Doubts Remain Over When NHS Staff Will Receive COVID-19 Vaccine

Peter Russell

December 04, 2020

Editor's note, 4 December 2020: This article was updated with the latest information.

Limited stocks of the newly approved Pfizer/BioNTech COVID-19 vaccine will mean that frontline NHS staff are unlikely to be among the first to receive it.

People aged over 80 who attend hospitals are expected to be top priority for initial supplies of the vaccine.

The first consignment of the Pfizer/BioNTech coronavirus vaccine has arrived in the UK.

It is understood stocks have been taken to a central hub at an undisclosed location and will now be distributed to hospital vaccination centres around the UK.

Chris Hopson, chief executive of NHS Providers, told the BBC today that the vaccines will have reached hospital hubs to enable vaccinations to begin on Tuesday.

"That's when we expect the first batches to be administered," he said.

Cold Storage Supply Problems

Older care home residents and their carers were listed as the number one priority to be inoculated under plans set out by the Joint Committee on Vaccination and Immunisation (JCVI). They were followed by all those aged 80 and over, together with frontline health and social care workers.

However, it quickly emerged there would be difficulties sending supplies to care homes because the vaccine is distributed in batches of 975 vials that must be stored at minus 70C.

At a news conference on Wednesday, Sir Simon Stevens, chief executive of NHS England, suggested it could take weeks before the Medicines and Healthcare products Regulatory Agency (MHRA) approved a way to split the packs for secure cold-chain distribution in smaller quantities.

Instead, vaccine recipients are likely to be older care home residents attending hospital appointments in the coming days. They could be followed by care home staff.

The first programme of care home vaccinations could happen this month, Sir Simon said, "with a fair wind".

Uncertainties Over Vaccines for Healthcare Staff

Limited stocks could mean that NHS staff listed in the next priority category might not be eligible for vaccination until after Christmas, the Health Service Journal reported.

It said only a few NHS staff could expect to be vaccinated from next week, where trusts had spare vaccine doses and were unable to give them to more care staff or those aged 80 plus.

The JCVI issued a COVID-19 vaccination priority list based on preventing mortality and maintaining the health and social care system.

  1. Residents in a care home for older adults, and their carers

  2. All those 80 years of age and over, and frontline health and social care workers

  3. All those 75 years of age and over

  4. All those 70 years of age and over, and clinically extremely vulnerable individuals

  5. All those 65 years of age and over

  6. All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality

  7. All those 60 years of age and over

  8. All those 55 years of age and over

  9. All those 50 years of age and over

The British Medical Association (BMA) called for healthcare workers to be prioritised in the rollout. Chaand Nagpaul, BMA council chair, urged the Government "to ensure healthcare workers at the highest risk from the virus [were] given priority".

The Government has ordered 40 million doses of the messenger RNA (mRNA) vaccine for delivery throughout 2020 and 2021, enough to vaccinate 20 million people.

The initial tranche, delivered from Belgium, is expected to total 800,000 doses.

Prof Jonathan Van-Tam, England's deputy chief medical officer, said he expected "some blending" in the rollout between the first priority group and those next in line, which includes people aged 80 or over, and frontline health and social care workers.

It was "not viable" to take the vaccine into individual homes if people were housebound, he added.

In the meantime, vaccinations would start at 50 'hospital hubs' in England next week, with GP practices able to operate local vaccination centres as stocks become available.

Prof Van-Tam said this could change once the AstraZeneca/Oxford vaccine gained regulatory approval, as it could be stored at normal refrigerator temperature.

Scotland, Wales, and Northern Ireland

Nicola Sturgeon, Scotland's First Minister, said she had been promised an initial delivery of 65,000 doses of the Pfizer/BioNTech vaccine.

Asked when care home residents in Scotland could expect to be vaccinated with it, she acknowledged that "if for the first period it is difficult to get the vaccine to care homes, obviously we will use these supplies for [the] NHS and staff who work in care homes".

The Welsh Government said it was ready to deploy the Pfizer/BioNTech vaccine in phases, starting with hospitals, and then in community settings.

However, "In practical terms at this stage we cannot deliver this vaccine to care homes", Vaughan Gething, Minister for Health and Social Services, stated.

Robin Swann, Northern Ireland's Health Minister, confirmed that health and social care workers, including care home staff, would be amongst the first priority groups, as would care home residents.

Guidance on the Pfizer/BioNTech Vaccine for Healthcare Workers

On Wednesday, the MHRA published information for healthcare workers for storing and administering the Pfizer/BioNTech vaccine.

It advised that each 195 pack would take around 3 hours to thaw at normal refrigeration temperatures of between 2C and 8C.

Once thawed, the undiluted vaccine could be stored for up to 5 days in a standard refrigerator, and up to 2 hours at room temperatures of up to 25C.

It said each vial (0.45 mL) contained five doses that needed diluting with sodium chloride before use.

Diluted vials should be used immediately, and within 6 hours following dilution.

The BMA has called for further guidance on how GP surgeries would be expected to handle and deliver the vaccine.

Dr Richard Vautrey, BMA GP committee chair, said he wanted "clarification and guidance from both NHS England and the Government on how exactly practices will be involved in this first phase, given the much-publicised practical restraints around storage and transportation".

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