Hundreds of thousands of care home residents will miss out on the first wave of Covid vaccinations when the rollout begins next week, the government has admitted.
The fragility of the newly licensed Pfizer vaccine means it will first be delivered only to hospitals. The news came hours after the joint committee on vaccination and immunisation (JCVI), which advises ministers, said care home residents and staff should be prioritised.
Boris Johnson described the distribution of the vaccine as “an immense logistical challenge” and said it would take months before all of the most vulnerable were protected.
Lorries containing freezer boxes of about 1,000 vials held at -70 to -80C were being loaded at the Pfizer plant in Belgium on Wednesday as news of Britain’s regulatory approval came through.
The boxes will go to a national hub in the Midlands before being distributed through a warehouse network that already supplies the NHS, and administered by an army of GPs and other recruits. An initial 800,000 doses of the vaccine are due in the UK by the start of next week, and 10m by the end of the year.
The first vaccine, which requires two doses 21 days apart, will now go to patients in hospital aged over 80 and some vulnerable people who were already scheduled to come into hospital, said Sir Simon Stevens, the chief executive of NHS England.
Care home staff will also be among the first group vaccinated and will be asked to travel to a network of more than 50 hospitals where the Pfizer vaccine can be stored.
Jonathan Van-Tam, the deputy chief medical officer for England, said: “As soon as it is legally and technically possible to get the vaccine into care homes, we will do so. But this is a complex product with a very fragile culture. This is not a yoghurt that can be taken out of the fridge and put back in multiple times.”
Johnson said that while the JCVI had advised that care home residents should be the top priority, part of the difficulty was that the cases of 975 doses held at temperatures colder than -70C could not be split into the smaller amounts needed for care homes.
The MHRA has authorised the rollout of the Pfizer vaccine only on the basis that those batches are intact. Plus, if the vaccine is not transported properly, it will not work, the prime minister stressed, adding: “We want to get it into care homes to protect the most vulnerable as soon as we possibly can.”
But Vic Rayner, the executive director of the National Care Forum, which represents not-for-profit care homes, said: “The vaccine has been billed as life-saving, and it must be afforded to those who need it most, and not fall at the first hurdle because of the absence of a thought-through logistical plan.
“Being the first western country to approve a vaccine for Covid is remarkable. Now let’s put our energy and ingenuity into ensuring the most vulnerable can be the first to receive it.”
Hospitals are preparing to start vaccinating staff in small groups in case some suffer side-effects such as fatigue or headaches and have to go off sick. Within weeks, GPs will set up thousands of centres to vaccinate more at-risk patients, but care homes will be sent vaccines only when the MHRA approves its distribution.
Wales’s health and social care minister, Vaughan Gething, said “logistical challenges” in handling the Pfizer jabs meant that the Oxford University/AstraZeneca vaccine under development was likely to be better for care homes. He said it “gives us a much greater ability to take it out to people, because it is a vaccine that can essentially be stored in a fridge, so there are significantly less logistical challenges to deliver”. That vaccine is awaiting approval by the MHRA.
BioNTech, which developed the approved vaccine with Pfizer, had said it could be used in care homes. “If you store the vaccine in a fridge, you can store it for up to five days,” said Sean Marett, the chief commercial officer. “If you want to take some of those phials out of the fridge containing the vaccine and ship them to a local care home, then you have to do that in six hours at 2 to 8 [degrees].”
That appears to present too tight a window for some care homes, especially if they are not close to a distribution hub. “It doesn’t seem as if the Pfizer vaccine can be easily rolled out to care homes,” said one senior care industry source. “It offers a very short window and its administration will take longer in a care home. This isn’t a case of people lining up with their sleeves rolled up.”