NHSE: Ethnicity and co-morbidities ‘could’ be considered for covid vaccine priority

A letter sent to GPs last night outlined the next steps in the primary care covid vaccination programme, under which 280 sites are due to start giving their first doses of the Pfizer/Biontech vaccine from Monday.

The vaccination sites will start booking people from Thursday (10 December) and the jabs will be delivered to them in batches of 975 from 15 December. Each site will have 3.5 days to administer the batch, due to its storage requirements.

The letter, signed by NHSE primary care directors Nikita Kanani and Ed Waller, said people over the age of 80 would be first in line for the vaccinations from the primary care centres.

It explains that GP groups will identify who they want to call in, and advises how they may need to prioritise if there are more than 975 over 80s who want to be vaccinated straight away. 

It says: “If your site potentially has more than 975 patients over 80 years who may wish to be vaccinated, and you need to prioritise which patients should have access to the first supply of vaccine to your designated site, then you could consider the following: i. Age 80 or over; ii. Co-morbidities; iii. Ethnicity.”

The government’s joint committee on vaccination and immunisation decided not to prioritise any ethnic groups — despite some calls for this because of higher rates of covid infection and mortality in some. But its guidance for the Pfizer/Biontech vaccine does state: “The committee’s advice is for NHS England and Improvement, the Department of Health and Social Care, Public Health England and the devolved administrations to work together to ensure that inequalities are identified and addressed in implementation.”

Its priority group advice does prioritise people who are “clinically extremely vulnerable” and have other underlying conditions, but only later in the process (alongside over 70s for the former, and after over 65s for the latter).

The NHSE adds that NHS England is putting measures in place to enable the safe transportation of the vaccine to care homes, such as small freezers and ice packs. Once they have been put in place, care home residents will start to receive the vaccine. It adds: ”Once further operational advice on vaccine handling has been agreed you should also start to vaccinate care home residents.” This is anticipated to begin in coming weeks.

The letter was published the day before the deadline given to GPs to sign up to the covid-19 vaccination enhanced services contract, with all primary care network practices expected to have opted in by today (Tuesday).

It states that vaccination sites should have at least one GP present on site for each vaccination session, adding that workforce arrangements should be finalised and any temporary staff should be in place by 10 December.

The letter adds: “We anticipate that your sites will for the most part be relying on their existing workforce initially. You may also find it helpful to connect with local government, community and voluntary sector colleagues to understand what other support could be mobilised locally.”

The covid-19 hospital hub vaccination programme started today, with 800,000 vaccines expected to be administered nationally from the first batch. Hubs at hospital sites in England are expected to vaccinate over-80s who are at hospital anyway, plus care staff and some NHS staff.