Cllr Sally Hawken
Cabinet Member for Children & Wellbeing
I am very aware that you are now receiving lots of queries about the rollout of the Pfizer vaccine and the impending rollout of the Oxford Astra Zeneca vaccine.
Many of the queries are arising because of the lack of local information and they relate to high levels of uncertainty about where vaccination will take place, when it will be available, who will receive it, how people will be called and, most recently, the administration of second doses.
The development of the programme has not been straightforward because our knowledge of how the vaccine needs to be handled and administered has changed significantly over the past months, which has meant that we have had to make changes to the programme. How we are working now is not how we expected to be working two months ago.
The rollout of the vaccine is being run by the NHS nationally. It is the largest vaccination programme that has ever been run in the country, and it is being rolled out to a very tight timetable.
In Cornwall, we will be endeavouring to vaccinate about 334,000 people. This is a huge undertaking and significantly more people than we vaccinate for flu every year. In addition there is not yet a consistent supply of either vaccine to any part of the country which makes the detailed planning of who will receive the vaccine and when very difficult.
The Pfizer vaccine is also a very difficult vaccine to manage. You will have heard reported that it must be stored at -70 degrees Celsius and, once thawed, has a limited shelf-life. It is delivered thawed to GP sites in large volumes of around 975 doses, or in smaller boxes of 75 designed for care home use, and has to be used within 3 days.
Deliveries are currently pushed to GP sites from the national team and it is not currently possible for GPs to order vaccines or specify delivery days.
It is an extremely fragile vaccine requiring expert preparation and careful handling to avoid damaging the vaccine and rendering it inactive. As an unlicensed vaccine, there are also strict rules about how, where and when it can be used which are defined in national Standard Operating Protocols (SOPs). Adherence to these SOPS is a condition for use by GPs. Currently it is only possible for GPs to transport the vaccines to:
· One care home. It is not possible to take the vaccine from 1 care home and move to another for example.
· A neighbouring external non-NHS building for on-the-day use and this requires special CQC approval.
To illustrate the limitations further, it is not permitted to move the Pfizer product from one GP practice to another or to use it to vaccinate those who are housebound.
This means that there are only limited places we can use to store, prepare and administer the vaccine. All of this makes delivering the mass vaccination programme difficult in most places, but in Cornwall this is an even bigger problem because we have many dispersed rural populations to whom we cannot take the vaccine.
This means that currently we have inequity of access to the vaccine and this will not be corrected until the Oxford Astra Zeneca vaccine is widely available because that is much more straightforward to store, transport, prepare and administer. It will not be the same as the flu vaccine but it will be more like that process.
Cornwall has received its first allocation of the Oxford vaccine but, as already noted, there is no routine supply yet to Cornwall or any other part of the country.
I know that many of you will also be concerned about whether staff and residents in care homes and frontline services are receiving the vaccine as a priority, and I am sure that you will have spoken to people who have not yet received their vaccine.
We are vaccinating in line with Joint Committee for Vaccines and Immunisations (JCVI) prioritisation with vaccines being given to the most vulnerable first, as set out
in a list of nine high-priority groups. To date our immediate focus has been on the top 2 groups
1. Residents in care homes for older adults and their carers
2. 80-year-olds and over and frontline health and social care workers
Care home staff have been invited to attend vaccination clinics at the Royal Cornwall Hospital Treliske and University Hospital Plymouth (Derriford).
We are aiming to vaccinate about 8,500 care home staff and 75% of people have already booked into the Treliske site clinics. Capacity still remains in these clinics.
Others will be vaccinated by GPs at the same time as care home residents. GPs have started to visit care homes, prioritising the largest homes first, and as more Oxford Astra Zeneca vaccine arrives, they will be prioritising care homes to ensure about 6,000 residents are vaccinated as quickly as possible.
I know that to avoid wastage, some spare vaccines have been offered at the end of a clinic to some people who are not operating in frontline services. I know this will be frustrating for you and your constituents but people are trying to make the best decisions under very restricted circumstances.
For further context about how this can arise, a couple of days into the national roll-out, and in response to clinicians noticing there was unused vaccine in a vial, the Medicines and Healthcare products Regulatory Agency (MHRA) agreed that it was permitted to obtain 6 Pfizer doses out of every vial rather than the initially planned 5. This is not always possible but when it is, it means we are able to increase how many people are vaccinated. Wherever possible, clinics will try to offer spare vaccine to frontline-facing staff.
I can assure you that we all want to ensure that the people most at risk receive the vaccine as quickly as possible and people are working hard to do that.