NHS working at break-neck speed to ramp up the Covid vaccine rollout

How long until you can get a vaccine?  If you are over 75 or a health or social care worker, you are most likely to be vaccinated by the end of January. If you are 65, the expected range is sometime in February or March. If you are a healthy 50 year-old, a new online calculator predicts June is your likely date with the syringe.

So far, 137,897 people had been vaccinated over the last week, according to government figures on Wednesday. At first glance this seems impressive. It’s undeniably better than anywhere else in the West where vaccines have yet to start. However, it’s also nowhere near fast enough – at this rate it would take four years just to vaccinate the 30 million people the government classifies as being “high risk” groups. And even then, once you have been given the first dose, people will have to wait another three weeks until the second dose to complete their treatment and then another 10 days for them to be considered in the ‘clear’. That means that those being vaccinated now, will not be considered immune for another month or so.

It’s why the NHS is rolling out the vaccine programme as swiftly as is humanely possible. This week alone new vaccination spots are being set up at ten hospitals, roughly 200 GPs surgeries, and some big venues like football stadiums. Mobile vaccination teams have also started visiting care homes. Another 1,000 local vaccination clinics are expected to open in the following weeks and the government is recruiting 30,000 volunteers to help with the mass rollout.

If 1,000 vaccination centres vaccinated 500 people a day five days a week it would still take nearly a year to vaccinate everyone over the age of 16 in the UK, according to calculations by SAGE member, Sir Jeremy Farrar, and Professor Tim Cook in the journal Anaesthesia.

The National Audit Office is predicting that full vaccination of over-16s will take even longer, and won’t be complete until 2022. Currently, NHS England and NHS Improvement are planning to vaccinate 25 million people by the end of 2021, an impressive number to be sure but this would leave just under half of England’s over-16s still unvaccinated.

If there is a silver lining it is that not everyone needs to be vaccinated for life to go fully back to normal, whatever that is. The rationale for lockdowns was always to prevent the NHS being overwhelmed by a flood of serious cases. Once the majority of those most vulnerable to the disease, mainly the over-65s, have been vaccinated the risk of this happening starts to disappear and lockdowns become less necessary. Some estimates suggest that this could be achieved as early as March. Some government figures have even voiced optimism that people might even be able to travel for their summer holidays next year.

Already senior health officials are complaining that the IT system being used to track who has been vaccinated and when to recall people for their second shot is “failing constantly”. There are also complaints that scheduled deliveries of the vaccine haven’t arrived on time. Allergic reactions to the Pfizer vaccine which have occurred in a few cases also means that GPs now need to observe their patients for 15 minutes after injecting them, further slowing the pace.

Vaccine supply is another major concern. The UK government has the rights to 40 million doses of the Pfizer/BioNTech vaccine currently being rolled out and had hoped to receive 10 million doses by the end of the year. However, now it looks like the number received by the end of the month will be about half that. Furthermore, the fact that people have to be vaccinated twice in order to gain full immunity means that 40 million doses only adds up to 20 million immunisations, just short of the 25 million people on the government’s priority list.

Other vaccines may help make up the shortfall. The Oxford University/AstraZeneca vaccine, which the UK has the rights to 30 million doses for, should hopefully be approved early next year. However, this vaccine has also been hit by delays to manufacturing which means the UK government expects to receive only 4 million doses by the end of the year.

A third highly effective vaccine, developed by Moderna, might also be approved in the near future. However, the UK government has only secured five million doses of it.

Even if everything does proceed smoothly and lockdowns are phased out – at least domestically – around March even this won’t mean a complete return to normal.  Professor Chris Whitty said he expected some measures such as wearing of face coverings and a degree of social distancing to remain for some time.

A key factor behind this is the fact that it is still unclear whether those have been immunised can still carry and transmit the virus. Research is of course proceeding apace to try and establish the facts, but until we know for sure we must assume that even the vaccinated might pose a potential risk of infection to others.

Other factors to consider include how many people need to be vaccinated for herd immunity to be established, and how long the vaccine will be effective for.

Regarding the former, estimates vary some suggesting that herd immunity requires 90% of the population to be vaccinated. Other estimates put the total at 80%, and some optimistic ones go as low as 66%. Here the uncertainty over whether vaccinated people can still spread the virus is a key factor behind the wide variation in estimates.

As for how long the vaccine lasts only time will tell. If it only lasts for one or two years then large numbers of people will need to be revaccinated, perhaps even as some people less at risk await their first vaccine, drawing out the timeline.

Finally, one cannot forget that this is a global pandemic. The UK is currently at the head of the pack when it comes to vaccination meaning other countries – especially the poorer ones – could face even longer timelines for bringing the virus under control. In the longer term, a new system of bureaucratic hoops based around proof of immunisation, for activities such as international travel and maybe even mundane activities like theatre-going, seem very likely.