Why ministers shouldn’t gamble on vaccine roll-out success by spring

Paul Nuki
·5-min read
A nurse from the Belfast Trust Vaccine Team prepares to inject care home staff with the Pfizer/BioNtech covid-19 vaccine - Liam McBurney /PA
A nurse from the Belfast Trust Vaccine Team prepares to inject care home staff with the Pfizer/BioNtech covid-19 vaccine - Liam McBurney /PA

With much of the country locked down hard and a “fast moving” new variant of the virus surging across South East England, the urgency to ensure that Britain’s 25 million most vulnerable people are vaccinated has never been greater.

“The new variant is out of control and we need to bring it under control,” the Health Secretary Matt Hancock told the BBC on Sunday. “We don't know how long these measures are going to be in place. It may be for some time until we can get the vaccine going.”

Yet rolling out the vaccine, which Mr Hancock suggests is the key to ending restrictions, will be made all the more difficult amid a third wave.

Responsibility sits with the NHS, which is stretched thin as it is treating more and more Covid patients while suffering significant staff absences due to illness and self-isolation orders. Already a fifth of England’s NHS Trusts are dealing with more Covid cases than in early April and non-Covid treatments are once again being cancelled.

The maths alone shows the scale of challenge ahead – a feat which a senior NHS England executive described on Sunday as “huge”, “massive”, “tricky” and “not to be underestimated”.

Those on the Government’s priority list number about 25 million in total – essentially everyone in the country aged 50 and above.

On Saturday, the Prime Minister said 350,000 people had already received their shots. On Sunday morning, Mr Hancock said he hoped that would stand at 500,000 by the evening.

Taking Mr Hancock’s more optimistic estimate, an average of 41,666 have been reached on each of the 12 days the programme has been running. At that rate, it would take 600 days – nearly two years – to get through all 25 million on the list.

Part of this “slow start,” as Professor Chris Whitty has described it, has been to ensure that patients given the vaccine are assessed closely, and the programme will hopefully scale up dramatically over the next few weeks.

Currently, there are 200 local vaccination clinics up and running and they will be followed by another 1,000.

“The scale of the vaccination program should not be underestimated,” Sir Jeremy Farrar, director of the Wellcome Trust and a member of the Scientific Advisory Group, wrote in a joint editorial this week.

“1,000 vaccination centres each vaccinating 500 people a day for five days a week, without interruptions of supply or delivery, would take almost a year to provide two doses to the UK population [of 66.65 million].”

A report by the National Audit Office published last week took a middle line. Warning of “complex logistical challenges” ahead, it said the NHS had capacity to distribute 25 million Covid vaccinations by the end of 2021 – a full 12 months away.

A senior NHS source said on Sunday that it hoped to do better but did not dispute the number or the scale of the task ahead.

The NHS must hire thousands of extra staff, said the NAO, if it is to hit the 12 month target. But personnel is not the only issue.

Adequate supplies of vaccine must be maintained and, for this, the UK urgently needs the Oxford AstraZeneca to be cleared by the Medicines and Healthcare products Regulatory Agency (MHRA).

Whitehall sources told The Telegraph last week they believe an emergency license will come through before the end of the year but the MHRA appears determined not to be rushed.

“Our rolling review of the Oxford/AstraZeneca Covid-19 vaccine is ongoing,” said a spokesperson.

“Our process for approving vaccines is designed to make sure that any Covid-19 vaccine authorised meets the expected high standards of safety, quality and effectiveness.”

If and when the Oxford vaccine is licenced, a total of 40 million doses (enough for 20 million people) should be supplied to the UK by the end of March, says AstraZeneca.

At the front line of the vaccine program, logistics problems are already apparent. Last week GPs told the Telegraph that a myriad of issues – from IT failures to last-minute vaccine deliveries – was disrupting a smooth rollout of the Pfier-BioNTech jab.

Dr Elliot Singer, a GP in North London, said he was concerned that as many as 100 doses from the first batch of 975 that a local vaccination centre received could be wasted.

The jab has to be distributed within 3.5 days, or it becomes unstable and ineffective. There is a “crunch moment” at the end of day three, Dr Singer said, and “if you haven't got enough people booked in [then], you're potentially looking at significant wastage.”

Yet getting elderly patients to attend clinics is much easier said than done. At one GP surgery uptake was running at just 12 per cent due to transport challenges. Many older people who have been sheltering for months are understandably reluctant to venture out.

“I don't think we can pin all our hopes on a vaccine… we need to have a basket approach,” Devi Sridhar, chair of global public health at Edinburgh University, told The Telegraph.

“The vaccine adds in your arsenal a weapon, and it's a really important one, but so is mass testing, border restrictions, isolation and restrictions on super spreading events.”