NHS leaders have raised concerns about the rollout of the coronavirus vaccine, with more than half of hospital trusts and two-thirds of GPs yet to receive supplies amid growing alarm over the new fast-spreading variant.
Dr Richard Vautrey, the chair of the British Medical Association’s GP committee, urged the government to speed up delivery of the Pfizer/BioNTech vaccine in order to save lives. Experts also demanded greater transparency from ministers on how many doses are available.
Vautrey said: “We need millions of doses to be made available as soon as possible – urgently – because it’s the number one priority for GP practices, our patients and the nation, especially given the new mutant strain.
“GPs who haven’t got it yet are frustrated because they want to be getting on and vaccinating their patients as well. Their frustration is understandable. They want to protect their patients, especially their vulnerable patients, as quickly as possible.”
Hospital bosses in England are also dismayed that, a fortnight after Margaret Keenan from Coventry became the first person to have the jab on 8 December, more than half of the country’s 135 NHS acute hospital trusts have still not received their first supplies. So far 57 (42%) of them have had a delivery and been able to start vaccination, the Guardian understands.
There are 414 GP-run vaccination sites in operation in England, NHS England confirmed. Given there is usually one site per primary care network, each of which is typically made up of five or six surgeries, that means about a third of GPs are now involved in administering the vaccine. All hospitals and GP administering sites are expecting to receive the vaccine by 4 January as the NHS rolls it out in stages.
The Medicines and Healthcare products Regulatory Agency (MHRA) is expected to approve a second vaccine, from Oxford University and AstraZeneca, as soon as Monday or Tuesday next week. However, all those who had a single dose of the Pfizer version will need a second dose of the same.
Whitehall and NHS sources say current supply of the vaccine is “limited” and “constrained”. This is thought to be why groups of GP surgeries working together in primary care networks to deliver the vaccine privately complain they often get only 24 hours’ warning of a delivery, forcing them to arrange at short notice the required number of often frail, elderly patients to come in so precious doses are not wasted.
Five million vaccine doses were forecast to arrive in the UK by the end of the year after Britain became the world’s first country to approve the Pfizer/BioNTech version on 2 December. That would be enough to inoculate 2.5 million of the most vulnerable people – mainly over-80s and care home staff – with the two doses needed for full immunity, three weeks apart.
The Pfizer/BioNTech Covid jab is an mRNA vaccine. Essentially, mRNA is a molecule used by living cells to turn the gene sequences in DNA into the proteins that are the building blocks of all their fundamental structures. A segment of DNA gets copied (“transcribed”) into a piece of mRNA, which in turn gets “read” by the cell’s tools for synthesising proteins.
In the case of an mRNA vaccine, the virus’s mRNA is injected into the muscle, and our own cells then read it and synthesise the viral protein. The immune system reacts to these proteins – which can’t by themselves cause disease – just as if they’d been carried in on the whole virus. This generates a protective response that, studies suggest, lasts for some time.
The two first Covid-19 vaccines to announce phase 3 three trial results were mRNA-based. They were first off the blocks because, as soon as the genetic code of Sars-CoV-2 was known – it was published by the Chinese in January 2020 – companies that had been working on this technology were able to start producing the virus’s mRNA. Making conventional vaccines takes much longer.
Adam Finn, professor of paediatrics at the Bristol Children’s Vaccine Centre, University of Bristol
However, there is confusion about whether that target will be met. The Department of Health and Social Care (DHSC) declined to say how many doses had arrived and when more would reach Britain from Pfizer’s production plant in the Belgian town of Puurs.
Amid disruption at UK ports caused by countries’ fears over the new variant, a DHSC spokesperson said: “We have sufficient doses to maintain our vaccination programme as it continue to expand and we are working closely with Pfizer to ensure vaccines keep arriving into the UK, with robust contingency measures, so deliveries from the continent will continue unimpeded.”
Global demand for the Pfizer/BioNTech vaccine has increased in recent days after the US Food and Drug Administration and European Medicines Agency gave it the green light.
At least 800,000 doses have arrived so far, with Boris Johnson confirming on Monday that more than 500,000 first doses had been administered to the elderly, care home staff and healthcare workers with underlying health conditions.
But the Royal College of GPs demanded that ministers clarify the supply numbers so as many family doctors as possible can join the rollout and help expand the numbers being vaccinated, and that those that have already started know when their next batch will come.
Prof Martin Marshall, the college’s chair, said: “Every vaccination site needs to know when their next supplies are arriving, with as much notice as possible, so that they can make necessary and feasible preparations.
“This includes being able to give patients as much notice as possible about their appointment, which will likely increase uptake.”
NHS sources say the vaccine deployment has acquired extra urgency as a result of the recent increase in the number of people infected and hospitalised with Covid-19.
Pfizer said 21 shipments had arrived in the UK since early December, which are thought to greatly exceed the initial 800,000 doses, and had “been successfully delivered to our four nations across the UK”. A spokesperson said: “We continue to work tirelessly to ensure the shipments remain on schedule.”
Doctors’ Association UK has joined calls for NHS staff to be given the vaccine as an urgent priority. The network of grassroots medics has written to the health secretary, Matt Hancock, urging him to ensure staff who deal with patients, including A&E, ward and intensive care unit personnel, are allowed to get immunised.
GPs in some areas began taking the vaccine into care homes this week for the first time, having previously administered it from vaccination sites, with batches of 75 doses sent to care homes with larger numbers of residents and staff.
The DHSC is expected to start publishing weekly figures on how many people have been vaccinated, possibly as soon as this week, in response to the calls for greater transparency.
