Cancelled and delayed supplies hamper rollout of Oxford Covid vaccine through GPs

The rollout of the Oxford vaccine in parts of England has been hampered by the failure to deliver supplies on time to GP sites, forcing some doctors to reschedule appointments with vulnerable patients.

Amid an escalation in cases and deaths across Britain, the arrival of the Oxford-AstraZeneca vaccine has been heralded as “game-changing”, with the government aiming to inoculate the UK’s top four priority groups – roughly 13 million vulnerable people – by mid-February.

Although the Pfizer-BioNTech jab has been available since early December, efforts to ramp up the UK’s vaccination programme have been boosted by the widespread rollout of the Oxford jab, which is cheaper and easier to store, from Thursday.

However, some GPs have complained that they have not received their expected supplies on the launch day of the rollout.

Dr Ammara Hughes, a GP at the Bloombsury Surgery in London, which was visited by health secretary Matt Hancock, told reporters: “We were expecting our first AstraZeneca [supplies] today, but we’ve had a pushback for 24 hours so we’re now getting that delivery tomorrow.

“It’s just more frustrating than a concern, because we’ve got the capacity to vaccinate and if we had a regular supply, we do have the capacity to vaccinate three to four thousand patients a week.

“We have been running since the middle of December, and on our busiest days we can vaccinate 500 people easily.

“If we could get the AstraZeneca, then we could easily vaccinate 500 a day, which would ease the pressure on the health service and we could get more and more people vaccinated quickly and hopefully get out of the pandemic.”

Dr Hughes said Mr Hancock was “quite surprised actually to learn that we don’t know when all of our deliveries are coming, they’re very ad hoc”.

Elsewhere, in the Midlands, an NHS spokesperson for the Black Country and West Birmingham said some of the region’s primary care networks were still waiting for confirmation that supplies of the Oxford vaccine would be delivered this week.

Local MPs and Birmingham council leaders have also warned that existing vaccine supplies are set to run out by Friday, and have written to the health secretary demanding answers.

In a letter sent to Mr Hancock, the group of politicians said: “We have also learned today that Birmingham has not yet been supplied with the AstraZeneca stock while current Pfizer stocks are scheduled to run out on Friday, with currently no clarity on when further supplies will arrive.”

The Royal College of GPs said the delays in deliveries were “demoralising” for staff and “confusing and disappointing for patients”.

Its chair, Professor Martin Marshall, said: “There still appear to be some issues with delivery of vaccine supply to some surgeries. We do not underestimate the scale of the challenge that NHS England are facing getting supplies to vaccine sites across the country.

“What’s important is that communication to practices about when they will receive a supply of vaccine is clear and reliable, with as much notice as possible – and that any last-minute changes of plan are minimised.”

The army is being drafted in to overcome the challenges of distribution and help to deliver hundreds of thousands of doses per day by the middle of this month.

Brigadier Phil Prosser, commander of Military Support to the Vaccine Delivery Programme, told a Downing Street briefing that his team was “embedded” with the NHS, adding that the army would be adopting “battle preparation techniques” as part of its efforts.

“My team are used to complexity and building supply chains at speed in the most arduous and challenging conditions,” he said on Thursday.

Surgeries are also facing ongoing disruption to supplies of the Pfizer vaccine. The Independent understands that one GP based in the north of England was informed on Thursday that a second batch of Pfizer doses, due to be delivered next week, had been cancelled.

As part of efforts to ensure wider national coverage, the supply is set to be allocated to a nearby surgery that still has many over-80 patients who have yet to receive a dose.

Appointments booked in for patients at the northern-based GP will now have to be rescheduled for a later date. No form of compromise has been offered to the surgery, which is concerned that “people will not come back for their boosters” due to the disruption.

These late cancellations are not unique to GPs. One insider at Conquest Hospital, in Hastings, said that a number of appointments had to be rescheduled last week after too many patients – due to receive the Pfizer vaccine – were booked in.

The Pfizer jab is delivered in batches of 975 doses, which need to be transported at -70C and used up within five days of thawing. Hospital vaccination hubs have been entrusted with administering this candidate on account of its complex storage demands, which GPs cannot meet.

The Conquest source said the hospital had overbooked due to fears that some of the doses could go unused if some patients did not turn up on the day.

Politics also seem to have hindered attempts to administer the Pfizer vaccine. A high-profile doctor said patients had turned down the chance to receive the candidate – developed by the German company BioNTech – saying they would “wait for the English one”.

Paul Williams, former Labour MP for Stockton South, said it shows nationalism has consequences, even at the height of a pandemic which, to date, has claimed more than 90,000 British lives.

Meanwhile, patients receiving a dose of the Oxford vaccine will no longer need to be observed for 15 minutes, according to a recently-updated standard operating procedure (SOP) for local vaccination services.

The policy change was announced on Wednesday night, ahead of the rollout within GPs and other community-based settings.

The move has been met with relief by GPs, who argue the removal of the observation period – which is not required for the annual influenza jab – will help to ensure more people can be vaccinated on a daily basis.

Dr Simon Hodes, a GP based in Watford, told The Independent: “What this means in reality is that unless there are evolving concerns, we can treat the Oxford jab like a seasonal flu vaccine if we have supplies.”

Professor Marshall said the new policy “will give GP-led teams more time to deliver the vaccine and protect a greater number of vulnerable patients”.

“GPs and our teams are currently working exceptionally hard, delivering the Covid-19 vaccination programme to vulnerable patients across the community, in the safest and most efficient way possible,” he told The Independent.

However, those being vaccinated with the Pfizer-BioNTech candidate must continue to be observed for 15 minutes after receiving their dose, due to the novel technology used for the vaccine and early indications it may not be suitable in people with a history of severe allergic reactions.

The government has repeatedly said that the “rate-limiting” factor in efforts to get people vaccinated is the time taken to assess the different batches of vaccine supplied by the UK’s two manufacturers.

On Thursday, Mr Hancock said Downing Street was “working with the companies – both Pfizer and AstraZeneca – to increase the supply”.

Separately, all NHS hospitals across England have been told to start vaccinating frontline health and care workers immediately in the face of growing coronavirus pressures on the health service.

In a letter sent to health bosses on Thursday, NHS England said all hospitals would be established as vaccine hubs by the middle of January with each one responsible for inoculating their local NHS and social care staff.

Priority will be given to those most at risk and treating infected patients but NHS England said it wanted all staff vaccinated as quickly as possible.

Speaking on Thursday, prime Minister Boris Johnson said almost 1.5 million people have now been vaccinated against Covid-19 and that the government intends to give everyone in care homes a jab by the end of January.