Most vulnerable at front of the queue for Pfizer’s Covid-19 vaccine

The NHS is planning a “get out the vote” style operation to ensure people have two doses of a coronavirus vaccine as it prepares to start immunising vulnerable people before Christmas.

However, Owl is reading reports that the trial continues: “by the third week of November, half of the patients in the study will have been observed for two months following their second dose. At that point, Pfizer will spend two to three weeks analyzing the data before sending it to regulators for approval.”

Chris Smyth, Whitehall Editor 

Hospital fridges are likely to be used to store a Pfizer vaccine that must be kept at -70C if it is approved by regulators, with health chiefs believing that it could be feasible to use existing infrastructure at least to reach health and care staff and care home residents, who will be first in line.

Initial plans envision a relatively limited vaccination programme targeting the most vulnerable, with communication efforts at first focused on urging people to wait their turn.

The NHS “help us to help you” slogan is expected to be deployed to encourage people to be patient, with some involved in planning concerned that sufficient supplies for non-priority groups may not be available for some time.

Jonathan Van-Tam, the deputy chief medical officer for England, predicted last night there would be “very significant demand in the elderly in particular for this vaccine and ones that follow” and that “even with enormous planning from the NHS, it is going to take time to roll that kind of programme out”.

While saying that he was “hopeful but not yet certain that we could begin to see some vaccine by Christmas” he emphasised: “Making vaccines is really difficult. Many things can go wrong during manufacture — indeed, each batch has to be quality assured before it can be released.”

The Pfizer jab requires two doses three weeks apart and Professor Van-Tam stressed that the other “big name contenders” also required two shots, with people not fully protected until five weeks after their first dose.

The Times revealed on Saturday that a Whitehall unit has been set up to promote a vaccine and allay people’s concerns about a new jab. Officials are also planning an individualised campaign involving GPs writing to their patients to ensure people turn up when requested.

Those involved likened this to election “get out the vote” operations, stressing the challenge of ensuring people turn up as requested on two separate occasions. Take up of routine vaccination can fall ten points or so between the first and second dose. “A lot of work is going on to make sure people who come for the first dose also come for the second” a source said, though details are still being finalised.

Once a jab becomes widely available, drive-through vaccination centres are being planned to cope with the huge logistical challenge of administering vaccines to tens of millions of people without it becoming a “social-distancing nightmare”.

Training is due to begin imminently of an army of physiotherapists, midwives and other health professionals who will be used to administer the vaccine after the law was changed to allow a wider group of staff to give jabs.

The armed forces are also expected to be called upon to help with logistics.

Under a provisional ranking drawn up by the Joint Committee on Vaccination and Immunisation, care home residents and staff would be first to be vaccinated, followed by all NHS and care workers and people over 80.

People aged 75-80 would be next and jabs would then be sequentially offered to the general population by decreasing five-year age bands, with experts saying that age-based programmes are faster and ensure higher uptake.

Once all those over 65 had been offered the vaccine, it would be offered to younger adults at high risk because of health conditions, which could include diabetes and obesity. Other over 50s would be next in line, with the under 50s at the back of the queue.

This plan is likely to be tweaked when details of the vaccine are finalised, and consideration will also be given to offering priority to those most likely to catch and spread this disease, potentially including people from ethnic minorities and workers such as taxi drivers and shop assistants.

Martin Marshall, head of the Royal College of GPs, said it “makes sense” for family doctors to help distribute the vaccine but said: “There will likely be logistical challenges to overcome, for example around supply and storage of the vaccine — which may require new or additional equipment for some practices.”

Provisional priority list

1 Elderly care home residents and care home staff

2 All those aged 80 and over and NHS and social care workers

3 All those 75 and over

4 All those 70 and over

5 All those 65 and over

6 High-risk adults under 65

7 Moderate-risk adults under 65

8 All those 60 and over

9 All those 55 and over

10 All those 50 and over

11 The rest of the population

Caution turns to elation at ‘a truly seminal moment’

In a human body only the brain is more complex than the immune system. Until you put a vaccine into someone, you have no idea what it will do (Tom Whipple writes).

So when scientists tried to guess how coronavirus vaccines would fare, they had little to go on. The best indication came from the natural immunity conferred by its established virological cousins. And, as anyone who gets the same cold twice can tell you, they don’t confer much.

Virologists, not wanting to oversell what could be the most important vaccine of the 21st century, tried to manage expectations. “The reason there was caution early on probably involved several things,” Dan Davis, professor of immunology at Manchester University, said. “Coronaviruses are not thought to trigger strong long-lasting immunity.”

Then there was the novelty of the technology. “We have tried to make vaccines against many things before, and even when ideas seem good they’ve fallen down. There’s still no vaccine for HIV.”

No one, he said, wanted to predict a magic bullet only to see it turn out to be a more leaden kind.

“For the sake of society, it may have been better to give the message we are in it for the long haul and had to push on,” he said.

But now, we have the answer, and it is better than any predicted: 90 per cent efficacy.

“It’s a huge moment, a truly seminal moment.”