The pandemic is a challenge of monumental scale and requires a response to match. Our NHS staff have risen to this challenge heroically, saving lives and providing care on overstretched wards and leading the charge in a national vaccination effort on top of all their other responsibilities. As the virus mutates and the daily death toll escalates, we owe it to them to get the vaccine rollout right. It is our way out of this crisis.
There are two issues we must take head on: supply of vaccines and the capacity of the system to absorb and use them. The first is to a large degree outside of the government’s hands, but the second is literally a matter of organisation and logistics. The point is, with the right plan in place there should be no barrier to using all available supplies, without wastage, and from March when there will be millions more doses the system should be able to use them to maximum effect. It goes without saying that whatever is supplied should be out of the door immediately.
Supply consists of two vaccine types. First is RNA – such as Pfizer and Moderna’s vaccine – complicated to store and requiring a degree of expertise to administer. Second are those vaccines akin to a flu shot, developed by AstraZeneca and Johnson & Johnson – it is these that will be the workhorses of our vaccine effort, deliverable at scale if we organise ourselves properly.
AstraZeneca is constrained by the production process but they’re ramping up fast. By the end of January there should be 2 million vaccines a week available. In February this could be pushed up further, and 3 million vaccines or more from then over time is possible - provided that amount can be absorbed. At the same time, we must do all we can to ready ourselves for the approval of Johnson & Johnson’s vaccine which is expected in February. Every day matters and we must not repeat the delay of five days between approval and administering the first shot. Do this, and it’s not unrealistic that we’ll have a supply of five million vaccine doses a week in March.
This ramping up would allow us to ease restrictions significantly in February and have a majority of the population vaccinated by early spring. That should be our ambition. The rest is a matter of logistics – the settings, the staff and the systems we use to underpin the rollout. The recently published vaccine plan from government provides a solid foundation for this.
In settings, we must use the largest number of venues in the right areas to reach as many people as possible. Government has recognised the role that GPs play in people’s lives but it’s important they do the same for pharmacies. During the pandemic over 70 per cent of people visited one and they’re embedded in local communities – even in remote areas. A recent commitment to mobilising 200 of these in the vaccine effort is welcome but more can be done to get most of the 11,539 community pharmacies involved in administering doses, as they do for flu vaccines. This means lowering the barriers to entry, particularly the requirement that pharmacies must have capacity to deliver 1,000 doses a week.
At the same time, every GP surgery should be involved in the vaccine effort, beyond the one third currently enrolled. If a surgery doesn’t have the physical space to administer vaccines then a local alternative should be sought, potentially using the polling station network. If surgeries require extra staffing, then we should recruit and train the largest number of people possible to safely administer vaccines – removing barriers to those who have experience in this area, and keeping surgeries open for as long as possible. Calls for twenty-four-hour stations should be heeded.
In systems, every piece of information on vaccinations should be held in a central database. This is critical to quickly identifying where mutations arise and monitoring the performance of different vaccine types. Moreover, this aggregated data should be publicly available, feeding into a dashboard that enables the entire country to see how the plan is working against its target. This is a national effort after all.
Vaccines will only free us from lockdown if they are properly recorded and if they live alongside other measures – including mass testing and the wider distribution of life-saving therapeutics. A CovidPass would give individuals ownership of their Covid status, enabling those who are vaccinated or have received a negative test result to travel and access other settings. It’s incumbent upon government that the data systems required to record this information are in place now.
This is the biggest challenge facing the country in my lifetime. It demands that we move onto a different footing altogether. Gearing the might of the state to get as many vaccines online and out the door as quickly as possible. It means a plan that goes beyond GP surgeries and vaccine centres. A plan that will require an unprecedented mobilisation of resources, leadership and ambition.
We are a great country. We can do this.