Exclusive GPs have been told they can now invite patients from priority cohort three – those over 75 – to receive unused Covid vaccines.
And the chief medical officer has backed ‘perfectly sensible’ GP efforts to ‘eke out’ every vaccine dose they can.
It comes as Pulse has learned that some unused vials of Covid vaccine are being wasted rather than given as second doses amid current NHS England guidance.
The JCVI has set out four priority groups for vaccination, with most sites still working on completing the first two groups – including giving first doses to care home residents, NHS and social care staff and over-80s.
But an NHS England spokesperson told Pulse that if no over 80s or health and social care workers are ‘left’ to receive their first dose of the vaccine, practices should start vaccinating patients over 75.
When asked whether PCNs that have exhausted efforts to vaccinate the first two cohorts can move onto the next, the spokesperson said it has been ‘made very clear’ that the vaccine ‘can be used for priority groups’.
They added: ‘We need to get as many people in the JCVI priorities list vaccinated with their first dose as quickly as possible, so if there are no health and care workers or over 80s left to receive the first dose they should vaccinate those over 75.’
It remains unclear whether PCNs can now move fully onto priority group three or simply begin vaccinating the cohort to exhaust current vaccine supplies.
Speaking at tonight’s Government press briefing, chief medical officer Professor Chris Whitty said that delivery has been ‘heavily concentrated’ on the top two priority groups but that GPs have been ‘very sensible’ when there ‘has been extra vaccine’.
He said: ‘If you look at the proportion of the vaccines that have been used, which are for people in care homes and people over 80, it is the overwhelming majority. But at the same time, GPs rightly have tried to make sure that they eke every vaccine out that they can.
‘And there have been some perfectly sensible decisions made by individual GPs, particularly with Pfizer vaccine where there is an issue about shelf life once something’s been unfrozen, to make sure that actually it’s possible to maximise the number of people vaccinated.’
Everyone must ensure we have the ‘minimum wastage possible’, with vaccine supply remaining the ‘limiting’ factor to delivery, he added.
However, a GP in East London – who wished to remain anonymous – told Pulse that 120 doses of vaccine were wasted yesterday because of NHS England red tape meaning it could not be given as second doses to NHS staff.
NHS England said there was ‘absolutely no reason’ why vaccines should be wasted, saying sites ‘should be managing their appointment lists to ensure all appointments are filled and they have a back-up list of patients and staff who can receive the vaccine at short notice’.
Doctors shared similar stories on Twitter, with consultant acute physician at The Royal London Dr Louella Vaughan writing: ‘Our hospital has been told to bin unused vaccine rather than give staff [second] doses.’
Dr Maryam Omar, medical registrar and MSc in public health and The London School of Hygiene & Tropical Medicine, said: ‘We have been told the same… official Trust policy.’
Pulse has attempted to contact both doctors directly.
The spokesperson added that NHS England has made ‘its position’ on the matter of giving out second doses ‘very clear’ and referred to the letter instructing sites to cancel all such appointments.
The letter, sent last week, said: ‘All vaccination sites must with immediate effect, ensure all second dose appointments that have not already been rescheduled must be rearranged… This includes second dose arrangements for both patients and health and care staff, and will enable us to protect double the number of frontline staff in half the time.’
However, tagged in a Twitter discussion on the matter, NHS England primary care clinical director Dr Nikki Kanani said they have ‘absolutely NOT told anyone to throw vaccine away’, describing the concept as ‘shocking’.
BMA council chair Dr Chaand Nagpaul said vaccine wastage is ‘absolutely unacceptable and morally wrong’ and called for doctors to have ‘discretion’ to ensure all supplies are used.
He told Pulse: ‘Reports of vaccination sites feeling pressured to discard unused doses of the Pfizer vaccine are extremely concerning.
‘This is absolutely unacceptable and morally wrong. Any wasted dose denies a real person the chance to be protected from serious illness or even death.’
There should be ‘no reason for any of the precious vaccine to be thrown out’ while there are ‘so many vulnerable patients still needing to be vaccinated’, but giving staff second doses should be allowed to avoid vaccine going ‘down the drain’, he added.
Dr Nagpaul said: ‘NHS England needs to urgently clarify that doctors and staff have the discretion to ensure that they can make full use of any unused vaccines, rather than have any go to waste.
‘This includes, if necessary, giving vaccines to patients in other priority groups as well as giving second doses where appropriate so they go into someone’s arm and not down the drain.’
The BMA is calling for health and social care workers to receive their second doses of the vaccine ‘as soon as possible’, he added.
Last week, Prime Minister Boris Johnson set out a target for all people in the top four priority groups to have received their first Covid vaccine dose by mid-February.
And Pulse previously reported that GP practices will not face repercussions if they waste more than 5% of Covid vaccine stock.
JCVI priority groups:
- residents in a care home for older adults and their carers
- all those 80 years of age and over and frontline health and social care workers
- all those 75 years of age and over
- all those 70 years of age and over and clinically extremely vulnerable individuals
- all those 65 years of age and over
- all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
Additional reporting by Eleanor Philpotts