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Urgent preparations are underway across the UK for the launch of the Covid vaccine, following the momentous news Monday that the Pfizer / BioNTech vaccine had shown 90% efficacy. Jonathan Van-Tam, England’s deputy chief medical officer, has said that the country and the NHS are preparing for the “most important vaccination program we have run in decades.” But that has raised questions about which organizations inside and outside of government will do what to speed delivery.
Q: Who is in charge of launching the Covid vaccine?
A: Politically, the government is responsible. But operationally, in England, the NHS is in charge of offering an unprecedented logistical challenge: immunizing the country against the coronavirus.
A Whitehall official explains: “Ultimately, the government is in charge of launching the vaccine. It is a program of the Department of Health and Social Care (DHSC). We lead policy and the NHS leads the operational execution of that plan. So it is an NHS vaccination program – it will be delivered by the NHS. But who is responsible? Ultimately, the ministers are responsible for it. “
So if things go wrong as the launch unfolds, for example if parts of the country do not get enough doses of the vaccine, ministers will be held accountable for that by parliament, just as they have for the many failures. from the government’s £ 12bn test-and-trace program.
However, neither the DHSC nor the NHS in England have formally announced that this is the division of responsibilities involved in the launch.
It is not yet known how the launch of the vaccine will take place in Scotland, Wales and Northern Ireland, although the NHS is likely to play the leading role as well. The 40 million doses of the Pfizer vaccine are for the whole of the UK and DHSC has spoken to decentralized administrations about this, but nothing has been decided yet.
Q: When will we get all the details on how the deployment will work?
A: NHS England is finalizing the details of its ‘implementation plan’ and DHSC for England. That may come as early as next week, but it is understood that there have been delays, so publication may be delayed until the end of November.
The plan is likely to describe the different but overlapping roles to be played by community-based vaccination sites, managed by GPs, who will administer 200 to 500 injections per day; mass vaccination sites, where between 2,000 and 5,000 people a day will be immunized; and the third planned vaccine delivery model, namely, pop-up sites and health professionals in vehicles, which will bring the vaccine to places such as residences and prisons.
However, a source with knowledge of the plan said it was unlikely to specify how many people he should vaccinate each day with each of these types of methods. “The government is not using targets for this, given what happened with all the different targets. [around coronavirus testing and PPE delivery] around the Covid pandemic this year, ”said the source.
The UK government’s joint committee on vaccination and immunization has published a list of groups of people who will be given priority to receive a Covid-19 vaccine. The list is:
1. Everyone over 80 years of age and health and social workers.
2. All those 75 years of age or older.
3. All those aged 70 or over.
4. Everyone over 65 years of age.
5. Adults under 65 years of age at high risk of serious illness and mortality from Covid-19.
6. Adults under 65 years of age at moderate risk of severe illness and mortality from Covid-19.
7. All those aged 60 and over.
8. All those 55 and over.
9. All those of 50 years or more.
10. Rest of the population
Q: Is the NHS the right organization to do this?
A: Yes, for various reasons. Family doctor surgeries, health centers and hospitals already deliver immunizations, like MMR and the six-in-one injections that most young children have. The NHS is the only organization with the necessary staff, expertise and facilities, given the scale of the task, although the service, especially in England, is understaffed. And finally, the general public trusts the NHS in a way that they are unlikely to trust any private company that ends up making vaccines. The very poor performance of Serco and Sitel in delivering evidence and tracing is prominent in ministerial thinking.
Q: What parts of the NHS will be involved?
A: Almost all of them, in one way or another. The task at hand – hitting tens of millions of people several weeks apart as soon as possible – is so huge that all sorts of NHS personnel will be involved. NHS England calls this their “all hands to the bomb” approach. Paramedics, podiatrists, physical therapists and many others will participate, not just doctors and nurses. They will come from general practitioner surgeries, hospitals and community health services. Hospitals will lose some of their staff, potentially for months, when they are assigned to the vaccine campaign.
Hospital heads privately admit that this is not ideal and that their services may be affected at a time when they will still have to cope with winter pressures and the second wave of Covid-19. But they say the job of vaccinating the population is so urgent and vital that the temporary interruption of normal care is justified in the long run.
Q: Will GPs play a key role?
A: Yes, especially at the beginning, when the first task will be the vaccination of the ten different groups considered of highest priority. These include nursing home residents, NHS and social care staff, those over 80 and the 2.2 million people on the “protection” list because they have serious underlying illnesses.
In England, the 1,260 primary care networks (groups of GPs) have to quickly identify at least one site in their area that will be open for vaccinations between 8 a.m. hits a week.
However, many other healthcare professionals, and even nursing and medical students, will participate, especially once mass vaccination sites start to open.
The Army will also be involved. They will help with the creation of pop-up sites and also with the transport and delivery of supplies throughout the UK of available vaccines.
