Vaccination – How quickly can the Government deliver?

There are a number of press articles discussing different aspects of the administrative task facing the Government and questioning whether it can expedite the vital task of getting “jabs into arms”.

For example, yesterday’s Times published an article under the heading: “Postcode lottery for life‑saving Covid vaccination”. This claimed that almost one in four people in England live in an area with no vaccination centre and 13 million people live in a constituency with no hospital, GP practice or community building for administering vaccines.

It contained a graphic showing that the three Devon coastal constituencies of: Totnes; Torbay and East Devon only had one centre each whilst all the other Devon constituencies had two and Exeter three (the two Plymouth constituencies have one each).

But the roll out of the the Oxford/AstraZeneca virus doesn’t necessarily require dedicated centres and is likely to be administered in a similar way to the ‘flu vaccine. The next two article indicate where, in Owl’s opinion, the real bottleneck lies.

The Observer view on information about the rollout of the Covid vaccine 

Observer editorial 

Tomorrow, Britain will witness an extraordinary moment in its grim struggle to limit the devastation caused by Covid-19 when the first Briton is injected with a vaccine developed by the University of Oxford and the pharmaceutical company AstraZeneca. The fact that this inoculation is occurring within a year of the emergence of a disease that has since ravaged the globe is an astonishing achievement, a tribute to world-class British science and a highly effective pharmaceutical industry. More importantly, the vaccine has arrived just in the nick of time. The newly discovered variant of Covid-19 is threatening to spread across the country and savage our beleaguered health service. A vaccine offers escape from the mounting horrors of this pandemic.

It is therefore right to celebrate the arrival of the AstraZeneca vaccine, though we should also note the pitfalls that await us. We are led by a government that has bungled so much of the Covid response – from its initial, criminally tardy response to the virus, to the shambolic distribution of PPE kit for health workers, to the pitiful rollout of test-and-trace programmes and to the bewildering U-turns on lockdown measures. We need drive and competence to undertake the speedy administration of the vaccine to millions of UK citizens. These qualities have not been displayed in abundance by the government to date.

On the other hand, early signs suggest the vaccine programme has been handled well. Shrewd choices were made in the selection of vaccines to purchase. The early rollout has been managed well and there is evidence of careful thought in the choice of early recipients. Equally, the decision to postpone the administration of second doses – to maximise numbers receiving first doses – suggests scientists and doctors advising the government are responding to the rapidly changing shape of the virus’s spread.

The decision has not been without its critics, and it will certainly have caused some alarm among older and more vulnerable citizens and their carers. They had expected to receive a second dose within days but will now have to wait for weeks. Rearranging thousands of appointments at short notice adds to the administrative burden facing already hard-pressed clinics and surgeries.

Nevertheless, chief medical officers are agreed this is the right move, both ethically and practically. Recipients of the first dose of the Covid-19 vaccine still gain strong protection. Indeed, delaying a booster jab may even trigger longer-lasting immunity. This, in turn, allows millions of others to be given protection in the short term against a virus that threatens to spread rapidly across the UK. Any alternative would mean that people who could have been saved might face death.

Scientists, doctors and nurses have worked wonders. Now, politicians and administrators must seize the advantage they have been handed and bring an end to the suffering this terrible virus has inflicted on us. And they need to do so in a manner that reassures the public that salvation is at hand.

Here, the signs are less encouraging. Boris Johnson was asked last week how many vaccine doses are going to be made available over coming weeks but claimed exact answers would be unhelpful. Nothing could be further from the truth. The nation needs to know – specifically – how many doses are going to be administered week by week. Will it be a million? If so, we will have to wait a long time before lockdown ends. Or is it going to be 2m doses a week? In this case, an enjoyable summer would look a more realistic prospect. (Nor is vaccinating two million people a week that difficult. We inoculate against flu every winter on a similar scale.) A lot depends on these figures and Britain now needs to be told if we have the supply chain to match the efforts of our scientists and doctors. In blunt terms, our hopes of ending our misery rest on being given an accurate account of those numbers.

Britain ‘pays price’ for running down vaccine factories

Anyone in Whitehall ever consider the need for “strategic industries” are we just a service based economy? – Owl

Rhys Blakely, Science Correspondent 

A lack of investment in capacity to produce vaccines left Britain woefully unprepared to face the pandemic, one of the country’s leading scientists said yesterday.

Sir John Bell, regius professor of medicine at Oxford, was instrumental in forging the partnership between the university and Astrazeneca to develop a British vaccine.

Yesterday, however, he voiced frustration that years of neglect by successive governments had left the country without the means to manufacture the vaccine at the pace required in a pandemic.

Britain has been forced to rely on repurposed infrastructure to make the Oxford vaccine, he said. “The government has been completely disinterested in building onshore manufacturing capacity for any of the life-sciences products,” he added. “I’m not talking about this government, I’m talking about all governments for the last ten years.

“And it turns out that manufacturing is a strategic asset for health security when stuff gets tough, which it is now.”

In May the government said that 30 million doses of the Oxford-Astrazeneca vaccine could be available by September but the target was later slashed. Last week Matt Hancock, the health secretary, said that only 530,000 doses would be ready to go on Monday.

Meanwhile, Pfizer-Biontech, which produce the UK’s only other vaccine in Belgium, said yesterday that their supply chain was overstretched.

Chris Whitty and the chief medical officers for Scotland, Wales and Northern Ireland warned that supply was the biggest barrier to maximising the number of eligible people who receive the vaccine. “Vaccine shortage is a reality that cannot be wished away,” they said.

Sir John said vaccine production had been allowed to wither in the UK. “When the pandemic started, we were not in great shape and I think we are probably paying the price for that. It’s not Astrazeneca’s fault — it’s a national legacy issue, and it’s one of the things we’ve got to fix.”

Other countries had shown it was possible to produce the vaccine in large amounts, he added, with the Serum Institute of India (SII), the world’s largest vaccine maker by volume, saying it has at least 50 million doses in vials ready to be used in clinics.

“We know people can make this vaccine at scale, that’s absolutely for sure,” Sir John said. “I think the fact that some people have many more stocks than we do probably reflects that we are operating on repurposed infrastructure.”

Astrazeneca was chosen as a partner by Oxford as one of the few companies with the ability to win regulatory approval for a new vaccine and to oversee large-scale production. It has struck deals to produce 3 billion doses around the world.

However, to produce the UK’s doses, the company has relied on a consortium of outside partners. They include Oxford Biomedica in Oxfordshire, Cobra Biologics in Staffordshire as well as a company called Halix in the Netherlands.

Once those companies make the vaccine in bulk it goes to a plant in Wrexham, run by an Indian company called Wockhardt, where it is decanted into vials, or transported to a similar plant in Germany.

In May the government said it would invest up to £93 million to speed up construction of the new Vaccines Manufacturing and Innovation Centre in Oxfordshire.

First announced in 2018, it is expected to eventually have capacity to produce enough doses for the whole UK population in as little as six months. However, it will not open until this summer and Sir John noted that Britain also lacks capacity to produce other medical products, such as monoclonal antibodies, at large scale.

He said Professor Whitty had been right to warn about supply problems. “There’s a potentially huge capacity to get vaccines into people,” he said. “And I think Chris was right when he alerted everybody to say supply is going to be an issue. If I had unlimited vaccine, I’d try and get the whole bloody country done in a month — because if you really wanted to you could.”

The Serum Institute of India supply is nearly ten times the 530,000 doses the British government has said will be released to the NHS on Monday.

SII expects to double its stockpile to 100 million doses — enough for 50 million people to be fully immunised — by the middle of this month. Half will be kept for India and the rest will go to 67 low and middle-income countries.