Experts and patient groups have warned that the high cost of private Covid vaccinations could exacerbate health inequalities and leave those more at risk from the virus without a vital line of defence. Both high street chain Boots and pharmacies that partner with the company Pharmadoctor are now offering Covid jabs to those not eligible for a free vaccination through the NHS, with the former charging almost £100 for the Pfizer/BioNTech jab. While Pharmadoctor says each pharmacy sets its own prices, it suggests the Pfizer/BioNTech jab will set customers back £75-£85, while the latest Novavax jab will cost about £45-£55. However experts have raised concerns that the high cost of the private jabs will widen inequalities, with the vaccinations unaffordable for many. “The most disadvantaged in society are most likely to be exposed to respiratory viruses due to things like poverty, intergenerational households and crowded workplaces. While they might be most in need of a seasonal vaccine, they will also be the least likely to afford £100 in the midst of a cost of living crisis,” said Dr Marija Pantelic, of the University of Sussex. Some have noted private Covid jabs cost far more than a seasonal flu vaccination, which retails at about £20. Graham Thoms, the chief executive of Pharmadoctor, said the margins were in line: “Pharmacists will buy flu vaccines from the manufacturers for about £5 whereas the Novavax Covid vaccine will cost them £36 [including VAT], hence why the Covid vaccination service using the Novavax vaccine will cost patients on average £50.” While free Covid jabs will be provided in the NHS spring booster campaign, they are limited to adults aged 75 years and over, residents in care homes for older adults, and those aged six months and over who are immunosuppressed – a smaller pool than for the recent autumn Covid booster campaign. Prof Sir Andrew Pollard, director of the Oxford Vaccine Group, said the NHS vaccination programme is based on cost effectiveness, and focuses on protecting those who are most vulnerable and therefore most likely to end up in hospital. “Vaccination of those who are not vulnerable, [such as] younger healthy adults, still has the potential to lower the risk of infection, which is good for them, but the benefits for the healthcare system and thus taxpayers, are very small,” Pollard said, although he noted workplace vaccination schemes might reduce employee absences which could be valuable to society. However many have expressed concerns that some groups at increased risk from Covid are no longer eligible for jabs on the NHS, meaning protection comes with a hefty price tag. “The availability of private vaccines will disproportionately affect high-risk groups, including diabetics, who have accounted for a significant number of Covid deaths,” said Lara Wong, founder of the support and advocacy group Clinically Vulnerable Families. “Despite being recently approved for antiviral treatments, these newly approved groups will not have access to them until 2025, and they are also not being offered the NHS spring boosters that they desperately need,” she said. Pantelic added some people may not even know they are at increased risk from Covid, given many have undiagnosed conditions and socioeconomic stressors that compromise their immune system. Prof Amitava Banerjee, of University College London, also voiced concerns over whether the booster campaign is reaching all high risk groups, adding the rationale for current eligibility needs to be better communicated, while greater consideration needs to be given to the potential impact of not widening free provision, including in terms of long Covid. The latter, he said, matters as vaccinations appear to reduce – although not eliminate – the risk of ending up with long Covid, and reduce the severity of the condition when it does occur – the only tool currently known to do so. “Again, by making [a Covid jab] something that people have to pay for, that reduces access to it – probably in the people who are most at risk and more vulnerable,” he said. Stephen Griffin, a virologist at the University of Leeds, agreed. “Whilst obtaining a vaccine privately may be better than nothing, it inevitably creates two-tier access,” he said. “This is an absurd price amidst a cost of living crisis and is not how the UK should be managing such an important public health issue.”