NHS staff no longer at front of queue for Covid vaccine after rethink | World news

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NHS staff will no longer be among the first people to be vaccinated against Covid-19 after a rethink about who should be given priority.

Hospitals will instead begin by immunising care home staff, and inpatients and outpatients aged over 80. The change is likely to disappoint and worry health service staff, some of whom had already booked appointments to get immunised.

Frontline personnel were due to have the Pfizer/BioNTech vaccine when the NHS starts rolling it out, probably next Tuesday, after the Medicines and Healthcare products Regulatory Agency approved it on Wednesday.

Separately, NHS bosses said the 800,000 doses that comprise the UK’s first consignment from Pfizer’s manufacturing plant in Belgium may be “the only batch we receive for some time”, raising questions about how soon further supplies will arrive.

NHS Providers, which represents health service trusts in England, on Thursday confirmed health service staff had been moved back in the queue for who gets immunised in the next few weeks. It follows new UK-wide guidance on priority groups issued by the joint committee on vaccination and immunisation and the uncertainty over when the rest of the 5m-strong initial batch of doses that ministers ordered will reach the UK.

The JCVI reiterated its previous stance that care home residents and staff and over-80s must be the first groups of people to have the Pfizer/BioNTech jab, with health workers next in line.

The British Medical Association, which represents most of Britain’s doctors, warned that the U-turn could lead to NHS staff dying. It backed care home residents having first access to the limited supplies of the vaccine, said its chair, Dr Chaand Nagpaul. But, he added: “Doctors and other healthcare staff will recognise the need to vaccinate care home residents and older patients first, but will likely be frustrated at the government’s inconsistent messaging changing from yesterday to today.

“In the first wave, we saw far too many health and social care workers become incredibly sick with Covid – with many tragically dying – and therefore those working on the frontline need to be given the opportunity to get protected early.”

He urged ministers to “make every effort to increase delivery of vaccine supplies so that frontline workers can receive the vaccine to ensure their safety as they battle the infection in the course of their duties”.

Chris Hopson, the chief executive of NHS Providers, detailed the new order in a series of tweets. He said: “JCVI prioritisation clear. Care home residents and their carers. Then over-80s and frontline health/care workers.

“Yesterday’s combination of JCVI prioritisation/MHRA authorisation conditions [on the vaccine’s licence] therefore changes previous, unofficial, assumption [that] hospitals would concentrate initially on staff.” Hospitals across England had expected to immunise their staff first and begin planning to do that from next week.

The question of whether care home residents and staff on the one hand or NHS personnel on the other should be prioritised for the first doses caused tension on Wednesday behind the scenes between NHS England and Downing Street.

The decision means even doctors and nurses who were due to have the vaccine in their hospital may now face a potentially lengthy delay before doing so, unless their underlying health or role in the NHS means they get one, he said separately.

The Pfizer/BioNTech Covid jab is an mRNA vaccine. Essentially, mRNA is a molecule used by living cells to turn the gene sequences in DNA into the proteins that are the building blocks of all their fundamental structures. A segment of DNA gets copied (“transcribed”) into a piece of mRNA, which in turn gets “read” by the cell’s tools for synthesising proteins.

In the case of an mRNA vaccine, the virus’s mRNA is injected into the muscle, and our own cells then read it and synthesise the viral protein. The immune system reacts to these proteins – which can’t by themselves cause disease – just as if they’d been carried in on the whole virus. This generates a protective response that, studies suggest, lasts for some time.

The two first Covid-19 vaccines to announce phase 3 three trial results were mRNA-based. They were first off the blocks because, as soon as the genetic code of Sars-CoV-2 was known – it was published by the Chinese in January 2020 – companies that had been working on this technology were able to start producing the virus’s mRNA. Making conventional vaccines takes much longer.

Adam Finn, professor of paediatrics at the Bristol Children’s Vaccine Centre, University of Bristol

“Our expectation is that the small number of NHS staff who have been booked for a vaccine will receive it, but hospitals will review those bookings in light of the JCVI guidance on prioritising the most at-risk staff.”

Hospitals will begin to inoculate care home staff by inviting them to come in for a jab, and people over 80 by giving the vaccine to those in that age group who are either already an inpatient or attending an outpatient appointment.

However, Hopson confirmed that, as the Guardian reported on Wednesday, the logistical complications the Pfizer/BioNTech vaccine involves means the UK’s 400,000 care home residents will have to wait. It needs to be stored and transported at -75C and all 975 doses in each batch used within six hours of the batch being opened. That makes it unsuitable for use in care homes, because of the small numbers of residents and staff.

However, Scotland announced on Thursday that it would be rolling out the vaccine to care homes within a fortnight, casting doubt on these logistical obstacles and increasing the pressure on Boris Johnson to prioritise care home residents in England.

The MHRA is reviewing the conditions it attached to the vaccine’s licence and is expected to approve the sub-division of the 975-dose batches into smaller quantities, but not for about two weeks.

“MHRA and NHS currently validating/working on process to enable splitting of boxes of 975 doses into smaller parcels,” Hopson tweeted. If the MHRA approves splitting, then healthcare workers will take smaller batches from hospitals to care homes and start administering jabs there.

NHS staff will only be able to get the vaccine if there are any doses still unused after those three groups have been immunised, which may prove unlikely, given the limited number of doses arriving initially. Hopson said: “If there are vaccine doses left over, hospitals will then vaccinate staff based on defined risk/already booked.”

The Royal College of Nursing warned the change in the priority groups was leaving NHS staff confused. “We understand why care home staff and residents are being given top priority given the level of risk they are facing. But mixed messages around when health and care staff will receive the vaccine is creating a significant amount of confusion on the frontline,” said Mike Adams, its director for England.

Meanwhile, the NHS in England is finalising a public information campaign to advise people who are keen to have the vaccine not to inundate GP surgeries asking for an appointment in the wake of the excitement its approval has generated.

“We want to stop the public bombarding their GP with requests for the vaccine. So there’ll be a campaign which basically says ‘we’ll contact you, don’t contact us’, which stresses that people in the priority groups will be contacted to arrange their vaccination, in the way that people are when they’re being offered the winter flu jab,” said a source with knowledge of the plan.

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Source: The Guardian
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