The priority list for the Oxford and Pfizer vaccines – and how they will be rolled out

Matt Hancock has pledged to offer all adults in the UK the coronavirus vaccine by autumn, as the Oxford/AstraZeneca and Pfizer rollout is ramped up.

Tens of millions of people will be immunised by spring at over 2,700 vaccination sites across the UK, the Government  announced on Jan 11, as part of comprehensive plans to rapidly scale up the Covid-19 vaccination programme.

Mr Hancock insisted that the Government is on course to reach its target of inoculating two million people a week by early February in the UK’s biggest ever inoculation campaign. 

In a further bid to accelerate vaccination, Boris Johnson has announced that 24-7 vaccine centres will be opened “as soon as we can”.

The Health Secretary told Sky News’ Sophy Ridge on Jan 10: “The rate limiting factor at the moment is supply but that’s increasing. I’m very glad to say that at the moment we’re running at over 200,000 people being vaccinated every day.”

Matt Hancock told a press conference on Jan 11 that the UK has “protected more people through vaccinations than all the other countries in Europe put together”, with more than 2.4 million people having received the vaccine as of Jan 12. 

The latest figures revealed that roughly 40 per cent of 80-year-olds in the country had been vaccinated already as well as 23 per cent of the elderly residents of care homes.

However, the Telegraph can report that some GP surgeries which are leading the way in the vaccine roll out are being told to “pause” in order to allow for those in other areas to catch up. 

It is understood that some GP surgeries are ready to start inoculating those in the over-70s group, but have been denied supplies to do so by local NHS leaders.  

Boris Johnson has promised that vaccines would soon be available to people within 10 miles of their home. For a small number of highly rural areas, the vaccine will be brought to them via mobile teams. 

Mr Johnson has pledged that the NHS is committed to offering a vaccination to everyone in the top four priority groups by Feb 15, which leaves 12.5 million people left to vaccinate in five weeks given the latest figures.

In total, 206 active hospital sites; 50 vaccination centres; and around 1,200 local vaccination sites – including primary care networks, community pharmacy sites and mobile teams – will be set up to ensure every at-risk person has easy access to a vaccination centre, regardless of where they live.

Also contributing to this “unprecedented national effort” will be the Armed Forces, who are set to be drafted in to help run mass vaccination centres in sports stadiums and public venues. 

The NHS have announced that high street pharmacies in England will be able to distribute coronavirus vaccines from Jan 14.

Boots and Superdrug branches will be among the six stores across the country which will be able to administer the jabs.

Boots in Halifax, and Superdrug in Guildford, will be in the first group to hand out the injections, alongside Andrews Pharmacy in Macclesfield, Cullimore Chemist in Edgware, north London, Woodside Pharmacy in Telford and Appleton Village pharmacy in Widnes.

The stores have been picked because they are capable of delivering large volumes of the medicine and allow for social distancing, while still giving a spread across the country.

By the end of the month, more than 200 community chemists will be able to give vaccines, according to NHS England.

Some 100 Oxford million jabs have been ordered by the Government, with 40 million due to be rolled out by March.

Read more: Tracking UK Covid vaccinations: Are we on target to end lockdown?

Who is receiving the vaccine first?

Prof Stephen Powis, the National Medical Director of NHS England, called the UK Covid-19 vaccine roll-out “two sprints and a marathon.”

Prof Powis says the NHS is in a “sprint” to mid-February, to vaccinate the most vulnerable groups. There will then be another sprint to April, when the rest of the priority groups will be given the jab.

Following this, there will be a “marathon” to the Autumn, when the rest of the country will receive it. 

People over 80 years old were prioritised first, as the Joint Committee on Vaccination and Immunisation determined age was the most important factor in Covid-19 deaths.

Margaret Keenan, 91, was the first person to receive the Pfizer vaccine at University Hospital, Coventry on Dec 8, and successfully received her second dose on Dec 29, while 82-year-old Brian Pinker was the first person in the UK to be given the Oxford/AstraZeneca vaccine at Oxford University Hospitals NHS Foundation Trust’s Churchill Hospital on Jan 4.

Brian Pinker, 82, receiving the first Oxford vaccine at Oxford University Hospital on January 4 as the roll out of the vaccine begins in the UK

Age aside, NHS workers and care home residents will be prioritised, followed by health and social care workers and then key workers such as first responders and teachers.

The first care home residents had doses of the Oxford/AstraZeneca vaccine brought to them as it was rolled out to GP surgeries on Jan 7.

On Jan 8, NHS England said letters inviting the over-80s to attend mass vaccination centres were starting to land on doormats. The letters have been sent to people aged 80 or older who live a 30- to 45-minute drive from one of the new regional centres, with information about how they can book a slot either over the phone or via an online national booking service.

Teachers will be considered as a possible priority for the next phase of the coronavirus vaccine rollout, a Joint Committee on Vaccination and Immunisation (JCVI) member has said.

Professor Adam Finn said committee members had been instructed to come up with a plan by the middle of February to determine the priority order of who should be vaccinated next.

Asked about the position of teachers on the priority list, he said: “I can’t predict exactly what will be prioritised but I can say that we will be discussing this and coming up with a plan, and I can also say that when it comes to teachers I think we all appreciate the critical role that they all play and so that really will figure in the discussions.”

Vaccines minister Nadhim Zahawi has suggested that teachers, police officers and other critical workers will be in the “highest category of phase two” of the vaccine rollout.

The UK could start administering vaccines 24 hours a day when enough coronavirus jabs become available, Mr Zahawi added.

“If we need to go to 24-hour work we will absolutely go 24 hours a day to make sure we vaccinate as quickly as we can,” he told BBC Radio 4’s Today programme.

Regulators have said the key to success will be to administer two full doses between four to 12 weeks apart, in order to give as many people the initial dose of the vaccine as possible, which offers some protection from the virus.

Prof Whitty said that extending the gap between the first and second jabs would mean the number of people vaccinated can be doubled over three months, after being asked whether the longer gap could lead to an increase risk in an “escape mutant”.

“Our quite strong view is that protection is likely to be lot more than 50 per cent”, he added.

“If over that period there is more than 50 per cent protection then you have actually won. More people will have been protected than would have been otherwise,” he told a No 10 news conference on Jan 8.

Scientists have said only half of those vaccinated could have immunity after a single dose and elderly people should wait until they are fully protected with a second dose before hugging relatives.

Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading, said that with the first and second jabs administered three weeks apart, it will take one week after the second jab to develop full immunity.

Which hospitals got the vaccine first?

The Oxford/AstraZeneca vaccine began to be rolled out from Jan 4, with 6 NHS Trusts in England initially administering the inoculation before GP-led services.

The NHS Trusts are: 

  • Royal Free Hospital London NHS Foundation Trust
  • Brighton and Sussex University Hospitals NHS Trust
  • Guy’s and St Thomas’ NHS Foundation Trust 
  • Oxford University Hospitals NHS Foundation Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • George Eliot Hospital NHS Trust

Here are the 53 NHS Trusts in England rolling out the Pfizer vaccine:

  • Blackpool Teaching Hospitals
  • Brighton and Sussex University Hospitals
  • Cambridge University Hospitals
  • Chesterfield Royal Hospital
  • Countess of Chester Hospital
  • Croydon University Hospital
  • Dartford and Gravesham Hospitals
  • Dorset County Hospitals
  • East and North Hertfordshire Hospitals
  • East Kent Hospitals
  • East Suffolk and North Essex Hospitals
  • Frimley Health NHS Foundation Trust
  • Gloucestershire Hospitals
  • Great Western Hospitals
  • Guys & St Thomas NHS Trust
  • James Paget University Hospitals
  • Kings College Hospital
  • Princess Royal University Hospital, Kings
  • Lancashire Teaching Hospital
  • Leeds Teaching Hospital
  • Leicester Partnership NHS Trust
  • Liverpool University Hospitals
  • Medway NHS Foundation Trust
  • Mid and South Essex Hospitals
  • Milton Keynes University Hospital
  • Norfolk and Norwich University Hospital
  • Northampton General Hospital
  • North Bristol NHS Foundation Trust
  • North West Anglia Foundation Trust
  • Nottingham University Hospitals
  • Oxford Health NHS Foundation Trust
  • Portsmouth Hospital University
  • Royal Cornwall Hospitals
  • Royal Free London NHS Foundation Trust
  • Salford Royal NHS Foundation Trust
  • Sheffield Teaching Hospitals
  • Sherwood Forest Hospitals
  • Shrewsbury and Telford NHS Trust
  • Stockport NHS Foundation Trust
  • St George’s University Hospitals
  • The Newcastle Upon Tyne Hospitals
  • University College Hospitals
  • University Hospitals Birmingham
  • University Hospitals Coventry and Warwickshire
  • University Hospitals Derby Burton
  • University Hospitals of North Midlands
  • University Hospitals Plymouth
  • United Lincolnshire Hospitals
  • Walsall Healthcare
  • West Hertfordshire Hospitals
  • Wirral University Teaching Hospital
  • Worcestershire Acute Hospitals
  • Yeovil District Hospital

Three modes of delivery

Health Secretary Matt Hancock said there would be “three modes of delivery”, with hospitals and mass vaccination centres along with pharmacists and GPs offering the jab.

After GPs have received the vaccine they have been instructed by NHS England to administer 975 doses to priority patients within three-and-a-half days.

The NHS plans to open GP surgeries from 8am to 8pm every day, each dispensing at least 1,000 jabs a week. However, there are talks that 24-hour vaccination centres could be put in place to speed up the roll out of the vaccines. 

This depends on vaccine deliveries from Pfizer, which has said it will distribute “as rapidly as the company can manufacture”.

Revised MHRA guidance states patients should be monitored for 15 minutes after inoculation, following adverse reactions from two NHS staff.

Easier to store, handle and more readily available than the Pfizer vaccine, the Government also intends to distribute the Oxford jab to mass vaccination centres, including sports hall, stadiums and conference centres from the second week of January.

Prof Whitty’s deputy, Professor Jonathan Van-Tam, also previously suggested that people who cannot leave their homes may need to wait for the Oxford jab as it can be more easily split into smaller quantities.

Michael Tibbs, 99, recieving the Pfizer/BioNTech covid-19 vaccine at Queen Alexandra Hospital in Portsmouth, making him the first person in the South West to have the vaccine

Where else will the vaccinations take place?

Military personnel have been ordered to transform 10 sites into vaccine hubs, including:

  • Nightingale hospital, London
  • ExCel Centre, London
  • Epsom racecourse, Surrey
  • Ashton Gate football stadium, Bristol
  • Robertson House conference facility, Stevenage
  • Derby Arena

Other facilities under consideration include:

  • The Black Country Living Museum, Dudley 
  • Millennium Point, Birmingham
  • Malvern’s Three Counties’ Showground, Worcestershire
  • Villa Park, home of Aston Villa FC
  • Leicester racecourse

How will I be contacted for the Covid vaccine?

The NHS will contact you when you are eligible for the vaccine and be invited to make an appointment. If you are registered to a GP, you will be contacted by your surgery either over the phone, by text, email or post, in order to book in to get vaccinated at your local vaccination centre.

You can still register at a GP surgery if you are not already registered to one, and it is advised that you make sure that your contact details are up to date to ensure that there are no delays. 

How will the storage requirements of the Pfizer vaccine affect the programme?

The vaccine must be stored at -70C to be effective, meaning it can only be delivered to GPs with the facilities to keep it at that temperature.

It will be difficult to administer in care homes. Deputy chief medical officer professor Jonathan Van-Tam said: “This is a complex product. It is not a yoghurt that can be taken out of the fridge and put back in several times.”

The vaccine will be rolled out to elderly residents in care homes with more than 50 registered beds in England within the next few weeks.

It is understood the vaccine batches are being broken down into doses of 75, and the focus over the next fortnight will be on elderly residents and staff in homes with more than 50 beds to avoid wastage.

The Oxford vaccine does not need to be stored in such cold conditions – it can be kept at temperatures between 2C and 8C.

This means it could be more mobile than the Pfizer jab and therefore more easily deployed into care homes of varying sizes and into private homes for individual doses.

Experts believe the Oxford jab will be easier to deploy beyond formal healthcare settings, in part because it does not need to be stored at such cold temperatures as the other approved vaccine.

Read more: How the UK will get Pfizer’s Covid vaccine from factory to patient

Will people receive vaccines 24 hours a day? 

Boris Johnson has confirmed that round-the-clock vaccine centres will be opened “as soon as we can”. The Prime Minister is currently under pressure by MPs to accelerate the vaccination schedule.

The Health Secretary told BBC Breakfast a 24-hour approach was unlikely to be “the major factor” in hitting the mid-February target, but he was “absolutely” behind it “if it helps speed things up”.

Sources in Whitehall have said that plans are in place to pilot a 24-hour vaccination centre to test demand. This comes as manufacturing companies have told ministers that they will be able to produce enough vaccines should 24-hour roll out be introduced across the country. 

Offering vaccinations overnight will speed up the rollout, and allow the Government to reach their goal of vaccinating 32 million people- 60 per cent of the UK adult population by Spring, which was announced on Jan 11. 

On the same day as the announcement, ministers were asked why jabs are only administered during daytime hours, when other countries, such as Israel, who has already vaccinated one-fifth of its population, continue to offer jabs overnight. 

What other problems does the vaccination programme face?

Two of the first NHS staff to get the jab suffered allergic reactions and the Medicines and Healthcare products Regulatory Agency warned the vaccine should not be administered to people with a history of ‘significant’ allergic reactions.

Prof Stephen Powis said that this was common for new vaccines and the staff have recovered well.

On Dec 13, news that up to 40 per cent of care home staff may not have jab sparked new fears that the vaccine roll-out may not be successful. 

This research, from the National Care Association, suggested that as many as 20 per cent of care workers are adamant they won’t receive the jab. Furthermore, 20 per cent of other care workers are unsure and may follow their example. 

Nadra Ahmed, a representative from the charity, revealed that “between about 17 and 20 per cent of staff in-services are saying they definitely won’t have it, and then you have the rest who are waiting to see”.

“So, we are looking at potentially 40 per cent who decide not to have it.”

The progress of the vaccination programme could be held up as retired doctors will still have to fill out 15 forms before being allowed to take part in the mass coronavirus vaccination programme, despite claims from Boris Johnson that red tape had been slashed. 

The Prime Minister, told MPs on Jan 6, that he had been assured by Health Secretary Matt Hancock that “all such obstacles and all such pointless pettifoggery has been removed”.

However, after being approached by The Telegraph, the Department of Health and Social Care admitted that only six of the training modules had been removed, leaving 15 different requirements still in place.

Vulnerable people suffering from rare diseases are also being forced to wait for a coronavirus vaccine because of an algorithm used to determine the risks, according to a member of the expert committee that advises the health department.

The QCovid algorithm was used by the Joint Committee on Vaccination and Immunisation (JCVI) to identify who was most likely to die if they catch coronavirus and therefore who should be prioritised in the government’s vaccine roll out. 

Although vulnerable people have been given priority in the Government’s vaccine rollout, committee member Jeremy Brown, a professor of respiratory infection at University College London, said the QCovid algorithm was likely to underestimate the risk coronavirus poses to people suffering from rare diseases.

“There are limits to the detail”, said Mr Brown. “The data for cancers is grouped as all cancers rather than different cancers and it is quite likely that some cancers are much more of a problem than others.” 

He added that people who are suffering from rare illnesses and have been shielding successfully are also unlikely to show up in the data.

What about the new variant of coronavirus? Will the vaccine still protect us?

The South African variant of the virus has threatened to undermine the vaccine and testing gains of recent months.

The Medicines and Healthcare products Regulatory Agency (MHRA) is expecting some vaccine tweaks to be needed as it has already begun to look at how quickly an altered jab could be approved, and Matt Hancock has said he is “very worried”.

Sir Patrick Vallance said in a press conference on Jan 5 that it is possible the South African coronavirus variant may have some effect on vaccine effectiveness but is unlikely to “abolish” their effect.

The chief scientific adviser said that a possible change in the virus shape in the variant “theoretically gives it a bit more risk of not being recognised” by the immune system.

“There is nothing yet to suggest that’s the case. This is being looked at very actively,” he said.

Read more: Analysis: Why the South Africa strain is so worrying

Source: The priority list for the Oxford and Pfizer vaccines – and how they will be rolled out

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