Kentish Gazette Canterbury & District
Delivering Covid-19 vaccine to thousands a ‘big ask’, warns GP
GP staff will likely work seven days a week and be supported by an army of volunteers as they bid to roll out a new Covid-19 vaccine across the Canterbury district. It was this week revealed the NHS is on standby to deliver millions of jabs from December, with people in the UK likely to be among the first in the world to receive them.
Leading GP Dr John Ribchester says some patients could even be given the vaccine on Christmas Day as staff work around the clock to deliver it to tens of thousands of people in the city, Herne Bay and Whiststable.
But he fears a number of logistical challenges lie ahead to avoid full waiting rooms and car parks. Among them is the fact patients will likely be required to stay on-site for 15 minutes after their vaccination, in case they experience an immediate reaction to the jab.
“That certainly gives us all a logistical problem,” he said. “To have people socially distanced 15 minutes beyond immunisation on-site is going to be a challenge. That’s going to slow delivery down enormously.” The two front-runners in the
Covid-19 vaccine race are US pharmaceutical firm Pfizer, which is working with German biotech company Biontech; and Oxford University, working with AstraZeneca.
Preliminary findings from Pfizer suggest its jab is more than 90% effective in preventing Covid-19, while data on the Oxford vaccine is expected within weeks. Health Secretary Matt Hancock warned on Tuesday there are still many hurdles to overcome before the “vast task” of vaccination can begin.
Dr Ribchester, GP and senior and executive partner at Whitstable Medical Practice (WMP), says there remain “many logistical questions to answer”. Definitive NHS guidance on how the vaccination programme will operate is not expected until the end of this month.
If willing to help administer the vaccine to their patients when it becomes available, primary care networks such as WMP have been asked to nominate a vaccination site.
WMP has been quick to put forward its four-lane drive-thru site at Estuary View Medical Centre - which is currently used to rapidly administer flu jabs.
“We could do four Covid vaccines a minute like we do with flu, but with that 15-minute wait
we’d pretty soon have completely full-up waiting rooms and car park,” said Dr Ribchester. “Our headache is where to put people for observation afterwards. “We’re going to have to space these vaccinations throughout the week and use areas where people can safely wait in case they have an anaphylactic reaction.” Dr Ribchester says the Covid vaccine is also likely to arrive in “multi-dose delivery systems”,
rather than pre-filled syringes. “With the Covid vaccine, it will be in a very, very cold storage tank with possibly up to 1,000 injections in one tank,” he explained.
“We’re going to have to thaw that out, and when it’s liquid, draw up each immunisation rather than having a nice, easyto-use pre-filled syringe.” In another key difference, patients are likely to require two
doses of the Covid-19 vaccine. But whether patients will definitely require two doses; the amount of time that must lapse between doses; and whether they will have to wait for a full 15 minutes after receiving jabs has not yet been confirmed by the NHS. “We don’t even know when the immunisation is going to be available,” added Dr Ribchester.
“We’re told as early as the beginning of December, but I’m having difficulty believing that. It’s been a bit of a case of ‘tell us if you want to do this and we’ll tell you what this is later’. But we want to do this for our population. If not us, then who? If the Army is an alternative, where are they going to work from? They’ve not got electronic patient records, which will be needed.” The Health Secretary has revealed the Army is on alert to help the NHS administer the vaccine, while £150 million has been set aside to help GP surgeries prepare.
The NHS has also stipulated that vaccinations should be available up to 12 hours a day, seven days a week, including bank holidays.
“So theoretically, if you want one on Christmas Day, you should be able to have one,” said Dr Ribchester. “It’s quite a big ask.”
Dr Ribchester says the rollout it is likely to take a toll on already under-pressure services.
“It is going to be problematic,” he said. “Because business as usual – our general practice, Urgent Treatment Centre, diagnostics and outpatients – all has to carry on. “I think we’ll be asking some staff to work extra hours, and we will probably call for volunteers again to help us with traffic flow as they did, very kindly, up until the end of the first lockdown.”
While the prospect of a vaccine has prompted widespread excitement, it has been met with suspicion from some quarters, due partly to its fast turnaround.
Dr Ribchester says he is worried by NHS surveys which suggest there could be some resistance to getting vaccinated.
“I read one that said as few as 40% of responders would have the vaccine in the first wave, which is low,” he said.
“It is a concern, and 40% probably isn’t enough for herd immunity either.
“I think that’s partly anti-vaxxers, and partly the fact this is being rushed out very quickly.”
While the NHS has not confirmed a schedule by which vaccinations will be administered, the government has suggested care homes residents and staff will be prioritised, along with health and social care staff, and the elderly.
‘Our headache is where to put people for observation afterwards’