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Covid-19 Primary Care Resources

Guidance on prescribing Covid vaccinations

Advice on prioritisation for the Covid-19 vaccine programme rollout and guidance on prescribing the vaccines

This information is sourced from GOV UK, GMC and NHSE:


GMC guidance states that doctors should be immunised against common serious communicable diseases unless medically contraindicated

On 2 March 2021 NHSE released a letter stating that a national campaign to support second doses of the COVID-19 vaccine will commence soon

JCVI have issued interim advice on Phase 2 of COVID-19 vaccination programme rollout. Prioritisation for vaccination will continue in the following order, once all at-risk groups in Phase 1 have been offered at least one dose of the vaccine:

  • All those aged 40-49 years
  • All those aged 30-39 years
  • All those aged 18-29 years

Prescribing vaccinations

  • The vaccines are Prescription only Medicines
  • A clinical supervisor (doctor, nurse or registered pharmacist) must be present and provide clinical supervision for the overall provision of clinical care of Covid vaccinations
  • The National Protocol is to be used as the primary mechanism in all deployment models

Three legal mechanisms are in place for administration of Covid vaccinations:

  • A new National Protocol published by PHE for the Pfizer and Astra Zeneca vaccines enabling registered and non registered health care professionals to administer the vaccine. Clinical assessment must be carried out by a registered health care professional.  Preparation, administration and record keeping of the vaccine can be undertaken by registered or non registered persons with appropriate training, competence and working under supervision
  • Patient Group Directions (PGDs) may be used to administer the vaccine.  Used when a single health care professional group undertakes the entire process. Supply and administration of the vaccine must not be delegated to any other person.  NHS England have published PGDs for the Pfizer and Astra Zeneca vaccines
  • A Patient Specific Direction (PSD).  This means an individual instruction from a prescriber for a specific patient.  A registered health care professional must carry out the assessment. Where an individual falls out of the inclusion criteria stated in the National Protocol or PGD they may need to be clinically assessed by a prescriber under a PSD

Preparation of the vaccines (dilution and drawing up) is covered by separate legislation. It is expected that preparation of the vaccine is carried out by registered healthcare professionals or suitably trained and experienced non-registered healthcare workers with the relevant skills and experience in aseptic technique, under the supervision of a doctor nurse or pharmacist if not one themselves


Patients are required to give informed consent.  There is no legal requirement for a signature on the consent form however this does serve to record the discussion and decisions that have taken place.

Where patients may lack capacity, health care professionals must take all steps to support the patient making the decision themselves

When a patient lacks capacity, a decision may be made on an individual best interests’ basis. Where appropriate, the patient’s advocates or those with Power of Attorney for Health and Welfare should be consulted.  This may include taking to account the patient’s views and beliefs around vaccination if they did have capacity.

Written by Dr Claire Davies