Destination Vaccination

It has been a number of months since I last put digital pen to paper through my blog, but it feels like only a number of days.

In the time that has passed since the Health Secretary made a newspaper announcement that he was to axe Public Health England, the executive agency has, somewhat unremarkably, remained Public Health England. With no actual change scheduled to take place in the land of the novel National Institute for Public Health until April 2021, it does beg the question of why the Government thought mid-global-pandemic was an appropriate time to make this announcement if there was no material change scheduled for at least half a year.

This week the Medical and Healthcare products Regulatory Agency (MHRA) approved the Pfizer/BioNTech COVID-19 vaccine for use in the UK. On the same day, nonetheless, that I was leading a Mass Vaccination Centre live exercise looking at the associated operational processes, policies and procedures required to support such centres. A positive day overall.

Some of the technical challenges in these centres involve arranging workforce, securing suitable estate with physical distancing arrangements, modelling and maintaining patient flow, effective operational management and communications, and vaccine/pharmaceutical management given the cold chain implications of the Pfizer/BioNTech vaccine requiring -70 degree Celsius storage before thawing for administration.

The approval of a vaccine for COVID-19 is of course good news. Expectations must be tempered with reality though. The rollout of the vaccine will take time and the immediate impacts will be to lessen fatalities and severe illness, not to prevent broad transmission in the community. Non pharmaceutical interventions (physical distancing, masks, hand washing) remain as important as ever.

We must also not forget this is a double dose vaccine. Those receiving their first vaccination in mid to late December will not benefit from immunity until mid to late January. The Joint Committee on Vaccination and Immunisation (JCVI) has published their priority list on the Gov.UK website which you can read here. We can appreciate from this, combined with the likely delivery timeline of the vaccine, that it will take a number of months to see the effect of the vaccine by way of a return to some normality in population and societal behaviour.

It is interesting to look back at the last pandemic vaccination campaign to forecast what the success of such a campaign may be for COVID-19. National uptake for H1N1 (swine flu) vaccination in targeted groups was only 34.5%. This figure increases slightly in certain cohorts, such as those clinical at risk groups where uptake was 37.6% and patients aged 65 and over in a clinical risk group where uptake was 40.4% (DH, 2010).

For further context, if we look at the uptake of the seasonal influenza vaccine in all population groups during 2019 we see a total uptake of 13.9% which is fairly steady on the previous year. In all age at-risk groups we see this figure rise to 44.9%. Now admittedly seasonal influenza is less impactful to our daily lives that COVID-19 has been, but it does give a reasonable indication as to the public value placed in vaccination for mild to severe respiratory illnesses where the risk factors are not evident to all those who are indeed at risk.

We must aim and hope to see a much higher uptake percentage for the COVID-19 vaccine for it to have the desired effect of dramatically reducing community transmission and the prevalence of the virus. We all have our part to play in achieving this, both through getting vaccinated when we are invited to do so and through positive messaging to our networks about the benefit of vaccination.

Department of Health. (2010). Pandemic H1N1 (Swine) Influenza Vaccine Uptake amongst Patient Groups in Primary Care in England. [Online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215977/dh_121014.pdf. [Accessed: 05 December 2020]

Public Health England. (2020). Seasonal influenza vaccine uptake in GP patients: winter season 2019 to 2020. [Online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/912099/Annual-Report_SeasonalFlu-Vaccine_GPs_2019-20_FINAL_amended.pdf [Accessed: 05 December 2020]

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