Britain has vaccinated 1.3 million people in just under a month … but the target is two million a week.
That’s the level needed to protect the four most vulnerable groups by February 15 – including all over 70.
Boris Johnson has blamed regulators for a slow start, warning that their strict protocols have limited the speed with which the vaccination program can be accelerated.
Industry Secretary Alok Sharma promised in May that 30 million doses of the vaccine from Oxford and AstraZeneca would be ready by September. Now, four months on from that date, our stocks are still falling close to the two million a week target.
The Prime Minister commented on the inoculation campaign: ‘The current limiting factor ensures that we get enough vaccines where we want them fast enough.
One of the problems as you know it is that the AstraZeneca vaccine needs to be properly tested with a badge, properly approved before it can be placed in people’s arms and this is just a process that takes time to to do … but we will review it up over the next few days and weeks. ‘
People queue outside the Covid-19 vaccine center in hopsital Guy in London on Tuesday
Other real problems include worldwide demand for glass filters. In addition, those hoping to join an army of volunteers to boost the national effort have joined forces in red tape.
Ministers say the NHS has the capacity to deliver two million doses a week – once it receives a supply from manufacturers that has been scrutinized by regulators. The Medicines and Healthcare products Regulatory Agency (MHRA) claims it is possible to do a batch test – but has been waiting to get more doses from manufacturers.
Chief medical officer Chris Whitty said at a Downing Street news conference yesterday that the six-week target was ‘reasonable but not easy’. So, as Britain embarks on the largest vaccination campaign in history, what are the main obstacles?
Is a batch test too slow?
Use London Nightingale? What an ExCellent idea!
London’s Nightingale Hospital is set to double as a main vaccination center, providing seven-day-a-week jobs from 8am to 8pm.
Work continued last night at the ExCel, the largest conference center in Europe. With things escalating dramatically in the capital, the Docklands site has already been ‘reactivated’ to ensure it can reduce pressure on the NHS if necessary.
The Epsom racecourse is among several other landmarks ready to offer a job as Britain’s vaccination program gathers pace.
Vaccine Driving: Removing Barriers at the ExCel Center
Earthworks: tents on the west side of the Docklands site
All batches must be certified for quality by the National Institute for Biological Standards and Control (NIBSC), part of the MHRA. The process can take up to 20 days.
A sample from each batch of vaccines – containing hundreds of thousands of doses – can be biologically tested for quality and safety.
Manufacturers must perform their own tests on each batch before submitting results as evidence to the NIBSC. Delays in providing that information – or any failure to meet standards – can slow down the whole process.
A batch is only released by regulators for use by the NHS once the two sets of tests have been completed – and the manufacturer’s results are deemed appropriate.
More doses are now being made, which increases the workload for laboratories handling quality control. An MHRA spokesman said: ‘We are working closely with the [Oxford vaccine] Manufacturer, AstraZeneca, to ensure that lumps of the vaccine are released as soon as possible.
‘NIBSC has increased its capacity to ensure that multiple batches are tested at the same time, and that this can be done as quickly as possible, without compromising quality and safety.’
Some observers have commented that the MHRA has succeeded in speeding up the process where Covid vaccines have been cleared for use. Critics may be wondering why the same cannot be done at this stage as well.
Are there enough filters?
Drug companies warned of a possible shortage of filters as far back as May, with high worldwide demand for vaccines.
The tubes are made of borosilicate glass, which keeps vaccines in the necessary stable state during storage and transportation. The glass is chemically unstable, meaning that there is no interaction between the vessel and the liquid it contains. This is important, as any chemical may affect the vaccine. Only a few companies make the filters, with Schott in Germany as one of the main producers.
Business supporters have suggested that the UK must ramp up production itself to stop trusting foreign companies. Dave Dalton, chief executive of trade body British Glass, said the supply chain needed to be ‘strengthened and improved’, saying the supply of medical glass and filters was something the industry had built itself – and it was ready for help with resolution.
Advanced nurse practitioner Justine Williams (left) is preparing to give a dose of the AstraZeneca / Oxford Covid-19 vaccine to 82-year-old James Shaw, the first person in Scotland to be vaccinated
Jonathan Van-Tam, England’s deputy medical officer, suggested that issues with ‘fill and finish’ products, including glass filters, could hinder the spread of the vaccine. ‘The only thing that is going to slow us down is that there are lumps of vaccines available,’ he said at a briefing on Downing Street. ‘Many of you already know it’s not just about vaccine manufacturing. It’s all about filling and finishing, which is a shorthand resource all over the world. ‘The Department of Health denies any vial shortages.
The UK has so far produced around 15 million doses of the Oxford-Astra-Zeneca vaccine, with plants in Germany and the Netherlands providing more of the early catches. However, only four million doses have gone through the filling and finishing process – and they are still awaiting MHRA approval.
Do we have enough people to provide jabs?
Doctors who have been appointed have complained that red tape has stopped them from returning to the front line to deliver Covid vaccines.
Health Secretary Matt Hancock vowed to tackle the problem, with some people willing to ask for 21 documents proving they are trained in areas such as terrorism and race equality.
NHS England says ‘tens of thousands’ of vaccines are ready to be requested when more doses are ready for delivery. The military is comprising health care workers such as physicians, nurses and paramedics who were given the green light to provide jobs after a rule change in the summer.
The NHS said there were ‘thousands more’ in training, but said the NHS was confident they had enough people to expand the vaccination program as it expanded. Physicians from the Armed Forces are also used.
Sister Practice Tina Sutton (left) delivers a dose of the AstraZeneca / Oxford Covid-19 vaccine to the Derek Davies Games at Pontcae Medical Center in Merthyr Tydfil in Wales
Are studies too long?
BUREAUCRACY is blamed for slowing down the actual vaccine activity, too, with patients experiencing lengthy questioning about their medical history.
Some say they went through a 15-minute medical questionnaire over the phone before being asked to get much of the same information when they arrived at their injection.
Once they have been vaccinated, patients should be monitored for 15 minutes to make sure they are not having any side effects – meaning the whole process can take about 45 minutes. Doctors have suggested that this should be skipped, as it severely limits how many vaccines can be delivered at a particular site in a single day.
What about the manufacturers?
Pharmaceutical companies have hit back at any suggestion that they are to blame for delays.
Pfizer and BioNTech – representatives of the first vaccine approved by the MHRA – said they have now sent ‘millions’ of doses to the UK, with up to 40 million expected in the coming months.
AstraZeneca has confirmed that it plans to deliver two million doses of Oxford vaccine to the NHS each week before the second half of this month, with at least 20 million due by the end of March. The injection had not been available at hospital hubs until now – but doctor’s surgeries will arrive tomorrow.