How the Pfizer/BioNTech vaccine is being rolled out - and who will get it first
More details have emerged about who will be first to get the Pfizer/BioNTech coronavirus vaccine when the UK rollout begins next week.
First doses of the highly anticipated jab reached Britain on Thursday after being brought through the Eurotunnel on lorries from Belgium.
It is just the start of the huge and complex logistical and technical operation that lies ahead to protect those most vulnerable across the UK.
How does it work?
The government has secured 40 million doses of the vaccine - enough to vaccinate 20 million people, as patients need two doses (administered three weeks apart) for the full effect. About 800,000 doses are due to arrive by next week.
Moving the vaccination to storage
Pre-packed boxes of the vaccine, which contain 975 doses, can be shipped by refrigerated lorry or plane to a centralised depot in the UK where the batches are tested for quality control purposes.
Once the vaccine batches are approved they have to be moved to storage freezers, where they can be kept for months as long as the temperature is initially maintained at -75C. It can only be moved four times.
How will it be distributed?
It is now being delivered to each of the devolved nations and will be distributed to 50 hospital hubs in the coming days.
Storage at -75C is only necessary in the case of long-term storage and isn't necessary at vaccination centres.
Once stored in boxes and regular fridges, the vaccine can last for over 30 days if the ice is replaced.
It can be stored before final use at 2-8C - but only for five days.
Job adverts to help prepare for distribution
With the vaccine approved by the UK's independent health regulator MHRA, which has defended the speed of its decision following questions from America's top infectious diseases expert, the NHS has begun recruiting staff who either have experience of delivering a vaccine or are willing to be trained.
An advert for one London healthcare trust says: "We are expecting to receive the COVID-19 vaccine very soon.
"Vaccinating as many Londoners as quickly as possible will require your help.
"We are looking for healthcare professionals from across the capital. You may already have experience of delivering a vaccine to people, or you may be willing to be trained."
Where will the vaccine be administered?
The 50 hospitals are:
- Blackpool Teaching Hospitals NHS Foundation Trust-Brighton and Sussex University Hospitals NHS Trust-Cambridge University Hospitals NHS Foundation Trust-Chesterfield Royal Hospital NHS Foundation Trust-Countess of Chester Hospital NHS Foundation Trust-Croydon University Hospital NHS Trust-Dartford & Gravesham NHS Trust-Dorset County Hospitals NHS Foundation Trust-East and North Hertfordshire NHS Trust-East Kent Hospitals NHS Foundation Trust-East Suffolk and North Essex NHS Foundation Trust (Colchester Hospital)-Frimley Health NHS Foundation Trust-Gloucestershire Hospitals NHS Foundation Trust-Great Western Hospitals NHS Foundation Trust-Guys & St Thomas NHS Trust-James Paget University Hospitals NHS Foundation Trust-Kings College Hospital NHS Foundation Trust-Kings College Hospital -Princess Royal University Hospital-Lancashire Teaching Hospital Trust-Leeds Teaching Hospitals NHS Foundation Trust-Leicester Partnership NHS Trust-Liverpool University Hospitals NHS Foundation Trust-Medway NHS Foundation Trust-Mid and South Essex Hospitals Trust--Milton Keynes University Hospital-Norfolk and Norwich University Hospital-Northampton General Hospital NHS Trust=North Bristol NHS Foundation Trust North West Anglia Foundation Trust-Nottingham University Hospitals NHS Trust-Oxford Health NHS Foundation Trust-Portsmouth Hospital University Trust-Royal Cornwall Hospitals NHS Trust=Royal Free London NHS Foundation Trust=Salford Royal NHS Foundation Trust-Sheffield Teaching Hospitals NHS Foundation Trust-Sherwood Forest Hospitals NHS Foundation TrustShrewsbury and Telford NHS Trust-Stockport NHS Foundation Trust=St George's University Hospitals NHS FT-The Newcastle upon Tyne Hospitals NHS Foundation Trust=University College Hospitals Trust=University Hospitals Birmingham NHS Foundation Trust=University Hospital Coventry & Warwickshire=University Hospitals Derby Burton NHS FT-University Hospitals of North Midlands NHS Trust-University Hospitals Plymouth NHS Trust-United Lincolnshire Hospitals NHS Trust-Walsall Healthcare NHS Trust-West Hertfordshire Hospitals NHS Trust-Wirral University Teaching Hospital-Worcestershire Acute Hospitals NHS Trust-Yeovil District Hospital NHS Foundation Trust.
These hubs are not necessarily where all patients will receive their vaccines, but are sites that are going to be capable of storing the vaccines and coordinate their distribution.
Who will get the vaccine first?
The government's Joint Committee on Vaccination and Immunisation (JCVI) has confirmed its priority list for the first phase of the UK's mass vaccine rollout as follows:
- Residents in a care home for older adults and their carers
- All those aged 80 and over. Front line health and social care workers
- All those aged 75 and over
- All those aged 70 and over. Clinically extremely vulnerable individuals
- All those aged 65 and over
- All individuals aged 16-64 with underlying health conditions which put them at higher risk of serious disease and mortality
- All those aged 60 and over
- All those aged 55 and over
How will people be vaccinated?
Chris Hopson, chief executive of NHS Providers, said in a Twitter thread on Thursday that the listed NHS trusts will be working with local care homes and local authorities to maximise the number of care home carers/workers coming into hospital hubs for vaccination.
Secondly, hospitals over the next few days will identify as many patients over 80 as possible that they can vaccinate against the coronavirus.
Obvious candidates would be those attending outpatient appointments and those receiving inpatient treatment.
There had been concerns that the vaccine's storage needs would make it difficult to deliver to care homes, but - while the task remains challenging - those fears have somewhat subsided.
The MHRA (Medicines and Healthcare products Regulatory Agency) has said vaccine boxes can be split into smaller numbers of doses, making it easier for the jab to be sent to care home residents.
The vaccine can be sent to care homes as long as it travels for no more than six hours after it leaves cold storage - and is then put in a normal fridge at 2-8C.
Given that the vaccine needs to be initially stored at -75C, Mr Hopson admitted: "This won't be easy."
If there are early vaccine doses left over after these priority groups are given the jab, hospitals will then vaccinate NHS staff based on risk factors.
Hospitals will be asked to ensure anyone who gets a first dose will be available for a second dose three weeks later, which is required for the vaccine to be effective.
Will there be enough of the early doses for front line NHS staff to be vaccinated?
According to a report in The Telegraph, they may not get it due to supply issues and "confusion over the number of doses that will arrive by the end of the year".
This is despite the UK expecting 10 million doses by the end of the year, it reports.
But Mr Hopson disagrees.
He pointed to his earlier Twitter thread which he said stated: "We know the number of Pfizer doses for December and January but not beyond that. We don't know when/if the two other vaccines at front of queue - Oxford and Moderna - will receive authorisation.
"We therefore have to work on the precautionary basis that this initial batch of 800,000 could be the only batch we receive for some time."
In response to the newspaper report, he tweeted on Friday: "The key words are 'precautionary basis' and 'could'. The principle is that we should act on the basis that this could be the only batch we receive for some time. We are all hoping and are very confident that there will be a lot more doses than 800k.
"Every day that goes past, we become more confident we will get a lot more and get them soon. But acting on a precautionary basis means that we should use the initial batch as much as possible for care home staff/residents and over 80s - the JCVI priorities.
"The alternative could have meant "let's vaccinate NHS frontline staff because they are the easiest to get to, and we know that more doses are on the way". But that's not what we are going to do. That's the only point I was making. NOT that there may be supply problems."
Mr Hopson warned the rollout would be a "large, complex, important logistical challenge", but he added: "This is what NHS is good at - and why we benefit hugely from having a National Health Service, as the creation of 33,000 beds for coronavirus patients in first phase showed.
"Trusts will deliver this vital task."
Who will not receive the jab?
The vaccine has not been advised for pregnant women as there is no data on its safety.
"Women should be advised not to come forward for vaccination if they may be pregnant or are planning a pregnancy within three months of the first dose," the JCVI said.
It will also not be generally available for children under 16. The JCVI added that "following infection, almost all children will have asymptomatic infection or mild disease" and as such don't need it.
However, it will be available for "those children at very high risk of exposure and serious outcomes, such as older children with severe neuro-disabilities that require residential care".
What happens after this initial first phase of the rollout?
The UK is the first country to approve the jab for use, and the first vaccinations are expected on Tuesday.
As more doses become available, possibly in the new year, the vaccination will be administered to other risk groups, with the bulk of vaccinations expected to take place between January and April.
What about other vaccines?
There are over 170 coronavirus vaccines in development across the globe, but there are a handful of frontrunners which are in the last stages of checks and could soon become available like the Pfizer jab.
A much cheaper and more easily stored option from Oxford University and AstraZeneca, albeit one with a lower efficacy rating, has been submitted for approval in the UK.
Meanwhile, scientists from American company Moderna are seeking approval from US and EU regulators to allow emergency use of their jab, which the UK government has ordered seven million doses of.
On Wednesday, Russia announced it will begin large-scale vaccinations using its jab called Sputnik V next week, and the Chinese military has approved another one made by CanSino Biologics.
Reference: Sky News: 19 hrs ago
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