The global COVID-19 vaccine roll-out started in the UK on 8 December 2020, with a 91-year-old grandmother receiving the Pfizer/BioNTech jab at University Hospital, Coventry. Roll-out of the Oxford-AstraZeneca vaccine followed at Churchill Hospital in Oxford on 4 January 2021.
An excellent start, but how is the vaccination campaign progressing now, at the end of January? Is the UK on track to meet its early vaccination targets? With COVID-19 deaths averaging over 1000 a day and hospital staff at breaking point, the need is urgent.
Ambitious plans for UK vaccine roll–out
With an aim to give everyone in the top four priority groups at least one vaccine dose by 15 February, the UK government set an ambitious target. These groups include ~15 million people who are most vulnerable to COVID-19: residents in care homes for older adults and their carers; all those 70 years of age and older; and clinically extremely vulnerable individuals.
Next to be invited will be the ~17 million people in a further five priority groups, including all those aged 50 years and older and those aged 16 to 64 years with underlying health conditions.
These groups represent about 99% of COVID-19 deaths, so the first phase of vaccination is expected to cause a marked drop in hospitalisations and deaths from COVID-19.
The second phase plan has not yet been confirmed but is widely expected to include additional frontline workers at high risk of exposure to infection.
For any members with questions about vaccine eligibility, guidance is available at Medical Defense Society.
How is the campaign going so far?
This is an enormous task requiring an immense effort by healthcare professionals across the UK. GP surgeries have played a major role, pulling out all the stops to vaccinate their local populations.
People are being invited to make appointments for their COVID-19 vaccinations at about 1000 GP-led sites, hundreds of hospitals and pharmacies, as well as care homes and mass vaccination centres. The NHS supplies the vaccine doses, which cannot be paid for privately.
As of 25 January, 6,853,327 people have received a first dose of vaccine, while 472,446 have received a second dose. According to Matt Hancock, “three quarters of all the 80-year-olds in the country and a similar number of care homes“ have received their first doses.
At the current rate of 358,724 vaccinations per week, we would vaccinate 14.5 million people by 15 February. That would be a remarkable achievement.
Members needing advice about giving or receiving vaccinations can get in touch with us at Medical Defense Society.
Concerns over vaccine supply
To achieve this plan, of course, requires a steady supply of vaccine. But that is not guaranteed.
The UK government has ordered 367 million doses from seven vaccine developers. So far only the Oxford-AstraZeneca and Pfizer/BioNTech vaccines are approved and available in the UK; the Moderna vaccine is expected to arrive in the spring.
However, scaling up vaccine production and distribution is a huge and complex logistical challenge. Already, delays have been declared. A temporary reduction in Pfizer/BioNTech vaccine deliveries is expected until early February while production capacity is scaled up. AstraZeneca also announced a cut in short-term supply to the EU, but that is not expected to affect UK supplies.
Uncertainty over vaccine supply has been frustrating GPs, who have warned that the roll-out is being slowed down. Currently, priority is being given to areas that need to complete vaccinating the over-80s, which means limiting supply to other areas.
Despite these difficulties, the UK reportedly has enough vaccine already to immunise the highest-risk groups by mid-February, although not all of it has undergone packaging and final quality checks.
Medical Defense Society is available to help any members with concerns about supplies.
Debate about the second dose delay
For both available vaccines, two doses are recommended. Given limited supplies and high infection rates, delivery of the first dose is being prioritised over the second dose for maximum coverage of vulnerable populations. The second dose of the Pfizer/BioNTech vaccine may be given after 3 to 12 weeks; for the Oxford-AstraZeneca vaccine, the gap is 4 to 12 weeks.
The decision to delay the second dose from 21 days is controversial. The British Medical Association has reportedly called for the gap to be halved, citing concerns over the duration of protection and whether limited vaccine supplies will stretch to cover second doses. However, the first dose is expected to provide most of the protection and government strategy remains the same.
If members have any queries about planning second dose appointments, the expert team at Medical Defense Society is ready to help.
Will life get back to normal in the spring?
With the plan being to vaccinate the most vulnerable groups by springtime, it is reasonable to wonder whether lockdown restrictions can then start to be lifted. However, it will take many weeks to see how effective the vaccination campaign is.
- How much vaccination will reduce virus transmission.
- The level and duration of protection the vaccines provide in the real world.
- Uptake of the vaccines – although overall 85% of people say they would accept the jab, there is alarm at the high proportion of black, Asian and minority ethnic patients as well as care home staff who refuse.
- Whether the vaccines will protect against new variants of COVID-19.
It seems likely that most restrictions will remain until after Easter, at least. Many experts believe we may continue to see periodic outbreaks of infection each year, necessitating annual vaccinations, much like seasonal flu.
Advice and support is available 24/7 for any members with queries or concerns about COVID-19 vaccination; please contact us at Medical Defense Society.