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GPs told they can give unused Covid vaccines to next cohorts

GPs told they can give unused Covid vaccines to next cohorts

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:

  1. residents in a care home for older adults and their carers
  2. all those 80 years of age and over and frontline health and social care workers
  3. all those 75 years of age and over
  4. all those 70 years of age and over and clinically extremely vulnerable individuals
  5. all those 65 years of age and over
  6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
  7. all those 60 years of age and over
  8. all those 55 years of age and over
  9. all those 50 years of age and over

Source: DHSC

Additional reporting by Eleanor Philpotts


          

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READERS' COMMENTS [11]

Please note, only GPs are permitted to add comments to articles

Concerned GP 15 January, 2021 6:41 pm

Just use common sense and use up all the vaccine doses – not the time to be faffing around with red tape I’m afraid ….

Patrufini Duffy 15 January, 2021 6:42 pm

Or give it to doctors and nurses, who have all been fobbed off for their sacrifice by their negligent employer against all scientific evidence and manufacturers advice, with a Russian roulette 12 week gap, and whilst using you as the machine that implements it all. It’s reminiscent of giving you carrier bagas and expire face masks. Perverse deja-vu.

Jonathan Pywell 15 January, 2021 9:14 pm

Could someone explain how following the Government’s new schedule instead of Pfizer’s trial schedule will “enable us to protect double the number of frontline staff in half the time”?
If I can give only one vaccine a week, in 12 weeks I can either give 12 first doses to 12 people or 6 first and second doses to 6 people. I am giving, therefore, the vaccine to twice as many people in the same time (but giving the 12 half the doses).

David Banner 16 January, 2021 1:22 pm

I’m sorry, NHSE, but this is what happens when you change your guidance week by week…….
1- give everyone 2nd dose after 3 weeks
2- errr, no, scrap that, make it 12 weeks…..but we’ll leave it to your discretion whether to honour 3 week appointments or not.
3- actually, you know what, cancel ALL 3 week appointments and make them ALL 12 weeks.
4- what?? You threw away vaccine intended for cancelled 3 week appointments? We never told you to do that!!

Fortunately most vaccination clinic leaders have the common sense to ensure excess vaccine goes into arms (any arms, carers , volunteers, car park staff, and yes, even heath care workers!) if the clock is ticking down on left-over Pfizer stocks that will end up being binned in an hour or so. But if those in authority keep moving the goalposts, these insane jobsworth poor decisions will continue to be made.

Generic Locum 16 January, 2021 4:18 pm

How do you end up throwing away 120 doses?! Did you actually book enough patients into the clinics?
That sounds like a ridiculous discrepancy.

Martin Coleman 16 January, 2021 8:15 pm

” @NHSEngland has absolutely NOT told anyone to throw vaccine away. The very concept shocks me! ” ?!?

Bonglim Bong 17 January, 2021 9:31 pm

asdff

The Prime Minister 18 January, 2021 10:05 am

THIS IS THE PROBLEM WHEN YOU ALLOW NHS ENGLAND TO DICTATE TO GPs…..ESSENTIALLY NON CLINICAL PEOPLE ARE TELLING CLINICAL PEOPLE WHAT TO DO…….WRONG……THE WRONG OF NON-CLINICAL PEOPLE IS TO “FACILITATE” CLINICAL PEOPLE TO DO THEIR JOBS….

David jenkins 18 January, 2021 1:18 pm

two doctors (at least) have stated they have been told to discard jabs. the “NHS” (who precisely) said this is not true.

who do you believe ?!

no contest in my book !

Robert Bruce-Chwatt 2 February, 2021 11:58 am

Since when have doctors slavishly followed ridiculous dictats? Ignore the orders, use all the vaccine available.