Delivery plan During the rollout of the Pfizer–BioNTech vaccine first doses, the UK government announced on 30 December 2020 that future deployment would focus on that initial dose, rather than giving the required two doses as quickly as possible. The announcement of this plan coincided with the approval of the Oxford–AstraZeneca vaccine, and so represented the strategy to roll out the two vaccines. The government stated that prioritising the first dose was on advice from the
Joint Committee on Vaccination and Immunisation (JCVI) and further assured that everyone would still receive their second dose within 12 weeks of their first. The new plan to increase the gap between first and second doses from 3 to 12 weeks was criticised as "unfair" by the
British Medical Association (BMA) on 31 December 2020, as appointments booked for 4 January 2021 or later would have to be rescheduled. In response, all four
Chief Medical Officers (CMO), plus England's Deputy CMO
Jonathan Van-Tam, signed an
open letter explaining the policy shift. They said by prioritising first doses, more people would have substantial protection faster, and the second dose adds relatively minor additional protection in the short term. They went on to say that for every 1,000 people given the second 'booster' dose, 1,000 new people would not be able to have up to 70% protection and would instead remain totally unprotected.
Delivery targets During his address announcing England's third national lockdown on 4 January 2021, Boris Johnson indicated a preliminary target for the vaccination programme, saying: He went on to confirm this would include all elderly residents of care homes and indeed everyone over the age of 70, as well as all frontline health and social care workers, and all those who are "clinically extremely vulnerable".
Vaughan Gething,
Minister for Health and Social Services in the
Welsh Government, matched England's targets by announcing that all people in groups 1–4 would be offered a first dose by mid February. A vaccination plan was published by the Scottish Government on 14 January. Part of this plan, subsequently withdrawn after objections from central government, projected the numbers of doses of vaccines delivered weekly to Scotland from the British Government until May, estimating that by mid-March there would be enough doses there to supply every person in the priority groups with their first doses, and enough doses by July to supply every adult with both doses. Extrapolating from these figures,
Sky News estimated that supply for the UK overall would be sufficient to meet the British Government's aim of immunising all 15 million priority individuals in the country by mid-February, and vaccinating all adults in Britain with their first dose by mid-July. The table shows the priority groups for the first phase of the roll-out. (but note that some people fall into more than one group). "Clinically extremely vulnerable" is defined as: • solid
organ transplant recipients • people with specific cancers: • people with cancer who are undergoing active
chemotherapy • people with lung cancer who are undergoing radical
radiotherapy • people with
cancers of the blood or
bone marrow such as
leukaemia,
lymphoma or
myeloma who are at any stage of treatment • people having
immunotherapy or other continuing antibody treatments for cancer • people having other targeted cancer treatments that can affect the immune system, such as
protein kinase inhibitors or
PARP inhibitors • people who have had
bone marrow or
stem cell transplants in the last 6 months or who are still taking
immunosuppression drugs • people with severe respiratory conditions including all
cystic fibrosis, severe
asthma and severe
chronic obstructive pulmonary disease (COPD) • people with rare diseases that significantly increase the risk of infections (such as
severe combined immunodeficiency (SCID),
homozygous sickle cell disease) • people on immunosuppression therapies sufficient to significantly increase risk of infection • people with
spleen problems, e.g.
splenectomy (spleen removal) • adults with
Down's syndrome • adults on
dialysis or with
chronic kidney disease (stage 5) • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. Women who are pregnant and children under 16 are not defined as clinically extremely vulnerable for the purpose of the vaccination programme. "People with underlying health conditions which put them at higher risk of serious disease and mortality" is defined as: • people with long-term lung conditions (such as severe
asthma,
COPD,
bronchiectasis and
cystic fibrosis) • people with long-term conditions affecting the heart or blood vessels (such as
congenital heart disease,
heart failure and
peripheral arterial disease): • people with
diabetes • people with
chronic kidney disease • people with long-term liver conditions (such as
cirrhosis and
hepatitis) • people with conditions affecting the brain or nerves (such as
dementia,
Parkinson's disease,
motor neurone disease,
multiple sclerosis,
epilepsy,
cerebral palsy or
stroke) • people with
learning disabilities • people with a condition or treatment that makes you more likely to get infections (such as
HIV or some treatments for
lupus,
psoriasis or
rheumatoid arthritis) • people with severe mental health conditions (such as
schizophrenia and
bipolar disorder) • people with rare diseases that significantly increase the risk of infections (such as
severe combined immunodeficiency (SCID),
homozygous sickle cell disease) • people on immunosuppression therapies sufficient to significantly increase risk of infection • People with severe
obesity (a BMI of 40 or above) The JCVI also noted that males from
BAME backgrounds and those with a BMI over 30 were at an increased risk, and therefore stated that it "strongly advises that individuals in these groups promptly take up the offer of vaccination when they are offered", with local officials advised to "promote vaccination in these groups". They were joined by all 16- and 17-year-olds on 4 August. The
Vaccinations Committee did not endorse vaccines for healthy 12- to 15-year-olds, on the grounds of only 'marginal gain' to the health of individual children. However, the
UK's chief medical officers agreed to the rollout of a single dose of the Pfizer vaccine to this age group on 13 September in order to reduce disruption to education. Second doses, three months or more after their first, were expanded to this age range on 29 November. On 15 and 16 February 2022, plans were announced across the UK to expand the Pfizer vaccine rollout to children from the age of five; the Vaccinations Committee approved this, taking into account an estimate that over 85% of all children aged 5 to 11 had experienced COVID-19 infection by the end of the previous month. That plan was later reversed, with no children under 12 being eligible after 1 September 2022 except for those in high-risk groups.
Booster doses In September 2021,
booster doses began to be given to members of the following groups, six months after their second vaccine dose: • people over the age of 50 • vulnerable people over 16 • health and social care workers • adult members of the households of immune-suppressed individuals It was decided in November that healthy people in their forties would also be eligible for a booster vaccination. Later that month, booster vaccinations were expanded to everyone over the age of 18 who had received their second dose more than three months earlier, whilst some people with severe immunosuppression became eligible for a fourth dose in response to the
SARS-CoV-2 Omicron variant. From Autumn 2022, further booster doses were offered to: • residents and staff in care homes for older adults, • front line health and social care workers, • people aged 50 years or older, • people aged 5 years or older who are in a clinical risk group or who have immunosuppressed household contacts, • people aged 16 years or older who are carers. == Progress to date ==