HDA UK Media and Political Bulletin – 15 March 2021

Media Summary

UK vaccine rollout scaled up amid supply concerns
Financial Times, Sebastian Payne, Sarah Neville & John Burn-Murdoch, 15 March

The Financial Times reports that the UK will scale up its Coronavirus vaccination programme this week despite continued concerns inside Government about supply issues. Ministers are preparing for a significant increase in vaccination rates over the next three weeks, before a drop-off in April.
On Sunday the Government reported that it had administered 512,108 first dose vaccinations on Saturday – the highest daily tally since February 12. Vaccines Minister Nadhim Zahawi said “March will be a very big month for us” and predicted jabs would be delivered at “twice the rate over the next 10 weeks as we have done over the past 10 or 11 weeks.”

However, individuals with knowledge of the programme said that the UK was still encountering “major production challenges” with vaccines from AstraZeneca and Moderna, with only Pfizer on track to meet its schedule after upgrading its main production facility in Belgium. Because of these issues, vaccination levels are expected to dip again in April. Second doses are also expected to become a priority next month, as the NHS is operating on a basis of delivering second jabs 11 weeks after the first.

Amazon’s next high street target: your local chemist
The Times, Sabah Meddings, 14 March

The Times reports that Amazon has signalled plans to break into the pharmacy industry in the UK, having registered the trademark “Amazon Pharmacy” with the Intellectual Property Office.

In America, Amazon’s existing online pharmacy delivery service offers prescription medicines at a discount. Amazon is a direct challenger to the main US players — Walgreens, the owner of Boots, and CVS Health. It offers discounts of up to 80 per cent on generic drugs and 40 per cent on branded medicines. When it announced plans to venture further into pharmacy in November, Walgreens’ shares fell by more than 11 per cent.

It is not known how the model would work in the UK, where the price of prescriptions is regulated. This means Amazon would not be able to compete on price – its advantage would be convenience and speed. Online pharmacy services are already growing in the UK. Pharmacy2U, which uses a subscription model, has about 550,000 customers and posted sales of £78.3 million in the year to the end of last March.

Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies, said that online dispensaries could not offer the service that community chemists provided. “When someone is diagnosed with a long-term condition such as asthma or diabetes, and is put on new medicines for the first time, the pharmacist can talk to the patient and ensure they are taking them correctly,” she said.

 

Parliamentary Coverage

There was no parliamentary coverage today.

Full Coverage

UK vaccine rollout scaled up amid supply concerns
Financial Times, Sebastian Payne, Sarah Neville & John Burn-Murdoch, 15 March

This article is subject to copyright terms and conditions. You can access the article here.

Amazon’s next high street target: your local chemist
The Times, Sabah Meddings, 14 March

Amazon has signalled plans to break into the pharmacy industry in the UK, having disrupted the $300 billion (£215 billion) prescription drugs market in America.

The tech giant has registered the trademark “Amazon Pharmacy” with the Intellectual Property Office.

In America, Amazon’s online delivery service offers prescription medicines at a discount. It is not known how the model would work in the UK, where the price of prescriptions is regulated.

The prospect of Amazon moving into the sector met with dismay from high street chemists this weekend. In America, Amazon is a direct challenger to the main players — Walgreens, the owner of Boots, and CVS Health. It offers discounts of up to 80 per cent on generic drugs and 40 per cent on branded medicines. When it announced plans to venture further into pharmacy in November, Walgreens’ shares fell by more than 11 per cent.

Leyla Hannbeck, Chief Executive of the Association of Independent Multiple Pharmacies, said that online dispensaries could not offer the service that community chemists provided. “When someone is diagnosed with a long-term condition such as asthma or diabetes, and is put on new medicines for the first time, the pharmacist can talk to the patient and ensure they are taking them correctly,” she said.

Online pharmacy services are already growing in the UK. Pharmacy2U, which uses a subscription model, has about 550,000 customers and posted sales of £78.3 million in the year to the end of last March.

Amazon has soared during the pandemic. It reported sales of $125.7 billion for the last three months of 2020, an increase of 44 per cent.

Unlike in America, UK drug prices are regulated, which means Amazon would not be able to compete on price. Its advantage would be convenience and speed. Amazon Prime members in America receive unlimited two-day delivery on pharmacy orders.

Amazon declined to comment.

Media Summary

UK and EU Vaccine Update – 11 March 2021

Tensions have risen between UK and EU leaders this week after European Council President Mr Michel claimed that: “The United Kingdom and the United States have imposed an outright ban on the export of vaccines or vaccine components produced on their territory.”

This latest disagreement follows a high-profile fall-out in January, when the EU briefly attempted to trigger Article 16 of the Brexit withdrawal agreement’s protocol to impose controls on the supply of vaccines into Northern Ireland. Brussels swiftly backtracked and apologised after coming in for heavy criticism over the move. UK-EU relations have run into trouble since then over Downing Street’s decision to unilaterally extend the grace period for fully implementing protocol arrangements contained in the Brexit agreement.

The UK is the biggest recipient of reported EU vaccine exports, securing 9.1m doses under the bloc’s authorisation scheme that came into force on January 30. EU controls were put in place after the bloc struggled to secure adequate volumes of vaccines for member states.

 

UK denies vaccine nationalism

The UK Prime Minister has denied the accusations made by Charles Michel that Britain has introduced an “outright ban” on vaccine exports. “Let me be clear: we have not blocked the export of a single COVID-19 vaccine or vaccine components” Boris Johnson told the House of Commons on Wednesday. Read more in Sky News.

The UK Foreign Office summoned Nicole Mannion, Deputy Ambassador of the EU to the UK and Charge d’affaires at the EU Delegation to the UK, for “further discussions” on the dispute on Wednesday. Read more in the Independent.

EU challenges UK to show vaccine export data

The European Commission has now acknowledged no formal ban is in place, but EU officials noted that Mr Michel was drawing attention to the fact that no vaccines have so far been sent from the UK to the bloc. Mr Michel said on Wednesday that the UK government should disclose data on the number of Coronavirus vaccines Britain ships internationally. Read more in The Express and the Financial Times.

Meanwhile, the EU’s ambassador to the UK denied the bloc is engaging in “vaccine nationalism” but similarly demanded more transparency from Britain as tensions simmer over the export of Coronavirus jabs. “I refute completely the accusation that the EU is protectionist or has engaged in vaccine nationalism,” João Vale de Almeida told British broadcaster ITV’s Robert Peston. The EU has been criticized and at times accused of protectionism over a new vaccine export control mechanism it says is intended to ensure suppliers are fulfilling their contractual obligations. Read more in Politico.

 

Concerns raised over impact of Brexit EU rules on medicines delivery to Northern Ireland

Concerns have been raised about the impact of Brexit on the delivery of medicines at the end of this year. TUV leader Jim Allister sought clarity from Northern Irish Health Minister Robin Swann on the issue and warned it could have serious implications for future vaccine rollout if Northern Ireland is tied to the EU vaccination programme. In response to a written question, Mr Swann said that Northern Ireland was only part of the UK’s vaccine rollout because of a year-long grace period stipulated by the protocol.

Mr Allister said the Health Minister’s response showed that “in simple terms, Northern Ireland is only able to benefit from the UK’s successful vaccine rollout now because of a grace period. But for the grace period, we would be tied to the failed and failing EU policy on vaccination.” Read more in The Irish News.

 

EU set to approve Johnson & Johnson vaccine today

The Johnson & Johnson vaccine is expected to get the green light today from the European Medicines Agency. The one-shot jab has already been approved in the United States and has a 66% efficacy rate. However, despite the European Commission securing a minimum of 200 million doses, Johnson & Johnson has not committed to any shipments until the second quarter of the year — meaning at least a three-week lag between the EU’s approval and Johnson & Johnson’s first deliveries. Read more in Politico.

 

Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

UK and EU Vaccine Update – 11 March 2021

Tensions have risen between UK and EU leaders this week after European Council President Mr Michel claimed that: “The United Kingdom and the United States have imposed an outright ban on the export of vaccines or vaccine components produced on their territory.”

This latest disagreement follows a high-profile fall-out in January, when the EU briefly attempted to trigger Article 16 of the Brexit withdrawal agreement’s protocol to impose controls on the supply of vaccines into Northern Ireland. Brussels swiftly backtracked and apologised after coming in for heavy criticism over the move. UK-EU relations have run into trouble since then over Downing Street’s decision to unilaterally extend the grace period for fully implementing protocol arrangements contained in the Brexit agreement.

The UK is the biggest recipient of reported EU vaccine exports, securing 9.1m doses under the bloc’s authorisation scheme that came into force on January 30. EU controls were put in place after the bloc struggled to secure adequate volumes of vaccines for member states.

UK denies vaccine nationalism

The UK Prime Minister has denied the accusations made by Charles Michel that Britain has introduced an “outright ban” on vaccine exports. “Let me be clear: we have not blocked the export of a single COVID-19 vaccine or vaccine components” Boris Johnson told the House of Commons on Wednesday. Read more in Sky News.

The UK Foreign Office summoned Nicole Mannion, Deputy Ambassador of the EU to the UK and Charge d’affaires at the EU Delegation to the UK, for “further discussions” on the dispute on Wednesday. Read more in the Independent.

EU challenges UK to show vaccine export data

The European Commission has now acknowledged no formal ban is in place, but EU officials noted that Mr Michel was drawing attention to the fact that no vaccines have so far been sent from the UK to the bloc. Mr Michel said on Wednesday that the UK government should disclose data on the number of Coronavirus vaccines Britain ships internationally. Read more in The Express and the Financial Times.

Meanwhile, the EU’s ambassador to the UK denied the bloc is engaging in “vaccine nationalism” but similarly demanded more transparency from Britain as tensions simmer over the export of Coronavirus jabs. “I refute completely the accusation that the EU is protectionist or has engaged in vaccine nationalism,” João Vale de Almeida told ITV’s Robert Peston. Read more in Politico.

Concerns raised over impact of Brexit EU rules on medicines delivery to Northern Ireland

Concerns have been raised about the impact of Brexit on the delivery of medicines into Northern Ireland at the end of this year. TUV leader Jim Allister sought clarity from Northern Irish Health Minister Robin Swann on the issue and warned it could have serious implications for future vaccine rollout if Northern Ireland is tied to the EU vaccination programme. In response to a written question, Mr Swann said that Northern Ireland was only part of the UK’s vaccine rollout because of a year-long grace period stipulated by the protocol.

Mr Allister said the Health Minister’s response showed that “in simple terms, Northern Ireland is only able to benefit from the UK’s successful vaccine rollout now because of a grace period. But for the grace period, we would be tied to the failed and failing EU policy on vaccination.” Read more in The Irish News.

EU set to approve Johnson & Johnson vaccine today

The Johnson & Johnson vaccine is expected to get the green light today from the European Medicines Agency. The one-shot jab has already been approved in the United States and has a 66% efficacy rate. However, despite the European Commission securing a minimum of 200 million doses, Johnson & Johnson has not committed to any shipments until the second quarter of the year — meaning at least a three-week lag between the EU’s approval and Johnson & Johnson’s first deliveries. Read more in Politico.

Media Summary

Over-40s could get first COVID vaccine in weeks as age to be ‘dominant’ factor in next phase of jabs rollout
Evening Standard, Sean Morrison, 19 February

The Evening Standard reports that Britons as young as 40 could be offered a Coronavirus vaccine within a few weeks. Age is likely to be a dominant factor in deciding the next phase of the rollout and the age brackets will reportedly be wider than in the previous stage of the nation’s inoculation drive. This means 40 to 49-year-olds are likely to be invited for a jab once the people in the top nine groups get their first dose.

Professor Wei Shen Lim, Head of the Joint Committee on Vaccination and Immunisation (JCVI), said age “dominates by a long way” in deciding the next phase of the rollout. Underlying health conditions contribute “some increased risk”, Prof Lim added, but not by a “huge amount.”

The JCVI has not yet set out plans on who should be vaccinated beyond the top nine priority groups, but has faced calls for police officers and teachers to be prioritised in the next stage.

 

COVID-19 collaborations could ‘unlock’ the potential of the UK’s life sciences sector
Pharma Times, Lucy Parsons, 18 February

Pharma Times reports that a new publication by Novartis UK has recommended continuing collaboration across the life sciences sector in the UK after identifying enhanced collective efforts to address the COVID-19 pandemic.

The ‘New Possible’ report has found that responses to COVID-19 were collective and represented an enhanced collaboration between government, regulators, academia and the pharmaceutical industry. This enhanced collaboration provides a new opportunity to ‘unlock’ the potential of the UK life sciences sector.

The report suggests the new ways of working, which have emerged in response to the pandemic, could help to accelerate future medical discoveries and also lead to more patient-centric approaches to healthcare in the future.

“COVID-19 and our collective response to it brought greater innovation and health service transformation than witnessed in generations,” said Chinmay Bhatt, Managing Director of Novartis Pharmaceuticals UK, Ireland and Nordics. “We have seen that we are stronger, more innovative and more sustainable when we work together. To overcome the substantial pressures on the health service, it is crucial that we sustain these new ways of working in the years to come,” he added.

 

Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

Over-40s could get first COVID vaccine in weeks as age to be ‘dominant’ factor in next phase of jabs rollout
Evening Standard, Sean Morrison, 19 February

Britons as young as 40 could be offered a Coronavirus vaccine within a few weeks, it has been reported.

Age is likely to be a dominant factor in deciding the next phase of the rollout, Government advisors have said.

And the age brackets will reportedly be wider than in the previous stage of the nation’s inoculation drive.

This means 40 to 49-year-olds are likely to be invited for a jab once the people in the top nine groups get their first dose, according to the Mail.

Professor Wei Shen Lim, head of the Joint Committee on Vaccination and Immunisation (JCVI), said age “dominates by a long way” in deciding the next phase of the rollout.

Underlying health conditions contribute “some increased risk”, Prof Lim added, but not by a “huge amount”.

The JCVI has not yet set out plans on who should be vaccinated beyond the top nine priority groups, but has faced calls for police officers and teachers to be prioritised in the next stage.

Appearing at an online event Prof Lim said that one of the “great successes” of the vaccination programme had been the rate of deployment and this was now the “most important factor”, according to the Daily Telegraph.

The newspaper also reported that the first “real world” data examining the impact of the vaccination programme suggests both the Oxford and Pfizer jabs cut two thirds of infections and transmissions.

Boris Johnson is understood to be expecting evidence on the impact of the UK’s jabs programme on hospital admissions and deaths by the end of Friday.

He will then set out his “road map” out of England’s lockdown next week.

Elsewhere, a range of health organisations have told the Prime Minister that guidance on PPE (personal protective equipment) must be updated to reflect the risks to medics and care workers from airborne transmission.

In a letter to Mr Johnson, they said that lives are being put at risk and branded measures to reduce airborne spread of the virus in high-risk health and care settings as “inadequate”.

The coalition includes the Royal College of Nursing (RCN), British Medical Association, Royal Pharmaceutical Society and the Royal College of Midwives, among a number of others.

It comes as Mr Johnson is set to pledge to donate the majority of surplus Coronavirus vaccines to poorer nations as he tries to rally world leaders to work together on efforts to combat the pandemic.

He will chair a virtual gathering of G7 leaders on Friday, including US president Joe Biden in his first major multilateral meeting, to discuss the response to the crisis.

In Wales, First Minister Mark Drakeford is set to announce on Friday that stay-at-home restrictions will remain in place for a further three weeks as the youngest children start returning to school from Monday.

Northern Ireland’s lockdown has been after the Stormont Executive decided to keep the majority of restrictions in place until April 1, but some primary school pupils will return to class on March 8.

Elsewhere, Scottish First Minister Nicola Sturgeon said she wants “if at all possible” for the current Coronavirus lockdown to be the last, as she stressed that the lifting of restrictions must be sustainable.

 

COVID-19 collaborations could ‘unlock’ the potential of the UK’s life sciences sector
Pharma Times, Lucy Parsons, 18 February

A new report by Novartis UK has recommended continuing collaboration across the life sciences sector in the UK after identifying enhanced collective efforts to address the COVID-19 pandemic.

The New Possible report has found that responses to COVID-19 were collective and represented an enhanced collaboration between government, regulators, academia and the pharmaceutical industry.

This enhanced collaboration, according to the report, provides a new opportunity to ‘unlock’ the potential of the UK life sciences sector.

The report suggests the new ways of working, which have emerged in response to the pandemic, could help to accelerate future medical discoveries and also lead to more patient-centric approaches to healthcare in the future.

It highlighted, among other things, the potential of collaborations aimed at finding new uses for existing medicines, which could be of particular use in rare disease research.

“Patient involvement in decision-making relating to their health is really important, particularly as the health service rebuilds for the long-term,” said Rachel Power, Chief Executive of the Patients Association.

“The ongoing COVID-19 emergency has shown the need to ensure the NHS and its partners are continually considering the impact of their actions on patients and involving them in decisions about their care,” she added.

“COVID-19 and our collective response to it brought greater innovation and health service transformation than witnessed in generations,” said Chinmay Bhatt, Managing Director of Novartis Pharmaceuticals UK, Ireland and Nordics.

“We have seen that we are stronger, more innovative and more sustainable when we work together. To overcome the substantial pressures on the health service, it is crucial that we sustain these new ways of working in the years to come,” he added.

Media Summary

COVID-19: How the UK vaccine rollout delivered success, so far
The BMJ, Chris Baraniuk, 18 February

In an analysis piece, The BMJ explains the elements that have made the UK’s vaccination programme a ‘front runner’ globally and describes the hurdles that lie ahead. The reasons for success include the early approval for the vaccine, and the early planning done by the UK Vaccines Taskforce.

In terms of supply and distribution, The BMJ notes that doses arriving from production facilities in Europe have continued to move smoothly despite Brexit and French traffic controls. Explaining the logistics behind vaccine distribution, Martin Sawer, Executive Director of the Healthcare Distribution Association, told The BMJ that after vaccine batches are tested by the MHRA, they are then taken from central storage hubs to vaccination sites by private couriers. “Obviously the whole process is new,” said Mr Sawer, “but from my members’ point of view, it’s going very smoothly,” he added.

Mr Sawer added that delivery staff in Northern Ireland have been offered vaccines, but not yet those working elsewhere in the UK. “They’re now included as frontline healthcare workers in a way they’re not in England, Scotland, and Wales,” he says, adding that he would like to see the policy replicated across all four nations.

 

Pharmacies able to do 400 COVID jabs a week invited to join service
Chemist + Druggist, Aleks Phillips, 17 February

Chemist + Druggist reports that NHS England has asked pharmacies that would like to operate COVID-19 vaccination sites to express their interest, including contractors who can administer 400 jabs a week.

In a letter to contractors and local pharmaceutical committees on February 16, NHS England and Improvement hinted at a relaxation to some requirements to aid better coverage, as the national vaccination programme enters its second phase. While contractors in general will still have to demonstrate that they can provide at least 1,000 jabs a week, NHSE&I are also asking for expressions of interest from contractors who could provide “up to 400 vaccines per week” where “a site offering 1,000 vaccines per week is unlikely to be viable, or where an additional site would offer significant benefits for specific patient cohorts”. The new call suggests more pharmacies with a lower capacity will be able to join the vaccination effort.

Supplementary to the letter, NHE&I released a list of areas it is keen to get better coverage across – including many postcodes in South London, the Midlands and the South East of England. The letter noted that this list would be updated on February 19 “if additional areas are identified”. “We want to offer our sincerest thanks in anticipation of your support to deliver this programme at a time when demands on pharmacy and the wider health system are significant,” the letter added.

Malcolm Harrison, Chief Executive of the Company Chemists’ Association, said it is “a ‘win win’ for the public, the NHS and community pharmacies. More people will be able to receive their COVID jab close to their homes, rather than having to travel up to ten miles to visit a larger, regional vaccination site.”

 

Parliamentary Coverage

Lord Frost CMG appointed as a Minister of State in the Cabinet Office
Prime Minister’s Office & Cabinet Office, 17 February

The Queen has approved the appointment of Lord Frost CMG as a Minister of State in the Cabinet Office.

Lord Frost will be a full member of Cabinet. His appointment will take effect from 1 March 2021.

Lord Frost will lead the UK’s institutional and strategic relationship with the EU and help drive through changes to maximise the opportunities of Brexit, including on international trade and economic issues.

This will include:

  • Co-ordinating relations with the EU institutions and the 27 member states, working closely with the FCDO and other Departments with an interest;
  • Working on domestic reform and regulation to maximise on the opportunities of Brexit;
  • Leading on central coordination and policy resolution on international trade policy, working closely with DIT; and
  • Becoming the UK Chair of the Partnership Council and the Withdrawal Agreement Joint Committee.

You can find the press release announcing the appointment here.

 

Full Coverage

COVID-19: How the UK vaccine rollout delivered success, so far
The BMJ, Chris Baraniuk, 18 February

It looks like a world beating performance—the United Kingdom has administered more COVID-19 vaccine first doses per 100 people (19) than any other nation of comparable population size.

At the time of writing, 12 million people—roughly as many as the entire population of another vaccine front runner, Israel—have received their first dose of either the Pfizer-BioNTech or Oxford-AstraZeneca vaccine. Daily reports indicate that, on some days, more than half a million people have received a dose.

The government seems reasonably well placed to hit its target of giving 15 million people their first dose by mid-February. But the full story of the vaccination programme shows bumps in the road as well as successes.

Head start

The UK became the first country in the world to approve a COVID-19 vaccine for emergency use in early December. But the groundwork was laid nearly a year earlier, when the Department of Health and Social Care reportedly began planning a mass vaccination programme before confirmation of the first COVID-19 case in the UK. Meanwhile, the Oxford University scientists who would go on to develop a vaccine began meeting to discuss it in January 2020, before the World Health Organization (WHO) had even come up with the name COVID-19. They were already working on a prototype vaccine against the Coronavirus that causes MERS and reasoned that they would be able to adapt the chimpanzee adenovirus vector they were using to confer protection against SARS-CoV-2.

Just five months later, in June 2020, the UK signed a contract for 100 million doses of the Oxford-AstraZeneca vaccine. A separate deal securing access to 30 million doses of the Pfizer-BioNTech vaccine was announced the next month. This was increased to 40 million doses in October. “They’ve got ahead on ordering vaccines and they’ve got [the doses in hand] to give,” says Simon Clarke, Associate Professor in Cellular Microbiology at the University of Reading. “It’s as simple as that.”

Pascal Soriot, Chief Executive of AstraZeneca, has said that the early orders were a reason why deliveries to the UK have not been held up in the same way as those to the European Union. Batches of vaccine must be made up months in advance, and because cell cultures are used in the manufacturing procedure, the exact yield is unknown until each process is complete. The UK’s deal was struck three months before the EU’s, so its batches were set in motion earlier and separate to those earmarked for the EU, the yield of which turned out lower.

The UK’s hefty vaccine orders were made in part thanks to the 2011 film Contagion. Health Secretary Matt Hancock was spooked by the ending of the film, in which countries ravaged by a respiratory disease are left fighting for a limited number of vaccine doses. He insisted on ordering 100 million Oxford-AstraZeneca doses despite receiving advice to order a mere 30 million.

The UK government’s vaccines taskforce, set up by Chief Scientific Adviser Patrick Vallance and led by venture capitalist Kate Bingham, was established to help accelerate the acquisition and distribution of vaccine doses. Bingham’s appointment attracted scrutiny because she does not have a background in vaccine development and is married to a Conservative Party minister. Nonetheless, Hancock cited her “excellent track record in the biotech industry” and “vast experience working with drug and therapeutic discoveries” as reasons for appointing her, given her long running business connections to the likes of BioNTech’s Chief Business Officer, Sean Marett.

Since May 2020 the taskforce, consisting of experts in science, technology, and logistics, has secured orders from seven different vaccine manufacturers—a total of 400 million doses or enough to vaccinate the entire UK population three times over. In an interview with La Repubblica Bingham said that her team placed emphasis on sourcing vaccines that could be used as early as 2020. “We weren’t choosing vaccines on the basis of being cheap [but on] being effective and available quickly,” she said, adding that they favoured Pfizer-BioNTech over Moderna because of the supply chain to European countries (Moderna had prioritised US supplies), knowing that initial stocks would be limited. Still, it was a gamble at a time when no vaccine had been found to be effective against the virus.

“Our actual upfront cost was £900m [€1000m; $1200m] . . . we were willing to write off the upfront money, which was largely for manufacturing, if actually those vaccines failed,” Bingham, who has now stepped down from the taskforce, told La Repubblica.

By the autumn, clinical trial data indicated that both the Pfizer and AstraZeneca vaccines were highly effective at preventing symptomatic disease. Moderna in the US also reported positive results, prompting the UK government to increase its order from five million to 17 million doses. So far, the Medicines and Healthcare Products Regulatory Agency (MHRA) has approved the Pfizer-BioNTech, Oxford-AstraZeneca, and Moderna vaccines for use under emergency authorisation in the UK.

Rollout

At 6.31 am on 8 December 2020 in University Hospital in Coventry, 90 year old Margaret Keenan became the first person in the world to receive a COVID-19 jab as part of a mass vaccination programme. Just two months later, millions have followed her.

From theatres to sports halls, and even Salisbury Cathedral, large buildings around the UK have been converted into vaccination sites, alongside hospitals and general practices. Eventually, hundreds of high street pharmacies will join the effort. Large and small vaccination sites are needed, says George Kassianos, National Immunisation Lead at the Royal College of General Practitioners. “As long as the vaccine supply flows freely to the centres, we will vaccinate even more than the prime minister promised,” he says.

According to the government, everyone in England now lives within 10 miles of a vaccination centre. A small number of people living in remote, rural areas have access to mobile vaccination units. In total, there are more than 1400 vaccination sites in England, 1100 in Scotland, 295 in Wales, and 328 in Northern Ireland.

The schedule of priority groups, defining the order in which members of the public should receive the vaccine, was devised by the government’s Joint Committee on Vaccination and Immunisation, made up of scientists, doctors, and others. In line with WHO guidance, first up are care home residents and health workers, then older and clinically extremely vulnerable people. Among those excluded from the mass vaccination plan at present are pregnant women, children under 16, and those with health conditions that put them at very high risk of serious outcomes. All eligible UK adults are due to be offered a vaccine by the autumn.

Different parts of the UK are approaching the priority group cohorts in roughly the same way, with GPs focusing on older patients and hospitals acting as hubs for the vaccination of health workers. But there are some regional differences. Northern Ireland, for example, launched a twin track approach in January, where seven regional vaccination centres (a mix of hospitals and leisure centres) have offered appointments, bookable online or by telephone, to 65-69 year olds. Some people have received their first dose within 24 hours of booking, though many have reported technical glitches with the online system for requesting an appointment. Meanwhile, GPs continue to offer jabs separately to older and clinically extremely vulnerable people.

The twin track scheme was unveiled suddenly and has befuddled some patients. “We received last minute communication about it,” says Louise Douglas, a GP in Belfast. “People have been phoning us saying, ‘We can’t get an appointment’ or, ‘We don’t want to go to the vaccination centre, we want to come to you.’” The BMJ has also heard reports of patients in England left confused after they received requests from both their local GP practice and the separate mass vaccination team to come for vaccination. While noting good progress overall, Douglas expresses frustration over being “drip fed” inconsistent and often relatively small batches of doses. “We’re only being given 100 at a time,” she said. “Unfortunately, that means that we cannot communicate in advance to our patients.”

A week after speaking to The BMJ, Douglas’s clinic received enough to vaccinate 550 people in one day. Ollie Hart, a GP in Sheffield, says that the first delivery of vaccine doses his practice received was double the number he and colleagues expected—nearly 400 in total. “It was literally the day before, we found that out,” he says. He adds that his practice could, in principle, routinely administer hundreds more vaccines per week than at present, were the supplies available and their delivery clearly communicated in advance.

An NHS spokesperson told The BMJ, “Vaccines delivered to the NHS are sent out as soon as possible to vaccination sites, with as much notice given of delivery dates as possible, as supplies come online and are made available to the NHS.”

There are measurable disparities in the density of vaccine doses administered so far. Officials have sought to smooth things out, though not without controversy. Doses were redirected from Yorkshire and the north east of England because those areas had vaccinated a higher proportion of their over 80 cohort than parts of southern England. Hart, whose practice is in Yorkshire, says it is “normal” to see disparities in the rate of vaccination between different parts of the country. “This obsession with keeping everybody absolutely level does seem a little bit strange,” he adds.

Still, there are challenges in comprehensively vaccinating every community. Some black and ethnic minority groups are more hesitant about getting vaccinated, in part because of concerns over whether ingredients in jabs are compatible with their religious or cultural beliefs. Nadra Ahmed, the Executive Chairman of the National Care Association, says that this is one reason why some staff at care home organisations have still not been vaccinated.

Production

Neither AstraZeneca nor Pfizer has made known the number of doses supplied to the UK so far, though Pfizer told Sky News in early January that 21 shipments had been delivered. When asked by The BMJ, a spokesperson declined to give the latest figure of shipments made or clarify how many doses were contained in each shipment. AstraZeneca did not respond to requests for comment on the progress of its deliveries.

AstraZeneca’s facilities in the UK are producing doses for the country, and the Telegraph reported in January that a new factory in Oxfordshire will be capable of making 70 million doses in 4-5 months, after it opens later this year. Construction of the Vaccines Manufacturing and Innovation Centre was already underway with a planned 2022 opening, but the government invested an additional £131m to bring the completion forward to 2021.

Doses arriving from production facilities in Europe have, according to the Transport Secretary, Grant Shapps, continued to move smoothly despite Brexit and French traffic controls. Martin Sawer, Executive Director of the Healthcare Distribution Association, told The BMJ that after vaccine batches are tested by the MHRA—generally taking two days—they are then taken from central storage hubs to vaccination sites by private couriers. Only a small number of companies are handling the Pfizer-BioNTech vaccine, as it requires cold storage at around −80°C. “Obviously the whole process is new,” says Sawer, adding that the number of staff involved in vaccine deliveries currently number a few hundred. “From my members’ point of view, it’s going very smoothly.”

Sawer says that delivery staff in Northern Ireland have been offered vaccines, but not yet those working elsewhere in the UK. “They’re now included as frontline healthcare workers in a way they’re not in England, Scotland, and Wales,” he says, adding that he would like to see the policy replicated across all four nations.

New challenges

Even if the government meets its mid-February target, there will still be tens of millions of people waiting in line for their first dose in the coming months. And the challenge will become more complex as vaccinators are tasked with administering millions of second doses on schedule.

With more countries around the world ramping up their own vaccination programmes, wrangling over vaccine supplies has become heated. The UK’s much debated decision to delay administrating the second dose from 3 weeks to up to 12 weeks will help stretch vaccine stocks over a larger proportion of the population, with preliminary data for the Oxford-AstraZeneca vaccine indicating that the tactic should allow people to achieve a degree of immunity against the virus while also potentially cutting transmission. Clarke argues, however, that there are insufficient data to support delayed dosing of the Pfizer-BioNTech vaccine.

And then there is the threat of new variants that could evade immunity, potentially requiring the production and rollout of a new generation of COVID-19 vaccines or boosters. Scientists are already working on this, with Oxford University saying that a tweaked version of its vaccine could be available by the autumn. The government’s vaccine taskforce has also struck a deal with German company CureVac to develop new vaccines against emerging COVID-19 variants, agreeing to purchase 50 million doses should they prove effective, and to convert an animal vaccine plant to bring human mRNA vaccine production to the UK. To date, the UK has had to rely on overseas production for these vaccines.

The government is already planning for a third round of booster shots in the autumn. And Bingham has spoken of the need for alternative delivery methods to injections, such as nasal sprays or patches, to allow vaccination in pharmacies or even self-administration at home. This could reduce the pressure on hospitals, vaccination centres, and GPs. As we learn to live with the virus and its variants, COVID-19 vaccination might become an annual event like flu jobs.

There is much uncertainty ahead. But swift progress of the mass vaccination programme so far has buoyed a country still in its third national lockdown that recently recorded its 100 000th COVID-19 death. “Everybody has come together to deliver,” says Kassianos. “That, actually, is our NHS.”

 

Pharmacies able to do 400 COVID jabs a week invited to join service
Chemist + Druggist, Aleks Phillips, 17 February

NHS England has again asked pharmacies that would like to operate COVID-19 vaccination sites to express their interest, including contractors who can administer 400 jabs a week.
In a letter to contractors and local pharmaceutical committees (LPCs) yesterday (February 16), NHS England and Improvement (NHE&I) hinted at a relaxation to some requirements to aid better coverage, as the national vaccination programme enters its second phase.

While contractors in general will still have to demonstrate that they can provide at least 1,000 jabs a week, NHSE&I is also asking for expressions of interest from contractors who could provide “up to 400 vaccines per week” where “a site offering 1,000 vaccines per week is unlikely to be viable, or where an additional site would offer significant benefits for specific patient cohorts”.

Supplementary to the letter, NHE&I released a list of areas it is keen to get better coverage across – including many postcodes in south London, the Midlands and the South East of England. The letter – signed by Dr Keith Ridge, England’s Chief Pharmaceutical Officer, Emily Lawson, NHS chief commercial officer, and Ed Waller, director of primary care – noted that this list would be updated on Friday (February 19) “if additional areas are identified”.

“We want to offer our sincerest thanks in anticipation of your support to deliver this programme at a time when demands on pharmacy and the wider health system are significant,” the letter added.

In November, a “limited number” of pharmacies were asked to become vaccination sites – with 194 pharmacy-led sites now live, according to the NHSE&I website. The requirement that these sites be able to administer 1,000 vaccines across a seven-day week was something that “precludes many community pharmacies”, according to Labour Cooperative MP Rachael Maskell.

Last month, C+D launched a petition urging NHSE&I to scrap the 1,000 vaccines a week requirement and let more pharmacy teams across England pitch in with national COVID-19 vaccination efforts.

As the government reached its 15 million vaccination target on February 15 – an achievement described by Prime Minister Boris Johnson as an “extraordinary feat” – the new call suggests more pharmacies with a lower capacity will be able to join the vaccination effort.

Association of Independent Multiple Pharmacies (AIMP) CEO Dr Leyla Hannbeck tweeted that she is “glad” to see NHSE&I reopening the designation process, as AIMp had been “campaigning hard for more pharmacies to be involved”.

Mark Lyonette, chief executive of the National Pharmacy Association, said: “It makes sense that more pharmacies will be joining the COVID vaccination effort, given the brilliant contribution of the early cohorts.”

While Malcolm Harrison, chief executive of the Company Chemists’ Association, said it is “a ‘win win’ for the public, the NHS and community pharmacies. More people will be able to receive their COVID jab close to their homes, rather than having to travel up to ten miles to visit a larger, regional vaccination site”.

Pharmacies interested in joining the local enhanced service have until Sunday, February 28 to register their interest.

Extra funding for residential vaccinations

According to a primary care bulletin released contemporaneously by NHE&I, pharmacy-led vaccination hubs will also be able to claim an extra £10 for each vaccine given in residential settings, such as care homes, homeless accommodation and to housebound patients. This is in addition to the £12.58 payment for each jab.

Already, pharmacists in South Tyneside have been vaccinating at-risk housebound patients in their own homes – a programme that Vaccinations Minister Nadhim Zahawi recently praised as “innovative”.

“Frustrating” for those initially rejected

Even though 194 pharmacy-led sites have so far been approved as vaccination hubs in the first phase of the rollout, many who applied were rejected.

That included Ronak Maroo, Manager of Janssen’s Pharmacy in Bedford, who initially applied for three of his pharmacies to become COVID-19 vaccination sites in December. All three sites were rejected, with Janssens making it onto a shortlist before Mr Maroo was told by NHSE&I that his site would not be needed.

Now, Mr Maroo said he would likely apply again to become a vaccination site, however remarked that it was “quite frustrating” that he would have to go through the same submission process again.

“Surely they would just approach the people that have already sent an application in, rather than go through another round – because we’ve already done everything that they’ve asked for, in a sense,” he added.

NHSE&I was approached for comment, but had not responded by the time this article was published.

Media Summary

UK anticipating dip in COVID vaccine supply in coming weeks
Financial Times, Sebastian Payne, Sarah Neville, John Burn-Murdoch and Clive Cookson, 16 February

The Financial Times reports that the UK may be anticipating a dip in its Coronavirus vaccine supply in the coming weeks, with potential to disrupt inoculation targets.

After hitting its mid-February goal for offering vaccines to the 15m most vulnerable UK residents, the government is aiming to give jabs to the next 17m most vulnerable, including all over-50s, by 30th April. The UK has delivered close to 3m doses a week over the past fortnight. If that supply and distribution level is maintained, this next target could be met by the week ending 28th March according to analysis by the Financial Times.

The government’s much longer target of 30th April suggests that ministers either expect supply levels to drop in the coming weeks, or want to play down expectations. According to individuals familiar with the programme, supply is expected to remain fairly constant over the next few months but some glitches have been factored into planning. However, one senior Number 10 official said that vaccine supply was “a difficult one” and the government was cautious on whether supplies would continue at the almost 3m doses a week rate seen in early February. “Targets for the end of March do not reflect our internal assessment,” the individual said.

 

Parliamentary Coverage

NHS England seeks further community pharmacies to contribute to COVID-10 vaccination programme
Emily Lawson, NHS Chief Commercial Officer and SRO Vaccine Programme; Ed Waller, Director of Primary Care; and Dr Keith Ridge CBE, Chief Pharmaceutical Officer for England, 16 February

NHS leaders have written to Community Pharmacy Contractors and Local Pharmaceutical Committees re-opening the designation process for pharmacy contractors to apply to become vaccination sites.

Applications will be open to contractors who may be able to provide a service where NHS England has identified there is still a need for local populations. Contractors must be able to provide at least 1000 vaccines per week and must be able to be open from 8am to 8pm, 7 days a week if required.

NHS England has also asked for expressions of interest from contractors who could provide up to 400 vaccines per week. These sites may be considered where a site offering 1000 vaccines per week is unlikely to be viable, or where an additional site would offer significant benefits for specific patient cohorts.

You can read the letter in full here.

 

Full Coverage

UK anticipating dip in COVID vaccine supply in coming weeks
Financial Times, Sebastian Payne, Sarah Neville, John Burn-Murdoch and Clive Cookson, 16 February

This article is subject to copyright terms and conditions. You can access the article here.

Media Summary

Five unanswered questions about the vaccine rollout
BBC News, Ben Butcher, 15 February

BBC News reports that although just over one in four adults have had their first dose of vaccine in the UK, there are some unanswered questions about the vaccination effort. One issue facing the vaccine roll-out is supply. While the Government has ordered enough vaccines overall, it is unclear when these will be delivered, and Health Secretary Matt Hancock has repeatedly said that supply is the “limiting factor” in the speed of the roll-out.

The Government expects to have enough supply to give people their second dose within three months, while also ensuring the next priority groups have their first dose. People who have had their first dose have a considerable amount of protection from the virus, but the second dose increases this. Getting the second dose within three months is not a rigidly set time-frame, says Eleanor Riley, a Professor in Immunology and Infectious Disease at the University of Edinburgh.

There are also questions about who will get the vaccine next. Currently, the Government has a list of nine groups who will be vaccinated before anyone else, including care staff, the clinically vulnerable and anyone over 50. After that, the Joint Committee on Vaccination and Immunisation will make suggestions on the next priority groups for the Government to consider.

 

Parliamentary Coverage

ABPI elects new President
Association of the British Pharmaceutical Industry, 11 February

The ABPI Board has unanimously elected Ben Osborn, UK Country Manager, Pfizer, as President Elect of the ABPI. Mr Osborn will formally take over the ABPI Presidency from Haseeb Ahmad on 1 May.

Mr Osborn has been a member of the ABPI Board since December 2018. He is currently an industry representative on the Patient Access to Medicines Partnership and is currently Chair of the ABPI’s Co-Chair Strategy Group and Co-Chair of the ABPI Commercial and VPAS workstream.

Prior to his appointment as UK Country Manager in 2018, he held the role of Chief Marketing Officer for the Pfizer Innovative Health division, where he led the marketing organisation across Europe, Japan, Korea and ANZ.

 

Full Coverage

Five unanswered questions about the vaccine rollout
BBC News, Ben Butcher, 15 February

The Government says that 15m people have been vaccinated across the UK.

This means just over one in four adults have had their first dose of vaccine but there are some unanswered questions about the roll-out.

What is the uptake in minority communities?

It appears that uptake in ethnic minority groups is lower than it is for the population as a whole.

This is despite some minority groups, including Bangladeshi and Pakistanis, facing higher Coronavirus death rates than white people.

A survey, carried out by the University of Oxford and the London School for Hygiene and Tropical Medicine, suggested that black people over 80 were almost half as likely to have had the vaccine than white people over 80.

The gaps are smaller for people in their seventies.

There are official statistics of vaccine uptake which show how many people in each ethnic group have had the vaccine, but they are not broken down by age or location.

Normally we would look at how these compare to the overall size of the population, but we don’t have much of an idea of how many people are in each ethnic group.

This is because the last census was done ten years ago.

Public Health England has said that supplying transparent data by ethnicity will “will help to build confidence in the fairness of offer – as will updates on the actions being taken to address inequalities in access or uptake that are identified.”

How many staff in care homes have been vaccinated?

Care home staff were one of the first groups to be prioritised.

But there are no publically available statistics of how many of England’s 1.2m care staff have been vaccinated.

On 15 February, Health Secretary Matt Hancock indicated that around two-thirds of this group had received their first dose, including staff who deliver care in people’s homes.

He also indicated that around 80% of England’s 2m NHS staff had received the vaccine.

In Scotland it is estimated that 91% of staff in care homes for the elderly are vaccinated and 83% in Wales.

The National Care Forum, a body representing not-for-profit care homes across the UK, found that half of the homes for the elderly which were surveyed had had less than 70% of their staff vaccinated.

The survey, which was conducted on 8-9 February and reached around 1,500 care services, showed that the reason for not having the vaccine was split evenly between vaccine hesitancy, lack of access, waiting for an appointment and health reasons.

How do we know everyone was “offered” a vaccine?

The Government said that the following groups should have been “offered” a vaccine by February 15:

  • Everyone aged 70 and over
  • Care home residents
  • Care and health staff
  • Clinically extremely vulnerable

Boris Johnson said this target has been hit in England, whilst the Welsh government announced it had “hit this milestone”.

An “offer” means you’ve received an invitation for a vaccine, normally through a phone call, text or letter.

Currently, we have no data on how many people have actively turned down the offer of a vaccine or have ignored their invitation for a jab.

We also don’t know how many of the 15m people vaccinated are outside of these priority groups.

These numbers would give a clearer picture on whether the target has been hit, and highlight where vaccine hesitancy is high.

For example, data from OpenSafely shows vaccination uptake is higher in wealthier areas, but it doesn’t highlight whether the apparent lower uptake in more deprived areas is down to people refusing a jab, or simply not communicating with the NHS.

The UK Statistics Authority, which regulates the government’s use of statistics, requested this information (as well as data on ethnicity and care staff vaccinations) on 20 January.

Will we have enough supplies?

While we know the Government has ordered enough vaccines overall, we do not know the details of when these will be delivered.

Health Secretary Matt Hancock has repeatedly said that supply is the “limiting factor” in the speed of the rollout.

The Government expects to have enough supply to give people their second dose within three months, while also ensuring the next priority groups have their first dose.

People who have had their first dose have a considerable amount of protection from the virus, but the second dose increases this.

Getting the second dose within three months is not a rigidly set time-frame, says Eleanor Riley, a professor in immunology and infectious disease at the University of Edinburgh.

“The main concern is that if people miss this twelve-week window for the second dose, there is a danger that they fall out of the system and don’t get their second dose at all. This would be very worrying, as the second dose is essential for conferring high levels of long-lasting immunity,” she says.

Currently, just 4% of people who’ve had their first dose, have gone on to have their second.

This is because the health service has been focused on delivering the first dose.

Who will be vaccinated next?

Currently, the Government has a list of nine groups who will be vaccinated before anyone else, including care staff, the clinically vulnerable and anyone over 50.

After that, the Joint Committee on Vaccination and Immunisation (JCVI) will make suggestions on the next priority groups for the government to consider.

In January, Vaccine Minister Nadhim Zahawi said that it’s his “very strong instinct… to say, those who through no fault of their own other than their work, have to come into contact with the virus, should be prioritised”.

He listed shopkeepers, teachers and police officers as those who might be prioritised next.

Media Summary

‘Logistical difficulties’ preventing wider pharmacy COVID vax rollout
Chemist + Druggist, Aleks Phillips, 11 February

Chemist + Druggist reports that “logistical difficulties” are preventing all pharmacies from becoming COVID vaccination sites – but that Vaccines Minister Nadhim Zahawi has said they will be part of the rollout’s “next chapter.”

Mr Zahawi said the reason all pharmacies were not being used as vaccination sites was because supply of the vaccine was “finite”. There are “logistical difficulties with having all pharmacies as vaccination sites – including vaccine transportation with time constraints, and of course providing sites with all the other equipment they need to operate effectively,” he added.

NHS England Chief Executive Simon Stevens and Healthcare Distribution Association Executive Director Martin Sawer have previously indicated that the supply of the vaccine was the “rate-limiting factor” for vaccine rollout.

 

Next phase of UK vaccine rollout ‘may not meet the public’s expectations’, group of MPs warns
Sky News, Editorial Team, 12 February

MPs have warned that a lack of planning could affect the next phase of the Coronavirus vaccine rollout, according to Sky News. The Commons Public Accounts Committee (PAC) praised the “world-beating” effort to get the jab to the most vulnerable, but said there is “much to be done” if the UK government is to hit its next target.

Despite confidence that the UK has access to more than enough doses, the committee said there were “concerns” over the supply chain. They said the Government will continue to face “significant challenges” in ensuring it gets the jab to “the right people at the right time”, particularly given the different handling requirements of the Pfizer and AstraZeneca vaccines.

The committee added there was a “strong case” for looking again at which groups should be prioritised after the most vulnerable have been vaccinated – especially frontline key workers who are more exposed to community transmission of the virus.

A government spokesperson said: “The government is confident the regular supply of doses we have secured for the UK will support the continued expansion of our rollout in the weeks ahead.”

 

Parliamentary Coverage

Medicines and Medical Devices Bill Receives Royal Assent
UK Parliament, 11 February

Yesterday, Speaker of the House of Commons Sir Lindsay Hoyle confirmed that the Medicines and Medical Devices Bill has received Royal Assent, following agreement by both Houses on the text of the Bill. The Bill is now an Act of Parliament (law).

Key elements of the Bill include:

  • Increasing the range of professions able to prescribe low-risk medicines;
  • Developing more innovative ways of dispensing medicines;
  • Implementing a scheme to stop counterfeit medicines entering supply chains; and
  • Implementing a registration scheme for online sellers.

You can read more about the Bill here.

 

Written Letter to Lord Teverson, Chair of the EU Environment Sub-Committee
Edward Argar MP, Minister of State for Health in the Department for Health and Social Care, 22 January

The EU Environment Sub-Committee has today published a letter from Edward Argar MP, the Minister of State for Health, to Lord Teverson, the Chair of the EU Environment Sub-Committee, dated 22 January 2021. The letter concerns the supply of pharmaceuticals into Northern Ireland after the Transition Period.

The letter notes that on 11 December 2020, the Medicines and Healthcare products Regulatory Agency (MHRA) published guidance setting out that companies will have 12 months from 1 January 2021 during which they can continue to supply medicines to Northern Ireland in much the same way as they have previously done, and after which they will need to be compliant with regulatory importation and Falsified Medicines Directive safety features requirements when supplying medicines from Great Britain to Northern Ireland.

The letter adds that the 12-month phased implementation provides the time and flexibility industry needs to plan and implement long-term solutions to supply Northern Ireland, such as by using the Common Transit Convention or rerouting supply directly to Northern Ireland.

You can read the letter in full here.

 

 

Full Coverage

‘Logistical difficulties’ preventing wider pharmacy COVID vax rollout
Chemist + Druggist, Aleks Phillips, 11 February

“Logistical difficulties” are preventing all pharmacies becoming COVID vaccination sites – but they will be part of the rollout’s “next chapter”, Minister Nadhim Zahawi has said.

Speaking at a webinar hosted by pharmaceutical manufacturer Sigma last night, Mr Zahawi was asked by C+D to clarify earlier comments in which he said he did not want vaccines “just sitting” in pharmacy fridges.

Mr Zahawi said the reason all pharmacies were not being used as vaccination sites was because supply of the vaccine was “finite”. There are “logistical difficulties with having all pharmacies as vaccination sites – including vaccine transportation with time constraints, and of course providing sites with all the other equipment they need to operate effectively”, he added.

The requirement that a pharmacy-led vaccination site be able to give a minimum of 1,000 jabs a week – which had ruled out many smaller sites, leading to a C+D campaign to reverse the decision – was “a deliberate part of the strategy at the moment” in order to “make sure the through-put is there”, he said.

However, Mr Zahawi added: “As we get millions more doses coming through in the weeks and months to come […] it then becomes about reach – and I think community pharmacy has tremendous reach into those hard-to-reach communities – and convenience. Again, you tick those two boxes brilliantly, which is where I see the next iteration or the next chapter of this story heading towards.”

Earlier in the event, Pharmaceutical Services Negotiating Committee (PSNC) Simon Dukes Chief Executive had said that community pharmacy had “the potential for thousands of vaccine sites, not just hundreds.”

He added that PSNC had worked up a proposal for smaller sites to be able to vaccinate less than the 1,000 doses per week requirement, as “the sector is keen to help”.

Mr Zahawi said that there would be over 200 pharmacy-led vaccination sites by the end of the month (currently, there are 192), but the limiting factor remained the supply of the vaccine.

NHS England Chief Executive Simon Stevens and Healthcare Distribution Association Executive Director Martin Sawer have previously indicated that the supply of the vaccine was the “rate-limiting factor” for vaccine rollout.

“It has been challenging to set up so many vaccination sites – no doubt,” Mr Zahawi remarked last night. “As Brigadier Prosser at one of the press conferences referred to it, it’s a bit like standing up a supermarket chain in a month and then growing it by 20% every week.”

Mr Zahawi also paid tribute to one of the first independent pharmacy-led sites to go live, Cullimore Chemists in Edgware – which he visited in January – stating that it had been “heartening” to see such “exceptional work”. He also made mention of the “innovative” work of community pharmacists in South Tyneside, who have been giving up their weekends to vaccinate at-risk housebound patients in their own homes.

He told delegates: “I want to recognise the immense contribution being made by you, the community pharmacy teams, especially in these unique and exceptional times. Your work is critical to the safe care of patients. Community pharmacists really are the local lifeline for patients and the public.”

Meanwhile, in yesterday’s (February 10) daily COVID-19 briefing, prime minister Boris Johnson said that community pharmacies would be reimbursed “as soon as possible” for pandemic-related costs they had incurred.

During the government’s daily briefing from 10 Downing Street, Mr Johnson’s attention was drawn to the many pharmacies closing due to financial pressures. He was asked when the government intended to reimburse pharmacies for additional costs caused by the pandemic, and how many pharmacies he was happy to see close before the government intervened.

The Prime Minister responded: “I don’t want to see any pharmacies close. I think community pharmacies, high-street pharmacies, provide an absolutely outstanding resource for our country and its healthcare needs. And I’m particularly grateful to pharmacies now for what they’re doing as part of the vaccine effort.”

Mr Johnson added that he wanted to “make sure they are reimbursed as soon as possible. They play a vital role in helping us fight the pandemic and many, many other public health needs.”

Yesterday, the National Pharmacy Association (NPA) indicated that pharmacists may have to resort to strike action if the £370 million in loans given by the government to cover COVID-related costs were not written off by the Treasury.

“This is a desperate situation for many of our members, so it’s not surprising that you do hear people talking about some form of protest,” Andrew Lane, NPA chair, said. “But no one wants to let their patients down, so strike action is the last thing any pharmacist would want to do.”

A September 2020 report, commissioned by the NPA, predicted that 72% of pharmacies would be in debt by 2024. An NPA petition launched last year – calling on the government to forgive the debts – garnered nearly 40,000 signatures.

In November, PSNC asked the government to waive the £370 million in advance payments of COVID-19 funding made last year, a request that the Department of Health and Social Care (DH) said at the time it was “carefully considering”. The Negotiator doubled down on this request this week, accusing the government of “failing in their duty to protect the sector financially”.

Mr Dukes has said in recent weeks that the funding the sector receives from the government through NHS contracts is “not sustainable”, meaning more pharmacy closures were “inevitable”.

 

Next phase of UK vaccine rollout ‘may not meet the public’s expectations’, group of MPs warns
Sky News, Editorial Team, 12 February

A lack of planning could affect the next phase of the coronavirus vaccine rollout, MPs have warned.

The Commons Public Accounts Committee (PAC) praised the “world-beating” effort to get the jab to the most vulnerable, but said there is “much to be done” if the UK government is to hit its next target.

Ministers are aiming to offer a jab to about 15 million people in the top four priority groups by 15 February, then a further 17.7 million people in the next five groups – including all over-50s – by the end of April.

But a new report by the PAC said: “We are concerned by departments’ lack of planning for the next phase of the programme and in learning the lessons from what has already been done that will be so vital to the programme’s success.”

Despite confidence that the UK has access to more than enough doses, the committee said there were “concerns” over the supply chain.

It urged ministers to ensure plans are in place to respond to potential future developments such as the need for an annual vaccination programme, or the discovery of new variants of the virus.

Earlier, both the Scottish and Welsh devolved administrations said they expected a slight drop in the number of vaccines – but added that the move was “planned” and “factored” in already.

The committee said the government will continue to face “significant challenges” in ensuring it gets the jab to “the right people at the right time”, particularly given the different handling requirements of the Pfizer and AstraZeneca vaccines.

There is a risk that its plans for the programme “will not meet public expectations”, the committee said as it stressed the need for clear messaging.

“Government has at times struggled to communicate clearly to the public about what they can expect from the vaccine programme, otherwise it risks confusion about who will be able to access the vaccine, how and when,” MPs said.

“With misinformation about vaccines being circulated on various digital platforms, clear communication from government is particularly important to maintain public confidence and take-up.”

The committee said there was a “strong case” for looking again at which groups should be prioritised after the most vulnerable have been vaccinated – especially frontline key workers who are more exposed to community transmission of the virus.

A government spokesperson said: “This report rightly recognises the huge effort under way to deliver the biggest vaccination programme in NHS history, with over 13.5 million people given their first dose so far.

“The government is confident the regular supply of doses we have secured for the UK will support the continued expansion of our rollout in the weeks ahead.

“We continue to work with Public Health England and our exceptional scientists to tackle the variants currently in the UK and to make sure we are ready to respond to new variants in the future if needed.

“And through the NHS, community leaders and faith groups we are working to tackle misinformation and raise awareness of the facts about vaccines.”

Media Summary

Tens of thousands of UK nurses yet to receive first dose
The Guardian, Denis Campbell, 09 February

The Guardian reports that tens of thousands of nurses across the UK have not had their first Coronavirus vaccine, sparking fears that they could contract COVID-19 or infect patients. A Royal College of Nursing (RCN) survey of 24,370 nurses found that 85% had had at least one dose, with the remaining 15% unvaccinated.

The findings show that the government is in danger of failing to deliver one of the main elements of its pledge that all 15 million Britons in the top four priority groups for immunisation – which includes all health and social care staff – should have been offered a first shot by next Monday, 15 February.

“It is extremely worrying that, as our survey suggests, many thousands of nursing staff have yet to be given their COVID-19 vaccine less than a week before the government’s deadline,” said Dame Donna Kinnair, the RCN’s Chief Executive and General Secretary. She added, “with only days to go, every effort must be made to reach all nursing staff to ensure their protection and that of the patients and vulnerable people they care for.” The RCN said scaling that 15% up to its 450,000-strong membership suggested an estimated 75,000 nurses had still not had their initial jab.

 

EU poised to reject two-year extension to Northern Ireland grace period
The Telegraph, Harry Yorke & James Crisp, 08 February

Brussels appears poised to reject the UK’s calls for a two-year extension of the grace periods for post-Brexit trade in Northern Ireland, reports the Telegraph.

Multiple Whitehall and EU sources have told The Telegraph that the European Commission is likely to agree to only a three to six-month extension of the arrangements in place for traders moving goods between Britain and the province. The mooted extension falls far short of Michael Gove’s request for the EU to agree to extend measures in place to reduce red tape on supermarket goods, chilled meats, parcels and medicines until January 2023.

Ahead of a crunch meeting in London on Thursday, EU figures also accused the UK of exploiting an international backlash against Brussels over its aborted move to erect a hard vaccine border on the island of Ireland.  While the UK argues the controversy has highlighted the need for urgent solutions to the problems being experienced in Northern Ireland, EU diplomats claimed the issue was being used to try to renegotiate the Northern Ireland Protocol.

This was also reported in the IndependentReuters, the Daily Express and the Daily Mail.

 

Parliamentary Coverage

International Trade Committee launches inquiry in UK-EU trade relationship
International Trade Committee, 08 February

The International Trade Committee is launching a new inquiry into the UK-EU trade relationship, focussing on the implementation of the trade provisions of the UK-EU Trade and Cooperation Agreement. The inquiry will explore:

  • The experiences of businesses and other stakeholders in the UK regarding implementation of the UK-EU Trade and Cooperation Agreement’s trade provisions;
  • How effectively the UK-EU trade relationship is being managed through the mechanisms under the Agreement;
  • The impact of the Agreement, now and in the future, on the UK’s wider trade policy – including in relation to trade with non-EU countries; and
  • How the implementation of the Agreement – along with the wider UK-EU trade relationship – is likely to evolve

Angus Brendan MacNeil, the Chair of the Committee, said: “Since the new arrangements for UK-EU trade began at the turn of the year, numerous reports have shown that businesses and consumers are experiencing a range of difficulties. My Committee will be exploring these issues, including their impact on particular industries – not least those concerned with exporting perishable foodstuffs.”

You can read the full press release here.

 

Letter on the flow of pharmaceutical products between the UK and EU
Stephen Crabb MP, Welsh Affairs Committee, 08 February

Chair of the Welsh Affairs Committee, Stephen Crabb MP, has written to the Secretary of State for Wales, Simon Hart MP, about the flow of pharmaceutical products between the UK and EU.

In a recent Welsh Affairs Committee session, one witness, Ian Price from the CBI, spoke about a pharmaceutical company manufacturing cancer drugs having to relocate production from Wales to Dublin. He said that two to three hundred consignments had to be destroyed after being blocked somewhere in the system in Europe. Mr Crabb MP asked if the Secretary of State was aware of the following issues, and asked if the UK Government had been informed about other instances of pharmaceutical firms experiencing issues importing or exporting products.

The full letter can be found here.

 

House of Commons, Written Answer, 08 February

Liam Byrne (Labour, Birmingham Hodge Hill): To ask the Secretary of State for Health and Social Care, what plans he has to use the 11,300 community pharmacies in England to administer the Oxford/AstraZeneca COVID-19 vaccine at scale.

Nadhim Zahawi (Conservative, Stratford-on-Avon): From 1 February 2021, 130 community pharmacies have started to offer the COVID-19 vaccination service, including the Oxford/AstraZeneca vaccine, with more pharmacies joining the service over the coming weeks. Some pharmacists and members of their team have also been working with general practitioners to deliver the vaccine in many areas of the country.

NHS England and NHS Improvement are working with all the national pharmacy organisations on plans to ensure that community pharmacies are used to optimal effect in the COVID-19 vaccination programme, starting with the sites that can do this at scale.

 

Northern Ireland Assembly, Written Question, 08 February

David Hilditch (DUP, Antrim East): To ask the Minister of Health what plans his Department has to use community pharmacies as part of the COVID-19 vaccination roll-out.

 

Full Coverage

Tens of thousands of UK nurses yet to receive first dose
The Guardian, Denis Campbell, 09 February

Tens of thousands of nurses across the UK have not had their first Coronavirus vaccine, sparking fears that they could contract COVID-19 or infect patients.

A Royal College of Nursing (RCN) survey of 24,370 nurses found that 85% had had at least one dose, with the remaining 15% unvaccinated.

The findings show that the government is in danger of failing to deliver one of the main elements of its pledge that all 15 million Britons in the top four priority groups for immunisation – which includes all health and social care staff – should have been offered a first shot by next Monday, 15 February.

“It is extremely worrying that, as our survey suggests, many thousands of nursing staff have yet to be given their COVID-19 vaccine less than a week before the government’s deadline,” said Dame Donna Kinnair, the RCN’s Chief Executive and General Secretary.

“With only days to go, every effort must be made to reach all nursing staff to ensure their protection and that of the patients and vulnerable people they care for.”

The RCN said scaling that 15% up to its 450,000-strong membership suggested an estimated 75,000 nurses had still not had their initial jab.

The college said it was critical that all nurses had a COVID vaccine so that they, their families and patients were protected, adding that any nurse left unvaccinated was “a risk to themselves and those they care for”.

While 91% of nurses directly employed by the NHS have had at least one jab, just 71% working for other organisations – such as district nurses, health visitors or those in care homes – have received theirs.

Overall, 20,719 (85%) of those surveyed had received the first of the two doses of either the Pfizer/BioNTech or Oxford/AstraZeneca vaccine. Seven in 10 of those who had not yet had a vaccine worked in non-NHS settings.

While only 6% of nurses who work directly for the health service have not been offered a vaccine, much greater proportions of nurses who work through an employment agency (35%) or as temporary staff (19%) have still not been invited for an appointment.

A minority of nurses do not want to have a COVID vaccine. The RCN asked the 1,624 nurses who had not taken up an offer of a jab why they had refused. Of those, 38% said they did not want to have the vaccine at the moment or were undecided, and 12% did not want to have a vaccine at all. A third (33%), however, had an appointment booked and planned to attend.

Overall, 902 respondents (4%) said they had decided not to have a vaccine or been advised against doing so. The most common reasons they cited were: worry that the vaccine was unsafe or had not been tested enough; fears about side-effects; and belief that it may not prove effective in the long term against all strains of COVID-19.

Chris Hopson, the Chief Executive of NHS Providers, which represents health service trusts in England, said: “It is encouraging to see high levels of NHS staff uptake on the first dose of a COVID-19 vaccine, as indicated by this survey.

“It is really important that as many staff as possible take the opportunity to get vaccinated to help protect colleagues and patients. Trusts are making concerted efforts to ensure coverage is as comprehensive as possible.”

The Department of Health and Social Care said it was following the joint committee on vaccination and immunisation’s advice and would have offered everyone in the top four priority groups a vaccine by next week.

A spokesperson said: “This includes temporary, agency and voluntary workers who are at an increased risk of contracting or transmitting the virus to other people particularly vulnerable to COVID-19, as well as to other staff in a healthcare environment.

“The NHS is working at pace to vaccinate these groups and we are on track to offer a vaccination to everyone in these first four priority groups by mid-February.”

 

EU poised to reject two-year extension to Northern Ireland grace period
The Telegraph, Harry Yorke & James Crisp, 08 February

Brussels appears poised to reject the UK’s calls for a two-year extension of the grace periods for post-Brexit trade in Northern Ireland.

Multiple Whitehall and EU sources have told The Telegraph that the European Commission is likely to agree to only a three to six-month extension of the arrangements in place for traders moving goods between Britain and the province.

Ahead of a crunch meeting in London on Thursday, EU figures also accused the UK of exploiting an international backlash against Brussels over its aborted move to erect a hard vaccine border on the island of Ireland.

While the UK argues the controversy has highlighted the need for urgent solutions to the problems being experienced in Northern Ireland, EU diplomats claimed the issue was being used to try and force through a renegotiation of the agreement.

The mooted extension falls far short of Michael Gove’s request for the EU to agree to extend measures in place to reduce red tape on supermarket goods, chilled meats, parcels and medicines until January 2023.

It has also reignited calls from the DUP for Boris Johnson to unilaterally override parts of the Northern Ireland Protocol, which was established to smooth over trade issues created by the province continuing to apply some EU customs rules at its ports.

Jeffrey Donaldson, the DUP’s Westminster leader, told The Telegraph: “I am disappointed but not surprised by this meagre response from the European Union. I really don’t think the Irish government understands the extent of the difficulty consumers and businesses are experiencing in Northern Ireland.

“Simply extending the grace period doesn’t resolve any of the difficulties and doesn’t fix the underlying problem, which is that people in Northern Ireland are facing barriers to trade with the United Kingdom.

“If this is the best the EU can do, by kicking the can down the road a little further and offering no substantive change… then the Prime Minister has a duty to act, and he has the power to act.”

Separately, George Eustice, the the Environment Secretary, wrote to Brussels calling for an “urgent resolution” to unexpected barriers being placed on some shellfish exports.

It comes after the EU warned fishermen that some types of live shellfish caught in parts of the UK’s fishing waters could not be exported to the bloc – a move the UK says does not tally with previous assurances it had received.

Appearing before the Commons EU Scrutiny Committee on Tuesday, Mr Gove told MPs that while he believed that problems in Northern Ireland could be dealt with, the two sides were still “very far from resolving” them.

He added that while ministers did not wish to trigger Article 16, enabling them to override parts of the protocol causing trade friction, the EU needed to be “practical and pragmatic” to avoid the measure of last resort being used.

“One of the points that I’ve made is that if people put a particular type of integrationist theology ahead of the interests of the people of Northern Ireland, they are not serving the cause of peace and progress in Northern Ireland,” he said. “That is my principal and overriding concern.”

Mr Gove also expressed his alarm that the EU may seek to trigger Article 16 again in the future, warning that its actions last month had opened the “Pandora’s box.”

“Article 16 isn’t there to ensure the EU’s vaccine procurement program can be salvaged,” he said. “There needs to be a realisation on all sides that this isn’t some arcane bit of diplomatic procedure. This has real consequences on the ground.”

His comments will be seen as a thinly-veiled swipe at Ursula von der Leyen and commissioners in Brussels, who have been accused of failing to understand the sensitivities around Northern Ireland and the Good Friday Agreement.

However, ahead of a meeting between Mr Gove and his EU counterpart, Maros Sefcovic, on Thursday, a Whitehall source said the EU was privately indicating it would only accept an extension of between three and six months.

“They are amenable to a three-month extension… whether we can do more we will probably have to wait for this week’s discussions,” the source added.

Two EU sources also confirmed that discussions were taking place over an extension of up to six months.

Media Summary

NHS plans for annual Coronavirus vaccinations
Financial Times, Sarah Neville & Jim Pickard, 07 February

The Financial Times reports that the NHS is planning a mass campaign of booster jabs against new variants of Coronavirus as early as the autumn, in what the Vaccines Minister suggested would become an annual effort to prevent COVID-19 as the virus keeps mutating.

High-street pharmacists and retired doctors who were not enlisted in the first phase of the vaccination programme could be involved in the effort to protect the UK against new strains, according to people familiar with the logistics.

Nadhim Zahawi, the Vaccines Minister, told the BBC’s Andrew Marr Show that the Government was expecting annual inoculations to take place every autumn in much the same way as flu prevention, adding: “Where you look at what variant of virus is spreading around the world, you rapidly produce a variant of vaccine, and then begin to vaccinate and protect the nation.”

In a statement the NHS said it had “mobilised efficiently and speedily to ensure that new vaccines and treatments are rolled out as they become available”. NHS leaders believe that the timing of the extra shots means they could be delivered alongside the annual seasonal flu vaccinations long offered to over-65s, and for which eligibility was last year extended to all over-50s.

This story was also reported in The Independent.

 

Free provision of vaccines is preventing criminals from infiltrating rollout, say UK police
The Guardian, Mark Townsend, 07 February

The Guardian reports that the UK’s rapid vaccine rollout is being protected from the threat of serious organised crime and corruption thanks to the centralised systems of the NHS, which help safeguard it from attempts to infiltrate its supply chain according to the National Crime Agency.

But it was the NHS’s principle of providing free treatment for all that was the most crucial factor in protecting the so far successful vaccine rollout, particularly when compared with countries that relied on private healthcare and were more vulnerable to fake vaccines and fraud.

“You can’t buy the vaccine and you can’t sell it, that from a clear public messaging point of view makes it easier,” said Ben Russell, Deputy Director of the NCA’s National Economic Crime Centre. “Also you know it’s real because it’s being administered by the National Health Service and they’re not going to ask for your bank details or turn up at your house unannounced.”

His comments coincide with the latest data from Action Fraud, showing there have been 580 reports of attempted vaccine fraud, but these appear to be low level opportunistic attempts to defraud the public rather than organised crime.

 

All over-50s in UK to be offered vaccine by May
BBC News, Editorial Team, 06 February

All adults aged 50 and over should have been offered a Coronavirus vaccine by May, BBC News reports. The UK had given a first jab to nearly 11 million people as of last Thursday and is aiming to reach 15 million vaccinations by 15 February.

Health Secretary Matt Hancock said a lot of things would “have to go right” to hit the May target for all over-50s. He added that supply was the “most difficult” limiting factor in the roll out.

However, he said the government was on track to vaccinate the first four priority groups by the middle of the month, these include the over-70s, frontline health and care workers and the clinically extremely vulnerable.

There is growing confidence in the UK supply chain, with the bulk of supplies now coming from UK-based plants, while the first batches of the Moderna vaccine – of which the UK has ordered 17 million doses – will start to arrive before Easter.

 

Parliamentary Coverage

There was no parliamentary coverage today.

 

Full Coverage

NHS plans for annual Coronavirus vaccinations
Financial Times, Sarah Neville & Jim Pickard, 07 February

This article is subject to copyright terms and conditions. You can access the article here.

 

Free provision of vaccines is preventing criminals from infiltrating rollout, say UK police
The Guardian, Mark Townsend, 07 February

The UK’s rapid vaccine rollout is being protected from the threat of serious organised crime and corruption by the structure and principles of the NHS, senior police officers say.

The National Crime Agency, which is monitoring any attempt by organised syndicates to profiteer from the Coronavirus vaccine programme, said the centralised systems of the NHS helped safeguard it from attempts to infiltrate its supply chain.

But it was the NHS’s principle of providing free treatment for all that was the most crucial factor in protecting the so far successful vaccine rollout, particularly when compared with countries that relied on private healthcare and were more vulnerable to fake vaccines and fraud.

“You can’t buy the vaccine and you can’t sell it, that from a clear public messaging point of view makes it easier,” said Ben Russell, Deputy Director of the NCA’s National Economic Crime Centre. “Also you know it’s real because it’s being administered by the National Health Service and they’re not going to ask for your bank details or turn up at your house unannounced.”

His comments coincide with the latest data from Action Fraud, which is overseen by the City of London Police, showing there have been 580 reports of attempted vaccine fraud, but these appear to be low level opportunistic attempts to defraud the public rather than organised crime.

Recently the government launched an information campaign reminding the public that the NHS would not ask for payment because the “vaccine is free”.

Figures from the City of London Police, which specialises in fraud investigations, also reveal they are aware of more than 8,200 vaccine related phishing emails, when criminals attempt to trick users into revealing personal data.

Concerns that transnational narcotics syndicates may attempt to use their supply chains to move into the illicit distribution of COVID vaccines have, said Russell, proved unfounded.

In December Interpol issued a global alert to global law enforcement agencies warning them that organised crime networks may target Coronavirus vaccines physically and online.

The international police coordination agency said the pandemic had prompted “unprecedented opportunistic and predatory criminal behaviour” and warned of a new wave of criminal activity “in relation to the falsification, theft and illegal advertising of COVID-19 vaccines”.

 

All over-50s in UK to be offered vaccine by May
BBC News, Editorial Team, 06 February

All adults aged 50 and over should have been offered a Coronavirus vaccine by May, Downing Street has confirmed.

Previously ministers had said it was their “ambition” to vaccinate the first nine priority groups by the spring.

The UK had given a first jab to nearly 11 million people as of Thursday and is aiming to reach 15 million vaccinations by 15 February.

Health Secretary Matt Hancock said a lot of things would “have to go right” to hit the May target for all over-50s.

He said supply was the “most difficult” limiting factor in the roll out.

But he said the government was on track to vaccinate the first four priority groups by the middle of the month, these include the over-70s, frontline health and care workers and the clinically extremely vulnerable.

The top nine priority vaccination groups – which are set by the Joint Committee on Vaccination and Immunisation (JCVI) – also includes people aged 16 to 64 with underlying health conditions.

Mr Hancock also said it was “still too early to say” when restrictions could be lifted and warned the health service was still under pressure.

Prime Minister Boris Johnson said, in a Twitter video, that on 22 February he would “set out the beginnings of our roadmap for a way forward for the whole country as the vaccine programme intensifies and, as more and more people acquire immunity, a steady programme for beginning to unlock”.

He also warned that these were still “early days” and rates of infection in the country were “still very high”.

It comes after Mark Harper, Chairman of the COVID Recovery Group made up of Conservative MPs who want lockdown to be eased, said it would be “almost impossible to justify having any restrictions in place” once the over-50s had been vaccinated.

Prof Graham Medley, who is a member of the Scientific Advisory Group for Emergencies, earlier said the government should avoid “setting dates” for lifting lockdown and focus on criteria, such as case rates, rather than a calendar.

A further 1,014 deaths within 28 days of a positive test were reported on Friday, taking the total by that measure to 111,264.

There have been 19,114 more positive cases of Coronavirus recorded, while another 480,560 people received their first dose of a vaccine – taking the total to 10,971,047 across the UK.

Coronavirus cases are showing clear signs of falling across the UK, the latest figures suggest, and the R number – the average number of people that someone with COVID-19 will go on to infect – has dropped slightly to between 0.7 and 1.

In a press release confirming May’s local elections will go ahead, the Cabinet Office said: “The UK’s vaccination programme is planned to have reached all nine priority cohorts by May, meaning that the government can commit to go ahead with these polls with confidence.”

BBC Health Correspondent Nick Triggle said, while the NHS has the staff, volunteers and clinics needed to vaccinate the 15 million people in the next priority groups, vaccine production was a biological process so there were no guarantees about how much could be grown.

But our correspondent said there was growing confidence in the UK supply chain, with the bulk of supplies now coming from UK-based plants, while the first batches of the Moderna vaccine – of which the UK has ordered 17 million doses – would start to arrive before Easter.

So far, the falls in COVID-19 cases and hospital admissions (about a fifth in a week respectively) are pretty much exclusively down to the effects of lockdown restrictions.

But soon, we’ll start to see the impact of vaccination too – and we will expect to see more good news, particularly falls in deaths which are heavily concentrated in the over-80s.

While deaths mainly occur in the over-80s, about 20% of hospital admissions are in 45-64-year-olds and another 20% in 65 to 74-year-olds. The latest commitment to vaccinate all over 50s could have a massive impact on severe illness and the strain it puts on the health service, too.

But the situation will remain precarious for a while. Cases, though falling, are still high – and despite a so-far successful vaccination campaign, large swathes of the country may still be unprotected come spring.

Though much rarer, a proportion of younger, healthy people will end up in hospital with COVID-19, and we’re only just beginning to learn about the burden of long COVID-19 on the previously well young.

So once the groups at highest risk of ending up in hospital and dying have been vaccinated, the government will face difficult questions about what level of risk it is willing to stomach to ease restrictions, while a prolonged lockdown carries its own risks that might be currently difficult to measure.

The UK’s drugs regulator, the MHRA, said the vaccines being distributed in the country were extremely safe, while new research shows the AstraZeneca jab protects well against the new “Kent” variant of Coronavirus.

Earlier on Friday, the government also announced a deal with biopharmaceutical company CureVac, which Business Secretary Kwasi Kwarteng said would allow the UK to “swiftly tweak and roll out” existing vaccines to combat new variants, with 50 million doses placed in an initial order for later this year.

The government also said no contracts had yet been awarded to hotels to take part in England’s new quarantine scheme, which will see all those arriving from 33 COVID hotspots have to stay in a hotel for 10 nights.

 

Media Summary

COVID-19: New Oxford vaccine ‘ready by the autumn’ to tackle mutations

BBC News, Nick Triggle & Philippa Roxby, 03 February

BBC News reports that a vaccine produced by the Oxford-AstraZeneca partnership to tackle Coronavirus variants could be ready to deploy by the autumn. Professor Andy Pollard from Oxford University said tweaking a vaccine was a relatively quick process and would only need small trials before roll-out.

There is still strong evidence existing vaccines work well against the mutations that have emerged, although their overall effectiveness may be weakened a little. Results released by Oxford University showed evidence that the vaccine can reduce the chances of people catching and passing on the virus, which has always been uncertain. The data showed vaccination with the Oxford-AstraZeneca jab could cut transmission by up to 67%.

Health Secretary Matt Hancock said the results were “absolutely superb” and showed vaccines are “the way out of this pandemic” but that the “on-going challenge” would be for vaccine manufacturers to keep up with what the virus is doing.

 

Parliamentary Coverage

World-first COVID-19 alternating dose vaccine study launches in UK
Department of Health and Social Care, 04 February

Patients taking part in a new clinical study launching today will receive different COVID-19 vaccines for their first or second dose. The study will be the first in the world to determine the effects of using different vaccines for the first and second dose – for example, using Oxford University/AstraZeneca’s vaccine for the first dose, followed by Pfizer/BioNTech’s vaccine for the second.

A same-dose regimen is currently implemented for the national COVID-19 vaccination programme, and there are no current plans for this to change. Anyone who has received either the Pfizer or AstraZeneca vaccination as part of the UK-wide delivery plan will not be affected by this study. However, should the study show promising results, the government may consider reviewing the vaccine regimen approach, but only if proven to be safe and recommended by the Joint Committee on Vaccination and Immunisation.

Minister for COVID-19 Vaccine Deployment, Nadhim Zahawi, said: “This is a hugely important clinical trial that will provide us with more vital evidence on the safety of these vaccines when used in different ways. This is another great step forwards for British science, expertise and innovation, backed by government funding – and I look forward to seeing what it produces.”

You can read the full press release here.

 

More than 10 million people receive first dose of COVID-19 vaccine in UK
Department of Health and Social Care, 03 February

More than 10 million people in the UK have received their first dose of a COVID-19 vaccine, marking a significant milestone for the largest vaccination programme. Figures out yesterday show the NHS vaccinated a total of 10,021,471 million people between 8 December 2020 and 2 February 2021, including 9 in 10 people aged 75 and over in England. These 4 groups account for 88% of COVID deaths, which is why the vaccines will play an important role in reducing the demand on the NHS and saving lives.

Health Secretary Matt Hancock said: “This terrific achievement is testament to the monumental effort of NHS workers, volunteers and the armed forces who have been working tirelessly in every corner of the UK to deliver the largest vaccination programme in our history. Every jab makes us all a bit safer – I want to thank everyone for playing their part.”

You can read a full statement here.

 

House of Lords, Written Answer, 03 February

Lord Scriven (Liberal Democrat): To ask Her Majesty’s Government what is the average waiting time to receive COVID-19 vaccinations in (1) mass vaccination hubs, (2) GP surgeries, and (3) community pharmacies.

Lord Callanan (Conservative): The UK COVID-19 Vaccines Delivery Plan sets out how the Government will work with the NHS, devolved administrations, local councils, and the Armed Forces to deliver the largest vaccination programme in British history.

As of 3 February, over ten million people across the UK have been vaccinated with the first dose of the vaccine. We continue to work to meet our target of vaccinating all four priority groups, as advised by the Joint Committee on Vaccination and Immunisation, by 15 February 2021.

Vaccines are a precious resource in very high demand across the world; therefore, for security reasons it is not possible to provide detail about the size of our supplies and exact detail about deliveries.

 

Next Steps on the Northern Ireland Protocol
Michael Gove, Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, 02 February

The Chancellor of the Duchy of Lancaster, Michael Gove, has written to Maroš Šefčovič, Vice President of the European Commission about the Northern Ireland Protocol.

Mr Gove requests, amongst other articles, that the arrangements on medicines agreed last December should be extended for a further year at least to 1 January 2023, ensuring that medicine supply chains are not impacted by further barriers to trade. The letter continues to say that the UK and EU must also immediately resolve for Northern Ireland patients all outstanding practical issues on medicines; and set out a long-term approach that will ensure no barriers of any kind to the movement of medicines into Northern Ireland.

The full letter can be found here.

 

Full Coverage

COVID-19: New Oxford vaccine ‘ready by the autumn’ to tackle mutations
BBC News, Nick Triggle & Philippa Roxby, 03 February

A vaccine to tackle the coronavirus variants could be ready to deploy by the autumn should it be needed, the Oxford-AstraZeneca team says.

Prof Andy Pollard, from Oxford University, said tweaking a vaccine was a relatively quick process and would only need small trials before roll-out.

It comes as the UK announced more than 10 million people had received a jab.

There is still strong evidence existing vaccines work well against the mutations that have emerged.

Although their overall effectiveness may be weakened a little.

The comments came after results released by the team showed the first evidence the vaccine can reduce the chances of people catching and passing on the virus, which has always been uncertain.

The data, which has not yet been published or reviewed, showed vaccination with the Oxford-AZ jab could cut transmission by up to 67%.

This means the vaccine could significantly slow the spread of the virus, potentially allowing restrictions to be lifted more quickly, as well as protect people from becoming seriously ill and dying with COVID-19.

Health Secretary Matt Hancock said the results were “absolutely superb” and showed vaccines are “the way out of this pandemic” but that the “on-going challenge” would be for vaccine manufacturers to keep up with what the virus is doing.

He described the fact that 10 million people had received their first dose of a vaccine as a “hugely significant milestone” and said “every jab makes us all a bit safer”.

There is most concern about the South African variant, which shows signs of being able to escape some of the protective effect of the vaccines. There are already signs this has begun circulating in some parts of the UK, prompting surge testing to be introduced into parts of London, Surrey, Kent, Hertfordshire and Southport.

The mutation behind this variant – called E484K – has also been detected in some of the infections caused by UK strains that are circulating in parts of Bristol and Liverpool.

Prof Pollard said his team were already looking at updating the vaccine to make it more effective against the mutations that are being seen.

“I think the actual work on designing a new vaccine is very, very quick because it’s essentially just switching out the genetic sequence for the spike protein.

“And then there’s manufacturing to do and then a small scale study. So all of that can be completed in a very short period of time, and the autumn is really the timing for having new vaccines available for use,” he said.

It’s not yet clear how the new vaccine would be given to people, but it is possible it could take the form of a one-dose booster which is updated and rolled out every year or so.

Sir Mene Pangalos, Executive Vice President of Biopharmaceuticals Research and Development at AstraZeneca, added: “Our ambition is to be ready for the next round of immunisations that may be necessary as we go into next winter. That’s what we’re aiming for.”

He added the manufacturing process would also be easier as plants would be fully up to speed by then.

The trials that would need to be run are only likely to involve a few hundred people as the team would only need to check safety and that a good immune response is generated by carrying out blood tests.

There were a further 1,322 deaths in the UK reported on Wednesday within 28 days of a positive test for coronavirus, bringing the total number of people who have died by this measure to 109,335.

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