Intended for healthcare professionals


Covid-19: Logistical problems frustrate GPs ready to deliver vaccine in England

BMJ 2020; 371 doi: (Published 15 December 2020) Cite this as: BMJ 2020;371:m4849

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  1. Elisabeth Mahase
  1. The BMJ

Some GPs are calling the roll out of the Pfizer BioNTech covid-19 vaccine in England a “shambles” as delivery delays have forced them to cancel appointments and poor communication has left them waiting all weekend for stock that did not arrive.

The vaccine, which was found to be 95% effective against covid-19,1 is being given to those aged 80 and over, as well as care home workers and residents. Hospitals started administering the vaccine on 8 December.

NHS England said GP practices in “more than 100 parts of the country” should have received their vaccine stock on 14 December. But GPs have taken to social media to share problems with deliveries, communication, and IT systems.

Yvette Rean, a single handed GP in Kent, said,2 “Having spent weeks organising these vaccines and getting 975 patients booked in, we have been told they won’t be arriving on Monday as planned but Tuesday sometime. I have 80 patients booked for Tuesday morning. We’ve just cancelled 80 patients. It’s so sad, they’d booked taxis and families had taken time off work. I even had a patient’s relative reschedule chemotherapy to be able to take them.”

Another Kent GP, Gaurav Gupta, chair of Kent local medical committee, said he received a “confusing email from the clinical commissioning group (CCG) saying we might be stood down. We do not want to be delayed or stood down. We have hundreds of patients booked on the back of email from the CCG and we have the highest infection rate in the country.”

Rolling out the Pfizer BioNTech covid-19 vaccine is complicated because it must be stored at −70°C, and once removed from its dry ice box can only be kept for five days in a fridge.

London GP Richard Van Mellaerts, medical director of the Kingston GP federation, said his staff had been waiting all weekend for stock that never arrived.3 “It’s been a shambles. We have moved heaven and earth despite constantly increasing demands and are fed up.”

The delivery problems come after Pulse revealed that some GP networks had withdrawn from the vaccination programme as a result of guidance from the Medicines and Healthcare Products Regulatory Agency which said people must be observed for 15 minutes following vaccination in case of allergic reactions.4

Herefordshire GP Simon Lennane told The BMJ, “We heard last night our delivery date has been moved back two days, which is frustrating having sorted out shifts and volunteers and already booked some patients. I’d love to know why delivery dates are so uncertain as this is unworkable in the longer term. We’re already relying on goodwill as we’ll have to put in extra shifts over the weekend.”

He said that the 15 minute observation post-vaccination5 had also added logistical pressure as it requires a large space for people to safely sit while physically distancing.

Lennane says he has been told to use new systems to book and record vaccinations. “It would be interesting to know who will have access to these data and why we’re being forced into using a new system which we were only given access to a couple of days ago. We already have a system we’re familiar with,” he said.

The BMJ asked NHS England about these concerns, but the questions were not answered. A spokesperson said, “Practices will start vaccinating once all the necessary safety checks have been completed, and when surgeries can demonstrate they meet updated guidance, with hundreds ready to vaccinate this week thanks to the hard work of GPs, nurses, pharmacists, and other primary care staff.”

Across the UK

In Scotland, 5000 key NHS workers and vaccinators were the first to receive the Pfizer BioNTech vaccine. The scheme has now been extended to include care home staff and residents, after Pfizer made it possible for the vaccine to be delivered in smaller pack sizes of 195 five dose vials which must be diluted before use. These can also be transported in an unfrozen state for up to 12 hours and can be stored undiluted for up to five days.

Northern Ireland has also prioritised roll out in care homes. As of 13 December, nearly 50 000 doses of the vaccine had arrived in the country, with people over 80 next in line to be vaccinated.

In Wales care home staff, those over 80, and frontline health and social care workers most at risk are top of the list to receive the vaccine.

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