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Covid-19: NHS will prioritise four most at-risk groups for second doses, says Stevens

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n252 (Published 27 January 2021) Cite this as: BMJ 2021;372:n252

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  1. Gareth Iacobucci
  1. The BMJ

The NHS will prioritise giving second doses of covid-19 vaccine to over 70s, clinically extremely vulnerable people, and frontline health workers before it starts vaccinating other at-risk groups, the chief executive of NHS England has said.

The government’s target is to vaccinate all care home residents and staff, all over 70s, all clinically extremely vulnerable people, and all healthcare staff with a first dose by mid-February and to offer all UK adults a vaccine by autumn.

Giving evidence to MPs on 26 January at the joint inquiry by the health and science select committees into lessons learnt from covid, Simon Stevens was asked whether he expected the NHS to slow down the rollout of the first dose to other groups (see box) from March, when large numbers of people in the four groups most at risk will be due for their second dose of vaccine.

He said, “First and foremost, those second doses have got to be delivered. So [if] we look 12 weeks on from when the first doses were delivered, we know that that has to be the first call on the vaccine available in those weeks. Over and above that, then as we get increasing clarity as to what the available supply will be, that will shape the speed at which we can advance into those other groups.

“My expectation is that we will do two things simultaneously as we move our way into working age adults more broadly. The first is that, when we’ve got a lot more supply, we will be able to make vaccines available in many different outlets . . . lots of high street pharmacists will be able to offer vaccines. At the same time, the larger vaccination centres that we’ve established will be going all guns blazing for increasing numbers of people. But right now, supply is constrained.”

Regional variation

Stevens was also asked how the NHS would be handling regional variation in vaccine delivery, after recent advice from officials to redirect available supply to areas that still had large numbers of patients in the highest priority cohorts awaiting first doses.

He told MPs, “We’re wanting to do it in a fair way so that each part of the country has enough vaccine to have been able to offer all of their 70 year olds and above, the high risk patients, and their staff that first vaccine [dose], which is why, for the time being, we’re on this so called ‘push’ model for fairness.

“But, for the second doses, we will be partly moving on to a so called ‘pull’ model where the local services will be saying, ‘I need this many vaccines next week for my second vaccinations,’ and then the vaccination team will make those vaccines available to them.”

Covid 19 vaccination priority groups

  1. Care home residents and staff

  2. Over 80s and frontline health and social care workers

  3. Over 75s

  4. Over 70s and clinically extremely vulnerable patients

  5. Over 65s

  6. Adults aged 16 to 65 in an at-risk group

  7. Over 60s

  8. Over 55s

  9. Over 50s

  10. Rest of the population (to be determined)

  • Source: Joint Committee on Vaccination and Immunisation

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