The priority list for the Oxford and Pfizer vaccines – and how they will be rolled out

The Oxford/AstraZeneca and Pfizer vaccine roll out is being ramped up across the UK, after Boris Johnson promised vaccines would soon be available to people within 10 miles of their home.

The Prime Minister confirmed that as of Jan 7, with the Pfizer and Oxford jabs combined, 1.26 million people in England and over 1.5 million across the UK have been vaccinated.

The latest figures show an increase of 200,000 vaccinations in one day, and includes more than 650,000 people over 80, which is 23 per cent of all the over 80s in England.

As he announced the national lockdown, that began on Jan 5, the Prime Minister insisted that that there is "one huge difference" compared to the lockdown of last March.

"We are rolling out the biggest vaccination programme in our history," he said. "We have vaccinated more people in the UK than in the rest of Europe combined. 

"By the middle of February if things go well, and with a wind in our sails, we expect to have offered the first vaccine dose to everyone in the four top priority groups identified by the Joint Committee of Vaccination and Immunisation."

Covid-19 UK Vaccination Roll-out – Key Dates

The Government faces a race to vaccinate as many people as possible against a highly transmissible new variant of Covid-19, which has been blamed for rocketing infection rates as many hospitals are pushed to breaking point.

595 GP-led sites are already providing vaccines, which should increase to 1,000 by the end of next week according to Mr Johnson. There are also 107 hospital sites with a "further 100 later this week", he added.

Also contributing to this "unprecedented national effort" will be the armed forces, who are set to be drafted in to help run mass vaccination centres in sports stadiums and public venues. 

100 Oxford million jabs have been ordered by the Government, with 40 million due to be rolled out by March.

On Jan 7, NHS England announced as many as 19,981 second Pfizer jabs were given as of Jan 3, before the Oxford/AstraZeneca vaccine rollout. All vaccinations given before Dec 29 were of first doses, and 60% of these were given to vulnerable people over 80, or those over 80.  

The Queen and Prince Phillip have been vaccinated, Buckingham Palace announced on Jan 9.

Vaccination numbers

The Joint Committee on Vaccination and Immunisation ( JCVI) has recommended that both the Pfizer and AstraZeneca vaccines are safe and do provide high levels of protection against coronavirus.

However, the head of immunisations at Public Health England has advised against mixing different Covid-19 vaccines. Dr Mary Ramsay said: "If your first dose is the Pfizer vaccine you should not be given the AstraZeneca vaccine for your second dose and vice versa."

Who is receiving the vaccine first?

People over 80 years old were prioritised first, as the Joint Committee on Vaccination and Immunisation determined age was the most important factor in Covid-19 deaths.

Margaret Keenan, 91, was the first person to receive the Pfizer vaccine at University Hospital, Coventry on Dec 8, and received her second dose successfully on Dec 29.

While 82 year old Brian Pinker, was the first person in the UK to be given the Oxford/AstraZeneca vaccine at Oxford University Hospitals NHS Foundation Trust’s Churchill Hospital on Jan 4.

Mr Pinker receiving the first Oxford vaccine on January 4

Credit: PA

Mr Pinker, who is a dialysis patient from Oxford, stated that he is "so pleased to be getting the Covid vaccine today and really proud that it is one that was invented in Oxford. The nurses, doctors and staff today have all been brilliant."

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

The first care home residents had doses of the Oxford/AstraZeneca vaccine brought to them as it was rolled out to GP surgeries on Jan 7.

Ten residents at Sunrise of Frognal care home in Sidcup, south-east London, received their first jab on Thursday afternoon.

Among them was Ellen Prosser, 100, who said getting the vaccine was "easy".

The widower and mother-of-six, who is known as Nell, said: "It didn’t hurt at all – I really didn’t feel a thing. I’m very, very pleased, because it’s been very well tested."

Pfizer vaccine roll-out

Regulators have said the key to success will be to administer two full doses between four to 12 weeks apart, in order to give as many people the initial dose of the vaccine as possible, which offers some protection from the virus.

Prof Whitty said that extending the gap between the first and second jabs would mean the number of people vaccinated can be doubled over three months, after being asked whether the longer gap could lead to an increase risk in an "escape mutant".

"Our quite strong view is that protection is likely to be lot more than 50 per cent", he added.

"If over that period there is more than 50 per cent protection then you have actually won. More people will have been protected than would have been otherwise," he told a No 10 news conference.

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 before hugging relatives.

Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading, said that with the first and second jabs administered three weeks apart, it will take one week after the second jab to develop full immunity.

Which hospitals will get the vaccine first?

The Oxford/AstraZeneca vaccine will begin to be rolled out from January 4, with 6 NHS Trusts in England initially administering the inoculation before GP-led services, which will take place later in the week. 

The NHS Trusts are: 

  • Royal Free Hospital London NHS Foundation Trust
  • Brighton and Sussex University Hospitals NHS Trust
  • Guy’s and St Thomas’ NHS Foundation Trust 
  • Oxford University Hospitals NHS Foundation Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • George Eliot Hospital NHS Trust

Here are the 53 NHS Trusts in England rolling out the Pfizer vaccine:

  • 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

Where the vaccines will be distributed to

Three modes of delivery

Health Secretary Matt Hancock said there would be “three modes of delivery”, with hospitals and mass vaccination centres along with pharmacists and GPs offering the jab.

After GPs have received the vaccine 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 vaccine deliveries from Pfizer, which has said it will distribute “as rapidly as the company can manufacture”.

Revised MHRA guidance states patients should be monitored for 15 minutes after inoculation, following adverse reactions from two NHS staff.

Easier to store, handle and more readily available than the Pfizer vaccine, the Government also intends to distribute the Oxford jab to mass vaccination centres, including sports hall, stadiums and conference centres from the second week of January.

Prof Whitty’s deputy, Professor Jonathan Van-Tam, also previously suggested that people who cannot leave their homes may need to wait for the Oxford jab as it can be more easily split into smaller quantities.

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

Credit: Ewan Galvin/Solent News & Photo Agency

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 storage requirements of the Pfizer vaccine affect the 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.”

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

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.

The Oxford vaccine does not need to be stored in such cold conditions – it can be kept at temperatures between 2C and 8C.

This means it could be more mobile than the Pfizer jab and therefore more easily deployed into care homes of varying sizes and into private homes for individual doses.

Experts believe the Oxford jab will be easier to deploy beyond formal healthcare settings, in part because it does not need to be stored at such cold temperatures as the other approved vaccine.

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

What other problems does the vaccination programme face?

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.

Prof Stephen Powis said that this was common for new vaccines and the staff have recovered well.

On Dec 13, news that up to 40 per cent of care home staff may not have jab sparked new fears that the vaccine roll-out 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, 20 per cent of other care workers are unsure and 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.”

On December 30, Deputy Chief Medical Officer Professor Jonathan Van Tam said that although people receiving the vaccine would be protected, he could not provide assurance they would not still "pose a hazard" to others in terms of passing on the virus.

"We will know quite quickly within a couple of months the impact of these vaccines on reducing severe illness in the population," he said.

"We don’t know if the vaccines will reduce transmission but Public Health England have their finger on the pulse."

On Jan 7, the Birmingham City Council leader, Ian Ward, also revealed that the city "has not yet been supplied with any AstraZeneca stock, while current Pfizer stocks are scheduled to run out on Friday." These claims come after Mr Ward shared an open letter to the Health Secretary, which sought "urgent clarity and reassurance regarding the vaccination rollout across our city over the coming weeks and months."

Mr Ward also called for "a realistic forecast" of vaccinations in the next week and assurances that vaccines’ supplies will keep up with the demand. 

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

The South African variant of the virus has threatened to undermine the vaccine and testing gains of recent months.

The Medicines and Healthcare products Regulatory Agency (MHRA) is expecting some vaccine tweaks to be needed as it has already begun to look at how quickly an altered jab could be approved, and Matt Hancock has said he is "very worried".

Sir Patrick Vallance said in a press conference on Jan 5 that it is possible the South African coronavirus variant may have some effect on vaccine effectiveness but is unlikely to "abolish" their effect.

The chief scientific adviser said that a possible change in the virus shape in the variant "theoretically gives it a bit more risk of not being recognised" by the immune system.

"There is nothing yet to suggest that’s the case. This is being looked at very actively," he said.

Read more: Analysis: Why the South Africa strain is so worrying

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.

On Dec 28, Sage advisor, Sir Jeremy Farrar, announced his concerns that one million Covid-19 vaccinations a week would still not be enough to bring the pandemic under control. 

Mr Farrar said: “We’re not going to be free of this pandemic by February; this is now a human endemic infection.

“If we do manage to hit the target of a million [vaccinated] a week, frankly I don’t think that’s enough to speed that up if we wanted to get the country covered.”

Prof Van Tam stated on December 30 that it would take up to two weeks for scientists to confirm the AstraZeneca and Pfizer vaccines were effective against the new strains of Covid-19.

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