Health Secretary Matt Hancock has rolled out an ambitious vaccination drive to bring the UK out of the “worst point” of the pandemic as it emerged that 1 in 30 Londoners were infected with Covid-19. The government has therefore, called for all hands-on deck including the GPs, community pharmacists and NHS doctors in ensuring that 15 million Britons in the top four priority groups are vaccinated in the next five weeks and that all adults are vaccinated by Autumn this year. While healthcare professionals have welcomed the government’s mass vaccination strategy, they worry around the lack of clarity in the timelines around vaccination of doctors. Most fundamentally, they are concerned if these medics are provided with sufficient financial, emotional and mental support to not burn out in the process.
British Medical Association (BMA) council chair Chaand Nagpaul has called on the Government to give urgent priority of vaccination to frontline staff to protect an already depleted workforce and to help prevent the NHS becoming overwhelmed. Dr Nagpaul said, “There are almost 27,000 patients with Covid-19 being treated in hospitals in England – an increase of more than 50 per cent since Christmas Day. Hospitals are becoming like warzones, and healthcare workers are the exhausted foot soldiers on the frontline. GPs are similarly pushed to the limit delivering a mass vaccination programme in the community. All of these workers are at constant risk of becoming infected, yet they are, beyond all doubt, the most important cog in the Covid-19 ‘care machine’.
“If they fall ill with the virus and cannot work, there would be no care, no medical procedures and no patients getting better and going home from hospital where they may then need GP care, who are also at huge risk and working often 18-hour days.”
Shortage of vaccines in GP-led hubs
The Government has begun its vaccination programme with two vaccines now approved for use in the UK but the approach to protecting healthcare staff has been left at a local level and the BMA has warned that the results have been “ad hoc and chaotic”. The BMA is also concerned that the slow pace of vaccination is leading to very significant staff absences because they either have the virus or are self-isolating. Frontline medical staff treating Covid patients at Greater Manchester hospitals have been told they must wait 11 weeks for their second doses of the Pfizer vaccine.
For weeks BMA has been calling on the NHS to prioritise health workers particularly as reports surfaced about black, Asian and Minority Ethnic (BAME) doctors once again being left at the fringe and forgotten. Some of these doctors have spoken up about how NHS admin staff were prioritised over those working at Covid-19 wards making them more susceptible to the new strain of the virus which is 70% more transmissible.
A row has broken out over delays in offering the Covid-19 vaccine to GPs who are in the frontline of patient care as thousands of people test positive for the virus. Their concerns appear after as a key tool in the HSE’s Covid-19 vaccine plan has suffered a setback after a new online system to allow GPs to register to get the jab for themselves failed to get up and running. Whereas, other GPs are still struggling to secure sufficient vaccine supplies as many doctors have described the large vaccine hubs as “white elephants” as bulk of the supplies get diverted to these hubs as opposed to the GPs. Professor Azeem Majeed, head of primary care and public health at Imperial College London, has consistently insisted that the funding and vaccines used to set up the new sites “should have gone to general practices and pharmacies, which have well-established systems for administering vaccine programmes.”
He said, “Currently, there is a shortage of vaccines in many GP-led hubs, leading to a stop-start vaccination programme for many sites. We need a guaranteed timetable for delivery of vaccines to these sites. If given the vaccines, GP and pharmacy sites can rapidly vaccinate at-risk groups. We have had too many examples from the government of wasted investment in our Covid-19 response. This includes large sums spent on substandard PPE, NHS Test and Trace, and Nightingale hospitals. Let’s not keep on making the same mistakes. Invest in NHS primary care.”
Sir John Bell, regius chair of medicine at the University of Oxford, told The Times that stubborn NHS bureaucrats were “standing in the way” of a high-speed mass inoculation programme that could prevent many further deaths.
NHS sparking panic
But there has also been a great deal of confusion particularly among the elderly after more than 130,000 letters were sent to the over-80s. These letters failed to make clarify that anyone who preferred not to travel to a super-centre could still receive the vaccine at a later date via their GP. The messages caused distress to elderly and vulnerable people who believed they would miss out on a vaccination unless they travelled up to 40 miles from their homes.
The original letters, seen by The Telegraph, told pensioners, "You are able to book your free NHS coronavirus vaccine now" and provided a link to an NHS website allowing them to book at their nearest super-centre. They further added, "You may also be contacted by your local NHS services. If you have, you can choose to either book your vaccination appointments through your local NHS services or using the details in this letter."
Support of community pharmacists
In the meantime, the government believes that pharmacies especially the community pharmacies have a quintessential role in creating awareness around the significance of coronavirus vaccine. They are particularly important for their inter-personal relationships within the community can remove all stigma and taboo attached with the vaccine and thus, break through the cultural barriers among the BAME communities.
According to the Pharmaceutical Services Negotiating Committee (PSNC), pharmacy trade bodies are already in talks with the government about “using more community pharmacies” in the national Covid-19 vaccination effort. In a statement, the PSNC said the Department of Health and Social Care and NHS England have agreed to work with community pharmacy bodies “on plans to ensure that community pharmacies are used to maximum effect in the Covid-19 vaccination programme”.
It said, “All parties agree on the benefits of using more community pharmacies in the national vaccination effort, recognising that, for some patients, pharmacies will offer a convenient setting in which to be vaccinated in due course.”
Commenting on the significance of community pharmacies, National Pharmacy Association chair, Andrew Lane, said, “Pharmacies can play a significant role in the Covid-19 vaccination programme, and we’re well equipped to get started immediately.
“We have been on the health service frontline throughout the pandemic and now we want to join this latest, decisive, battle against this deadly virus. The vast majority of pharmacies provide flu vaccinations, so there are thousands of potential local pharmacy sites for vaccinating against Covid, capable of protecting millions of people within weeks. We are bound to ask, what on earth is stopping the NHS from mobilising more pharmacies for this vital task? Pharmacists want to help, they are already trained for giving vaccines, and people are crying out for convenient local access to the vaccine. It’s surely a no-brainer that pharmacies should be supported to take part in this urgent national effort.
“The process for signing-up to give vaccines needs to be as agile as the workforce and should allow pharmacy teams to come on board rapidly. Approval of the Oxford-Astra Zeneca vaccine, for which storage is easier, means that many more pharmacies are now capable of offering vaccinations.”
Parliamentarians and council leaders have also raised similar concerns around the safety of the frontline doctors, especially those who are being treated with leftover doses of the vaccine. Some have even proposed that councils in London should be given dedicated funding to run multi-lingual campaigns aimed at targeting vaccine hesitancy in their communities.
Shital Patel, area manager for South West England Independent Pharmacies said, “Logistics of the Pfizer vaccine is very complicated. It needs come under special storage condition. We need to be reconstituted and observe the patient for 15 mins and 975 minimum in 3 days due to the storage restrictions. Only very few pharmacies got selected and we weren’t one of those.
“Astra Zeneca is almost like a flu jab. It does not need to be stored under special conditions; patients don’t have to wait for 15 mins. People are walking into high street pharmacies asking why haven’t we rolled out the vaccines yet? There is a lack of awareness for sure because there are many phone calls asking when they would receive vaccines.
“If pharmacies can do flu jabs, apart from the trainings, what is taking so long for the government? We are qualified, systems are set up, with guidance we can vaccinate easily. We still haven’t heard anything.
“There is a possibility some GPs would be reluctant for us to do the Covid vaccination and there may be a shortage of stock, hence the delay. But while you are waiting, it surely isn’t about who does it but it's about the patient care and their choice between a GP and high street pharmacy."
Temples, mosques and churches offer support
In the meantime, community organisations and faith leaders have also pitched in creating awareness among the ethnic minority communities about the importance of being vaccinated and in following the social distancing guidelines. The NHS has been given permission to use a leisure centre in Harrow as a Covid-19 vaccine site to support the rollout over the next year.
Tweeting about the vaccination of his grandmother, Councillor Krupesh Hirani wrote, “Just arrived home after taking my 97-year-old grandmother for her second dose of the Pfizer Covid-19 vaccine. Thank you to Brent Council for making it a seamless process and Neasden Temple volunteers who are helping coordinate at the Wembley Centre for Health and Care.”
Sheetal Davda, also tweeted, “Huge thanks to the wonderful NHS staff and BAPS volunteers at Neasden Temple for their efforts in vaccinating the vulnerable which included my dad today. Truly uplifting and humbling to see the kind, professional and speedy work to protect our communities.”
Fake NHS vaccine message
Fraudsters are scamming vulnerable and isolated people with bogus text messages about the coronavirus vaccine in an attempt to steal bank details. This comes after last lockdown saw many people falling prey to door to door selling counterfeit scammers or some pretending to be officials who have come for testing.
Trading standards officers have warned that the scam text message mostly tells people that the recipients are “eligible to apply for your vaccine" with a link to a bogus NHS website, which in turn asks for card details or bank details for crucial ‘verification’.
The warning comes the same day as MPs heard that Covid is leading some people into the net of pension fraudsters.
The NHS has reiterated that they will never ask for your personal details or payment for vaccination.
Assembly member concerned about frontline staff being given left-over vaccines
Labour’s London Assembly Health Spokesperson, Dr Onkar Sahota AM, has said if the problem is not “urgently and robustly addressed”, it would throw a “huge spanner in the works” of the national vaccination programme. In his letter to the Health Secretary, he asked what strategy the Government has had in place to tackle misinformation surrounding the Covid-19 vaccine and encourage take-up in BAME communities. This follows a survey published in November by the London Assembly Health Committee which found that a quarter of Londoners would decide against getting the vaccine. A separate poll commissioned by the Royal Society for Public Health in December, found that only 57% of respondents from BAME backgrounds were likely to accept the vaccine, compared to 79% of white respondents.
“Our research from City Hall shows that a quarter of Londoners could refuse the vaccine, and this figure is higher when you look at BAME communities. If not quickly and robustly addressed, the scale of this problem could throw a huge spanner in the works of the national vaccination programme.
“As we saw during the initial lockdown period, councils played a vital role in amplifying and targeting multi-lingual public health messaging in their communities. With extra, dedicated funding they could significantly boost local campaigns to tackle vaccine hesitancy.
“I am also pressing the Health Secretary for his reassurances that there will be a tighter strategy in place to vaccinate frontline staff going forward. It simply isn’t good enough that so many of our heroic NHS workers are having to rely on leftover doses and ad hoc appointments to protect themselves, their patients and families from the virus”.
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Following JCVI recommendation and vaccination prioritsation
Healthcare professionals have been flagging concerns about the safety of the frontline doctors and NHS staff from the black, Asian and minority ethnic (BAME) backgrounds as the first wave of coronavirus in the UK demonstrated the disproportionate impact of the virus on those from minority backgrounds. Besides, urging that sufficient and adequate Personal and Protective Equipment is provided to those at the frontlines, some organisations have also raised concerns about how BAME doctors are neglected in the Government's vaccination strategy.
Responding to these criticisms, Dr Nikki Kanani, GP and NHS medical director for primary care, said, “The NHS is following the JCVI recommendation that priority is given to frontline staff at highest risk. Healthcare providers have been undertaking staff risk assessments throughout the pandemic to identify these individuals, and these are based on a combination of where they work and what their individual risk factors are. Black, Asian and minority ethnic staff make up around a fifth of the NHS workforce and have been disproportionately affected by the pandemic, so it’s crucial they take up the offer of a vaccine when offered.
“The NHS is experienced in vaccinating hundreds of thousands of staff quickly and safely – we do it every year for the flu vaccine – and we’re working hard to ensure that 100% of eligible staff have the opportunity to take it up over the coming weeks and months.
“The decision from the UK’s four Chief Medical Officers to have a longer timeframe between first and second dose will allow us to get the maximum benefit for the most people in the shortest possible time and will help save even more lives. Both vaccines give high levels of protection from the first dose alone so it really is worthwhile getting it as soon as possible.
“The government has now published its vaccination delivery plan. It is a huge challenge, but NHS staff are doing an incredible job to deliver what it is the largest vaccination programme in our history, at the same time as continuing to be there for everyone who needs care. Those staff have worked incredibly hard during the pandemic and it’s been tough physically and emotionally, but what people are saying to me is that the vaccine offers hope of a better future, and that’s what is motivating them to carry on and make sure everyone who would benefit is offered this vital protection.”
