing it elsewhere, which means that other services get cut." Pat Cullen, general secretary of the Royal College of Nursing, said she is worried about the "scale and pace" of the new rollout, as the "same nurses are already facing huge demands under existing unsustainable pressures". While Chris Hopson, chief executive of NHS providers, warned the health service is "already beyond full stretch" and the changes would see more procedures postponed in the coming days. Read full story Source: Sky News, 13 December 2021
  7. News Article
    GPs and hospital leaders have been left hanging over plans to drop “non-urgent” care, and warn there’s no way to safely stem demand without impacting patients health or “swamping” the NHS further. On Monday evening the NHS published guidance for GPs and hospital leaders over expectations to deliver the government’s new deadline for all adults to be offered a booster vaccine by the new year. The guidance comes as reports surfaced on Tuesday that ministers were warned the NHS should expect a “significant” increase in hospitalisations, as modelling showed Omicron cases may reach 200,000 a day. NHS England sent letters to all GP practices and Trust chiefs on Monday evening setting out some plans to support the vaccine drive, which included opening community vaccine clinics 12 hours a day every day of the week. However, the guidance was not clear on what work GPs and trusts could specifically drop to support the drive. Several NHS leaders raised concerns over the “nightmare” of deciding what care can be reduced, in lieu of any detailed guidance from the government or NHS England, with one leader calling for “clear directive”. Read full story Source: The Independent, 14 December 2021
  8. News Article
    The NHS must apply Covid infection prevention and control measures more robustly if it is to avoid a steep rise in infections within healthcare settings, a senior doctor at NHS England has said. The warning came from NHS England national clinical director for antimicrobial resistance and infection prevention and control Mark Wilcox during a webinar for NHS leaders. He said that the effectiveness of the vaccination programme had led “understandably” to the NHS being more relaxed when it came to Covid IPC. However, he warned that “the effectiveness of the vaccines has diminished substantially with respect to two doses” because of the omicron variant, and that “if we carry on with the level of IPC that we have been lulled into then we will see very significant problems with nosocomial infection”. Read full story (paywalled) Source: HSJ, 14 December 2021
  9. News Article
    Hundreds of Britons faced many hours-long queues to receive their coronavirus booster jab in a day of chaos that saw lateral flow tests run out on the government website and the NHS site struggle with the surge in booster bookings. It comes as Boris Johnson opened the booster jab programme to all adults in a bid to offer the third dose to all over-18s by the end of December, bringing his original target forward by one month. St Thomas’ Vaccination Centre in Westminister confirmed a wait time of six hours for a booster jab, The Independent was told, with queues snaking around the building. The hospital trust warned the public of a “high demand” for walk-in appointments causing extended waiting times. Operations manager Ria Burke, 25, who had been waiting in the queue for 20 minutes, said: “It’s the first day my age group is allowed to get jabbed and I live locally. “I’d like to not endanger my family at Christmas. This is my third jab. I watched the prime minister’s announcement last night and it was a good sign post but I think like a lot of other people I was just waiting for the portal to open.” At Essentials Pharmacy in Covent Garden, Grace Whiley, 26, had been waiting in the queue for an hour and a half. She said: “It was a last-minute decision, I work round the corner and my age group can’t book til Wednesday. I just want to get it done. I’m pregnant so I want to be as protected as possible.” Read full story Source: The Independent, 13 December 2021
  10. News Article
    Lessons learnt in relation to increasing uptake of the COVID-19 vaccine among ethnic minority groups should now be applied to the booster programme, a government progress report recommends. This includes continuing to use respected local voices to build trust and to help tackle misinformation, the report from the government’s Race Disparity Unit says. Such approaches should also be carried over to the winter flu and childhood immunisation programmes and be applied to the work to tackle longer standing health disparities. In June 2020 the minister for equalities was asked to look at why COVID-19 was having a disproportionate impact on ethnic minority groups and to consider how the government response to this could be improved. This latest report is the final one of four. Taken together the reports identified that the main factors behind the higher risk of COVIDd-19 infection for ethnic minority groups include occupation, living in multigenerational households, and living in densely populated urban areas with poor air quality and high levels of deprivations. Read full story Source: BMJ, 3 December 2021
  11. News Article
    The NHS has a backlog of 5.8 million waiting for surgery and specialists are increasingly frustrated at how the unvaccinated have left them unable to tackle it. Doctors and nurses have told of their anger and frustration at not being able to treat seriously ill patients as new figures show that more than 90% of Covid sufferers requiring the most specialist care are unvaccinated. While the success of the vaccination rollout has reduced the overall impact of COVID-19 on hospitals, intensive care clinicians from across England have spoken out over the continuing pressure they are under. Between 20% and 30% of critical care beds in England are occupied by Covid patients and three-quarters of those have not been vaccinated, according to the latest data up to July this year. Read full story (paywalled) Source: The Times, 4 December 2021
  12. News Article
    Three pharmacy and medication safety organisations are warning clinicians about a reported increase in age-related COVID-19 vaccine mix-ups. The Institute for Safe Medication Practice's National Vaccine Errors Reporting Program said it's seen a "steady stream" of mix-ups involving the Pfizer vaccine intended for kids ages 5-11 and formulations for people 12 and older. ISMP said the reports involved hundreds of children and included young children receiving formulations meant for those 12 and up or vice versa. The safety organisation said some errors were linked to vial or syringe mix-ups. In other situations, healthcare providers gave young children a smaller or diluted dose of the formulation meant for people 12 and up. "Vaccine vials formulated for individuals 12 and up (purple cap) should never be used to prepare doses for the younger age group," the organisation said. Read full story Source: Becker's Hospital Review, 7 December 2021
  13. News Article
    NHS staff who have to be redeployed because they refuse to be vaccinated against covid may be forced to ‘compete’ for a new role and could find their pay and pensions affected if their transfer becomes permanent, according to new NHS England guidance. Health and social care secretary Sajid Javid announced last month that all patient-facing NHS staff would need to have received two doses of the covid vaccine by 1 April 2022. This includes non-clinical staff who may have face-to-face contact with patients, such as receptionists, porters and cleaners. Guidance published this week urged organisations to identify options for potential redeployment to non-face-to-face roles, but advised against taking formal action until the new rules receive Parliamentary approval. The guidance said: “Employers should consider the possibility of redeployment for staff in scope of the regulations and who remain unvaccinated on 1 April 2022.” Read full story (paywalled) Source: HSJ, 8 December 2021
  14. News Article
    Doctors' leaders have welcomed plans to allow GPs in England to defer some services to deliver Covid booster jabs instead. Practices can postpone minor surgery and routine health checks for over-75s and new patients until 31 March. All adults in England are expected to be offered boosters by the end of January in response to the emergence of the Omicron variant. A further 75 Omicron cases were confirmed in England on Friday. On Saturday the UK reported a further 42,848 cases of coronavirus and 127 deaths within 28 days of a positive Covid test while 372,557 booster jabs were administered on Friday. Dr Farah Jameel, the GP committee chair of the British Medical Association, said the new measures would release GPs from "filling out paperwork" and chasing unnecessary and often undeliverable targets. She told BBC Radio 4's Today programme: "We have been struggling with significant prevailing workforce pressures - backlog pressures, winter pressures, pandemic pressures. "Whilst these changes make a difference and start to create some time, I think every single practice will have to look at just how much time it does release." Read full story Source: BBC News, 5 December 2021
  15. News Article
    A House of Lords committee has raised several concerns about the proposed legislation to make vaccination against COVID-19 mandatory for all NHS staff in England, particularly whether the benefits of vaccinating the remaining 8% of NHS workers were proportionate and how the NHS would cope with losing the 5.4% who don’t want to be vaccinated. The Secondary Legislation Scrutiny Committee said that the government’s plans had not been thoroughly thought through, leaving the House of Lords unable to scrutinise the proposed legislation. On 9 November England’s health and social care secretary, Sajid Javid, announced that all staff who work in health and social care settings regulated by the Care Quality Commission will have to be fully vaccinated by 1 April 2022.2 “We must avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS, and protect the NHS itself,” he said. But in a report published on 30 November the committee said that the benefit of increasing the protection from vaccinating staff who had not yet taken up offers of the jab “may be marginal” and that the government had failed to publish any contingency plans on how it would cope with the loss of staff who do not want the vaccine. The report said that of the 208 000 NHS staff who weren’t currently vaccinated 54 000 (26%) would take up the vaccine under the law and 126 000 (61%) would leave their jobs. “Given the legislation is anticipated to cause £270m in additional recruitment and training costs and major disruption to the health and care provision at the end of the grace period, very strong evidence should be provided to support this policy choice. DHSC [Department for Health and Social Care] has not provided such evidence,” it said. Read full story Source: BMJ, 3 December 2021
  16. News Article
    Children with poorly controlled asthma are up to six times more likely to be admitted to hospital with Covid than those without the condition, research has suggested. Scientists involved in the study said 5 to 17-year-olds in this category should be considered a priority for Covid vaccination. About 9,000 children in Scotland would benefit from the jab, researchers said. Vaccines are offered to the over-12s in Scotland, but not to younger children. In the study, poorly controlled asthma was defined as a prior hospital admission for the condition, or being prescribed at least two courses of oral steroids in the last two years. Prof Aziz Sheikh, director of the University of Edinburgh's Usher Institute and Eave II study lead, said: "Our national analysis has found that children with poorly controlled asthma are at much higher risk of Covid-19 hospitalisation. "Children with poorly controlled asthma should therefore be considered a priority for COVID-19 vaccination alongside other high-risk children." Prof Sheikh said it was important to consider both the "risks and benefits" from vaccinations. He added: "Emerging evidence from children aged five and older suggests that COVID-19 vaccines are overall well-tolerated by the vast majority of children." Read full story Source: BBC News, 1 December 2021
  17. News Article
    Two specialist Covid vaccination clinics for people with learning disabilities are to be held in Leicestershire. Local health bosses said the sessions would provide a calm environment, longer appointment times and extra support. They will take place at Loughborough Hospital later and at Leicester's Peepul Centre on 15 December. Pre-booked visitors can receive their first, second or booster jabs. Sam Screaton, learning disability vaccination clinical lead at the Leicestershire Partnership NHS Trust, said: "It is extremely important to us to ensure the Covid-19 vaccines and boosters are accessible to everyone. "All staff working at these clinics will go the extra mile to ensure patients feel comfortable, calm and able to have the vaccine." Read full story Source: BBC News, 30 November 2021
  18. News Article
    The UK's Health Security Agency says its analysis of English data shows Covid vaccines are safe in pregnancy, reinforcing international evidence. The agency found similar rates of stillbirths and preterm births for vaccinated and unvaccinated mothers. Researchers say women should feel confident the jabs will help protect them and urge more to take them. Their report shows just 22% of women who gave birth in August had had at least one jab. Since mid-April, mothers-to-be have been offered the Pfizer-BioNTech or Moderna jab, with the second dose recommended eight weeks after the first. But women first eligible for vaccination were more likely to be older or have an underlying medical condition - putting them at higher risk of premature births, researchers say. Meanwhile, studies suggest about one in five women admitted to hospital with the virus have their babies delivered early and some of these babies need special intensive care. And evidence suggests the risks of stillbirths are higher if a woman has Covid in pregnancy. UKHSA immunisation head said the new information on safety was reassuring. "Every pregnant woman who has not yet been vaccinated should feel confident to go and get the jab and that this will help to prevent the serious consequences of catching Covid in pregnancy," she said. Read full story Source: BBC News, 26 November 2021
  19. News Article
    When the UK’s jab programme began, expectant mothers were told to steer clear – so Samantha decided to wait until she had had her baby. Two weeks after giving birth, she died in hospital from Covid. Samantha was unvaccinated – she had received advice against getting jabbed at an antenatal appointment. When the Covid vaccine programme began in the UK on 8 December 2020, pregnant women were told not to get vaccinated. But in October 2020, the Royal College of Obstetricians and Gynaecologists (RCOG) published guidance warning that “intensive care admission may be more common in pregnant women with Covid-19 than in non-pregnant women of the same age” and that pregnant women with Covid were three times more likely to have a preterm birth. Further evidence emerged in 2021 indicating that pregnant women were particularly vulnerable to Covid, especially in their final trimester. Research from the University of Washington, published in January, found that pregnant women were 13 times more likely to die from Covid than people of a similar age who were not pregnant. But throughout February and March, the JCVI’s scientists did not appear especially concerned about examining the case for vaccinating pregnant women. Priority in the early stages of the vaccine programme was being given to older people, so many pregnant women remained towards the back of the queue. The maternity campaign group Pregnant Then Screwed said: “If you look at who was on the Covid war cabinet and leading the daily briefing, it was nearly all men,” says Joeli Brearley, its founder. “Pregnant women were treated as if they were very similar to the general population, rather than being seen as a special cohort that needs special consideration. They were just not a priority.” Read full story Source: The Guardian, 23 November 2021
  20. News Article
    Researchers have launched a major clinical trial investigating whether people on long-term immune-suppressing medicines can mount a more robust immune response to COVID-19 booster jabs by interrupting their treatment. The VROOM trial will have implications for people on immune-suppressing medicines, who are among the millions of clinically vulnerable patients advised to ‘shield’ during the pandemic. The study is funded by an NIHR and the Medical Research Council (MRC) partnership, and led by a team at the University of Nottingham. Approximately 1.3 million people in the UK are prescribed the immune-suppressing drug methotrexate for inflammatory conditions such as rheumatoid arthritis, and skin conditions such as psoriasis. Many of them were among the 2.2 million clinically extremely vulnerable people advised to shield during the first phase of the pandemic, depending on specialist advice and on their risk factors. While methotrexate is effective at controlling these conditions and has emerged as first line therapy for many illnesses, it reduces the body’s ability to generate robust responses to flu and pneumonia vaccines. Researchers will recruit 560 patients currently taking methotrexate, to investigate whether taking a two week break in this drug immediately after they receive the COVID-19 booster jab improves their immune response to vaccination, while preventing flare-ups of their long-term illness. The study will take between one to two years to complete. All participants will have had the Pfizer-BioNTech vaccine as their third jab, as part of the national vaccination programme against COVID-19. Professor Andy Ustianowski, NIHR Clinical Lead for the COVID-19 Vaccination Programme and Joint National Infection Specialty Lead, said: “Although the vaccine rollout has saved many lives and helped drive down the effects of the pandemic, there are still groups of vulnerable people who can’t always mount robust immunity against the virus. " “It’s important to establish if people can safely improve protection from their booster jabs by taking a break from their immune-supressing medicines, and this pivotal study will help develop our understanding of immune responses in people taking this widely prescribed medicine." Read full story Source: NIHR, 12 November 2021
  21. News Article
    A global threat in the form of a measles outbreak is mounting as more than 22 million infants missed their first vaccine dose for the disease in 2020, warned the world’s top health agencies. The World Health Organization (WHO) and the US Centres for Disease Control (CDC), in a joint statement on Wednesday, said the number represents the largest increase in missed vaccinations in two decades. The 22-million figure is three million more than in 2019, “creating dangerous conditions for outbreaks to occur,” according to the agencies. The surveillance of measles cases deteriorated because of the coronavirus pandemic, which resulted in a reported dip in cases by more than 80%t in 2020, the statement said. Measles is one of the most contagious viruses to date. It kills more than 60,000 people a year, mostly young children. But at the same time, the disease is entirely preventable through vaccinations, which have averted more than 30 million deaths from the disease globally. “Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support Covid-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, the CDC’s global immunisation director. Read full story Source: The Independent, 11 November 2021
  22. News Article
    Frontline NHS staff in England will have to be fully vaccinated against Covid, the health secretary has announced. A deadline is expected to be set for 1 April next year to give unvaccinated staff time to get both doses, Sajid Javid told the Commons. Between 80,000 and 100,000 NHS workers in England were unvaccinated, said Chris Hopson, head of NHS Providers. Thursday is the deadline for care home workers in England to get vaccinated. The government's decision follows a consultation which began in September and considered whether both the Covid and flu jabs should be compulsory for frontline NHS and care workers. Mr Javid said the flu vaccine would not be made mandatory. There will be exemptions for the Covid vaccine requirement for medical reasons, and for those who do not have face-to-face contact with patients in their work, he added. In a statement to MPs, Mr Javid said: "Having considered the consultation responses, the advice of my officials and NHS leaders including the chief executive of the NHS, I have concluded that all those working in the NHS and social care will have to be vaccinated." "We must avoid preventable harm and protect patients in the NHS, protect colleagues in the NHS and of course protect the NHS itself." Read full story Source: BBC News, 9 November 2021
  23. News Article
    Saiqa Parveen was eight months pregnant and weeks from welcoming her fifth daughter to the world, but died of Covid after putting off getting the coronavirus jab. Her family have now issued an emotional plea for pregnant women to get vaccinated. Parveen, 37, had planned to delay having the jab until her baby was born, her family said, but she was admitted to hospital with breathing difficulties in September and put on a ventilator. A decision was taken by medical staff at Good Hope hospital in Sutton Coldfield, Birmingham, to deliver the baby by emergency caesarean section. Parveen died on 1 November after spending five weeks in intensive care. Asked what her last words were, her husband Gahfur said: “She couldn’t even talk. She couldn’t breathe properly … She couldn’t talk.” He added: “I’m going to pass this message to the whole world, I just beg all people to get the vaccine, otherwise it’s very hard for them. It’s a very deadly disease, you know. She planned so many things, and this disease didn’t give her a chance.” Covid vaccines are recommended for pregnant women. In a letter to midwives, obstetricians and GP practices in July, the chief midwife for England, Jacqueline Dunkley-Bent, said all healthcare professionals had “a responsibility to proactively encourage pregnant women” to get vaccinated. Parveen chose not to have the vaccine, but concerns have been raised that pregnant women are being turned away from vaccine clinics despite clinical advice. Members of the Joint Committee on Vaccination and Immunisation told the Guardian that they were urging ministers to focus more on pregnant women because only about 15% in the UK have been fully vaccinated. Read full story Source: The Guardian, 7 November 2021
  24. News Article
    Mandatory Covid vaccinations will be imposed on NHS staff, despite fears it could cause a workforce exodus, The Independent understands. Sources have confirmed the government is expected to make an announcement tomorrow on plans to make jabs a condition of employment for the 1.3 million NHS staff in England. Ministers are likely to delay the new requirement until next spring, after health bosses raised concerns over the impact it would have on NHS staffing levels during this winter. Earlier this week. NHS Providers, which represents NHS trusts in England, warned the imposition of vaccinations could drive staff out of the NHS. Around 100,000 workers are yet to have a Covid vaccination. Chris Hopson, chief executive of NHS Providers, warned the government needed to acknowledge the risk to patient safety if thousands of unvaccinated NHS staff opted to leave their jobs rather than have the vaccine. Read full story Source: The Independent, 3 November 2021
  25. News Article
    The NHS vaccination programme to prevent cervical cancer has so far stopped thousands of women from developing the disease and experiencing pre-cancerous changes to cells, a study has found. In the first proof that the programme launched in England 13 years ago is saving lives, the Cancer Research UK-funded study found that cervical cancer rates in women offered the vaccine between the ages of 12 and 13 (now in their 20s) were 87% lower than in an unvaccinated population. Researchers said cases in this age group, which are rare, dropped from about 50 per year to just 5. There were also reductions in cervical cancer rates of 62% in women offered vaccination between the ages of 14 and 16, and 34% in women aged 16 to 18 when vaccination was introduced. Professor Peter Sasieni, lead study author, from King’s College London, said: “It’s been incredible to see the impact of HPV vaccination and now we can prove it prevented hundreds of women from developing cancer in England. Read full story Source: The Guardian, 4 November 2021
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