Covid vaccine roll-out fears – from not enough glass vials to too few staff to give jab

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Britain is in a race to vaccinate – but there are fears we might stumble along the way?

Boris Johnson wants all over-70s, the clinically vulnerable and frontline health and care workers – around 13 million people – to have had their jabs by mid-February.

GPs have today received the first doses of the Oxford vaccine and people have been pictured queueing to receive their dose.

But will all this be enough to get the jab out to enough people by mid-February.

Will we make it? Here are some of the questions that need to be answered…

CAN WE MEET THE GOAL SET BY GOVERNMENT?

Health secretary Matt Hancock has downplayed the target of vaccinating 13 million – around 2 million a week – saying the ambitious number announced by the PM is only the “best case scenario”. UK vaccine minister, Nadhim Zahawi, meanwhile, says he is “confident … we will meet that target”.

Epidemiologist Dr Mike Tildesley, a member of government advisory group Sage, believes ramping up vaccinations is vital but says: “The Government shouldn’t have announced it if it was only a best case scenario. Now rather than offering carrots to the public they need to do everything to meet that goal.”

Boris Johnson wants 13m people vaccinated by mid-February
(Image: Daily Mirror/Andy Stenning)

IS THE VACCINE SUPPLY WHAT WAS PROMISED?

The Government has secured orders for millions of doses of several different vaccines, including 40 million doses of the Pfizer vaccine and 100 million doses of the AstraZeneca/Oxford vaccine – enough for the whole population.

Some 800,000 doses of the Pfizer vaccine have been delivered so far, but it is unclear when more will arrive from the manufacturer. And while 530,00 doses of the AstraZeneca vaccine have been cleared for use, another 3.5 million doses are still awaiting approval.

IS BATCH CHECKING TAKING TOO LONG?

Boris Johnson has suggested that batch testing is one of the main reasons vaccines aren’t being rolled out more quickly.

Rules mean each batch must be tested for quality and safety by an independent laboratory, the Institute for Biological Standards and Control (NIBSC) – a process that can take up to 20 days.

Manufacturers must also carry out their own tests on each batch before submitting their results to the NIBSC. Dr June Raine, chief executive of the Medicines and Healthcare Products Regulatory Agency (MHRA), said the testing is “important for confidence as the new products comes through.”

Minister responsible for vaccine rollout Nadhim Zahawi
(Image: PA)

DO WE HAVE ENOUGH GLASS VIALS?

Once the substance of the vaccines have been produced they are then put into vials and packaged for use, a process called ‘fill-and-finish’.

The tubes must be made from borosilicate glass, which is chemically inert, meaning there is no interaction between the container and the liquid inside it. Drugs firms warned of a shortage as far back as last Spring.

That’s part of the reason why, while 15 million doses of the Oxford-AstraZeneca vaccine have been produced, only four million have been through the fill-and-finish process.

Following shortage warnings back in May, the Government commissioned a study on setting up a factory to make the specialist glass in the UK. But the idea is believed to have been shelved after it was found it could take at least 18 months to get up and running.

People are calling for the army to be brought in to help out
(Image: PA)

DO WE HAVE ENOUGH VACCINATORS?

Even when we have enough vaccines, there is concern there might not be enough people to administer them.

 Martin Marshall, head of the Royal College of General Practitioners, said: “There is not a big enough workforce in primary care or mass vaccination centres come three weeks’ time, when we start seeing the AstraZeneca vaccine coming through a volume.”

The RCGP has also been lobbying the Government to cut the red tape that had been hampering recruitment of tens of thousands of retired doctors, nurses and pharmacists who have to fill in a 20-page form and produce dozens of documents proving they are trained.

It was only yesterday Matt Hancock said volunteer vaccinators will no longer need anti-terrorism training.

There have also been calls for other professionals with experience in administering injections such as midwives, paramedics, and even vets to be brought in to help.

SHOULD THE ARMY BE DRAFTED IN?

Health Secretary Matt Hancock
(Image: PA)

With a huge, historic task ahead, many believe it is time to bring in the army to coordinate the national vaccination effort. It was reported that last month Matt Hancock refused aid from the Ministry of Defence but has since accepted help with vaccinations from 21 military combat medic teams.

Former home secretary David Blunkett yesterday called for a “military operation on a scale never seen in peacetime” to deliver the Government’s aim of vaccinating two million people a week.

ARE THERE ENOUGH VACCINATION CENTRES?

To ramp up inoculations once the most vulnerable have been protected, seven mass vaccination centres will be opening next week at locations such as sports stadiums and exhibition centres.

That will be in addition to 207 hospitals and 775 GP-led sites around the country.

This week the Government was accused of ignoring the 11,400 high street pharmacies that already administer millions of flu jabs very year, with the capacity to vaccinate around 1.3million people against Covid every week.

NHS England needs volunteers
(Image: Daily Mirror/Andy Stenning)

Yesterday vaccine minister Nadhim Zahawi said community pharmacy networks will be “very much involved” in the race to vaccinate. But the president of the Royal Pharmaceutical Society said small pharmacies have been snubbed by the Government after they offered to help deliver the vaccine.

Sandra Gidley said: “There are over 11,000 pharmacies. If each of those does 20-a-day that is 1.3 million-a-week extra vaccines that can be provided, very often to those who are hardest to reach. Why would any Government not want to do that?”

SHOULD THERE BE 24/7 VACCINATIONS?

Israel has already immunised 1.4million people – nearly a sixth of its population – thanks to a vaccine drive which goes on day and night without stopping.

The city of Haifa is even offering drive-through vaccinations.

Last week Dame Clare Gerada, former Royal College of General Practitioners chair, insisted the UK could vaccine its entire population by spring with a 24-hour programme using large venues like football stadia.

But so far vaccinations have been taking place in hospitals and clinics during normal appointment hours. New guidance issued to NHS trusts has also warned jabs won’t be issued on Sundays or after agreed ‘cut-off’ points every lunchtime.

CAN’T WE GET MORE DOSES OUT OF EACH BOTTLE?

Israeli Minister Yuli Edelstein said they have managed to vaccinate even more people after nurses managed to extract six doses from each vial rather than the five that are advertised.

It means younger people have been able to walk into clinics at the end of each day to receive surplus doses which would otherwise be wasted.

GPs in the UK were told in December they they could use the sixth dose “at their discretion”, rather than throwing it away. But with vaccinations being arranged by appointment, it is not known how much, if any, of the surplus left in the vials is being used.

NHS staff, health and care workers pictured queuing outside the New Lister Building to receive the Covid-19 vaccine
(Image: Glasgow Times / SWNS.COM)

DO PATIENT CHECKS TAKE TOO LONG?

The bureaucracy around administering each jab has also been blamed for slowing down the vaccination effort. Patients undergo a 15-minute medical questionnaire over the phone, before being asked for many of the same details on the day.

Doctors have urged a streamlining of the process so they can vaccinate a greater number of people. They have also criticised the decision to use a new system to book and record vaccinations which staff are not familiar with, which often causes more hold ups.

WILL IT TAKE THE SAME TIME AGAIN TO GIVE THE SECOND DOSE?

The Government is delaying the second dose of the vaccine so more vulnerable people will have some protection, but that means they will all have to have a second jab before other groups can start to be vaccinated.

Dr Mike Tildesley says: “You won’t be able to move down the priority order as rapidly those people need to be vaccinated again within 12 weeks.

“It’s really important they get the second one in time, so the Government needs to resolve issues of supply and delivery now to ensure there’s a constant flow of vaccines to do that.”


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