The approval of the Oxford/AstraZeneca vaccine has created great expectation that it will lead to a rapid and significant expansion of the UK’s effort to immunise the population against Covid-19. The NHS across the four home nations is now gearing up to start deploying it from next Monday, 4 January. It will be the second vaccine to be used in Britain to fight the pandemic, after the BioNTech/Pfizer jab.
Ministers and the NHS have been very eager to see the Oxford vaccine approved. Why?
Because it is so much easier to deploy than the Pfizer product. It can be stored in normal fridges and carried around in coolbags, which means it can be taken by doctors and nurses into people’s homes, care homes and other settings, such as mental health facilities, with non-mobile populations. In contrast, the Pfizer jab has to be transported at -75C and can only be moved a maximum of four times before it becomes unstable and thus ineffective. In addition, it is made in Britain – in Wrexham in north Wales – unlike Pfizer’s drug which is produced in Belgium. And people who receive it do not have to be observed for 15 minutes afterwards, unlike the Pfizer one.
Who is in line to get the Oxford vaccine?
The 25 million or so people in nine ranked groups based on age and underlying health that the government’s advisory Joint Committee on Vaccination and Immunisation has identified as the top priority. That is everyone in the UK aged 50 or older.
Care home residents and staff are the top priority, followed by everyone aged 80 or above and anyone working in health and social care. Those first two groups have been the main recipients so far among the 616,933 people who had their first dose by 20 December. The government has not said when it hopes to have vaccinated those 25 million people by, but it will probably take months.
AstraZeneca has pledged to deliver several million doses within weeks.
Who exactly will administer the Oxford vaccine?
GPs will play the key role, at least initially. Prof Martin Marshall, the chair of the Royal College of GPs, said the vaccine “will be a gamechanger for the rollout of the vaccination programme in primary care”. Its ease of distribution will help overcome many of the Pfizer vaccine’s “huge logistical challenges” because it is just like any of the other vaccines that family doctors and practice nurses already deliver, such as the winter flu jab. That makes it “easier for GPs, our teams and other primary care professionals to store it appropriately, and ultimately vaccinate a greater number of patients, [and] at a faster pace in the community,” Marshall said.
However, the Oxford vaccine becoming available will also lead to a wide range of health professionals, including physiotherapists and paramedics, inoculating people, not just doctors, nurses and pharmacists. The law has been changed to allow this, as part of the emergency response to Covid-19. The NHS is also training ordinary members of the public to deliver jabs, to help get large numbers of people vaccinated as soon as possible.
Where will people be able to get the Oxford vaccine?
Everywhere that vaccines are administered: GP surgeries, GP-run vaccination centres, mass vaccination centres, in their own homes and potentially also in hospitals (for NHS and care staff).
Until now there has only been one “vaccination site” in each primary care network (PCN) area in England, which is made up of typically five or six GP practices. But the NHS Confederation is pressing for all of the UK’s 7,500 surgeries to deliver the Oxford vaccine. That again could boost the number of recipients, and quickly.
But Ruth Rankine, the confederation’s director of primary care, said: “This [ambition] needs to be balanced with the current workload of general practice and the workforce available.” The Covid resurgence means GPs are busy at the moment, with many working at their own surgery, local “hubs”, in 111 call centres and some at A&E units.
How many people could each of these sites vaccinate?
“If there is no 15-minute waiting period post-vaccination then we could see a much greater throughput of the public receiving vaccination,” said Rankine. “The precise numbers will depend on the size of the facility and the workforce available. One PCN clinical director suggested that they would be able to vaccinate 6,000 people over one weekend across three sites, subject to the supply of the vaccine being available and no 15-minute observation period.”
It is hoped that each mass vaccination centre – at sports stadiums, leisure facilities and conference centres – will be able to immunise 2,000-5,000 people a day, using either vaccine.
Will people be able to get the Oxford jab at high street pharmacies too?
Quite possibly. Some of the UK’s 57,000 registered pharmacists have already been assisting the rollout of the Pfizer vaccine that began on 8 December. The Royal Pharmaceutical Society (RPS) is keen to have as many of them as possible, and the 12,900 pharmacies in England, Scotland and Wales, play a much bigger role with the Oxford jab. NHS England is already in talks with the pharmacy profession about that, and details of how many and which pharmacies are involved will be agreed soon. “It is critical that pharmacy teams are involved to help deliver the numbers required from government and the NHS,” said Ravi Sharma, the RPS’s director for England.