The priority list for the Pfizer vaccine – and how it will be rolled out

The largest-scale vaccination programme in British history is underway, and the Pfizer Covid-19 jab has already been rolled out to half a million people, according to the Government.

The first vaccine was received by Margaret Keenan, a 90-year-old grandmother from Coventry, on December 8, as the Government is prioritising the over-80’s in the first phase of the roll out.

In addition to the Pfizer jab, senior Whitehall sources expect the Oxford vaccine to be approved within days of Christmas, kickstarting a massive drive to give jabs to millions of people in January.

Football stadia and other sites across the country will be opened from the first week of January, to allow mass vaccinations on a scale never seen before in the UK. 

However, dozens of GPs have opted out of administering vaccinations over concerns practices are already struggling with heavy workloads.

Furthermore, 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.

Professor Stephen Powis, national medical director for the NHS in England, said this was common for new vaccines and the staff have recovered well.

Who is receiving the vaccine first?

From December 14,, 300 GP surgeries will begin administering vaccines to people over 80 years-old, as the Joint Committee on Vaccination and Immunisation determined age was the most important factor in Covid-19 deaths.

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

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 after Christmas before hugging relatives.

Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading, said it takes three weeks to get the second jab and another week to develop full immunity.

The bulk of the vaccines will be administered in 2021 using the Oxford/AstraZeneca version to boost supply, according to Business Secretary Alok Sharma.

In a promising development on December 13, Professor Sarah Gilbert of the University of Oxford revealed there is a “pretty high” chance the Oxford vaccine will be rolled out before the end of the year. She shared: “I think the chances are pretty high. But we do need multiple vaccines, all countries need multiple vaccines, the world needs multiple vaccines, and we need vaccines made using different technologies, if that’s possible.”

Which hospitals will get the vaccine first?

Here are the 53 NHS Trusts in England rolling out the vaccines:

  • 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, pharmacists, and mass vaccination centres and GPs offering the jab.

After GPs have received the vaccines 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.

This depends on the speed of Pfizer, which has said it will distribute ”as rapidly as the company can manufacture”.

However, dozens of GP’s have been forced to opt out of the vaccination programme due to concerns over heavy workloads. New MHRA guidance states patients should be monitored for 15 minutes after innoculation, following the adverse reactions from two NHS staff.

But the new measures impose further pressure on already stretched services, with some GP’s saying they simply don’t have the capacity during the busy winter season, meaning thousands of people will need to go elsewhere to receive the vaccine.

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 the temperature of Pfizer affect the vaccination 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.”

However, amid uncertainty over how many jabs would reach the UK before the end of the year, care homes were bumped back up the list.  Therefore, on December 5, the MHRA approved the way doses of the vaccine would be distributed to care homes and said it will be ready for distribution across the UK within the next two weeks.

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

It follows a pilot which started on Dec 16 where the jab was taken to residents and staff in a small number of care homes, believed to be seven homes.

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.

NHS England would not say how many residents or care homes have received doses as part of last week’s pilot, but called the initial rollout a “significant step”.

The Scottish Health Secretary, Jeane Freeman, has insisted they will deliver the vaccine to care home residents in Scotland before Dec 14, stating that her talks with Pfizer had revealed the vaccine can be transported in an unfrozen state for up to 12 hours.

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

What other problems does the vaccination programme face?

On December 13, news that up to 40 per cent of care home staff may not have jab sparked new fears that the vaccine rollout 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, a further 20 per cent of others who are unsure, and therefore, 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.”

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

On December 14, in his address to Commons the Health Secretary announced a new strain of coronavirus has been identified in England.

However, Mr Hancock has said it is “highly unlikely” that the new variant will cause a more serious disease or compromise the vaccine. 

In his address to the Commons, he shared: “I must stress at this point that there is currently nothing to suggest that this variant is more likely to cause serious disease and the latest clinical advice is that it’s highly unlikely that this mutation would fail to respond to a vaccine, but it shows we’ve got to be vigilant and follow the rules and everyone needs to take personal responsibility not to spread this virus.”

The chief executive of BioNTech says the German pharmaceutical company is confident that its coronavirus vaccine works against the UK variant, but further studies are need to be completely sure.

Ugur Sahin said on Dec 22 that “we don’t know at the moment if our vaccine is also able to provide protection against this new variant,” but because the proteins on the variant are 99 per cent the same as the prevailing strains, BioNTech has “scientific confidence” in the vaccine.

Mr Sahin said BioNTech is currently conducting further studies and hopes to have certainty within the coming weeks.

“The likelihood that our vaccine works … is relatively high.” But if needed, “we could be able to provide a new vaccine technically within six weeks,” he added.

Source: The priority list for the Pfizer vaccine – and how it will be rolled out

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