By Joanna Sugden and Will Horner
LONDON -- The U.K. became the first Western country to start distributing a Covid-19 vaccine to its population, rolling out a mass inoculation program that could provide a template for other countries, including the U.S., of the practicalities and potential pitfalls of vaccinating at speed and scale.
Less than a week after Britain granted emergency-use authorization for the shots developed by Pfizer Inc. and Germany's BioNTech SE, the first people earmarked for the vaccine began to receive it across the U.K. on Tuesday.
Those over 80, nursing-home workers and other high-risk health-care staff were front of the line: a group estimated to number six million. The rollout is being paid for by the U.K.'s state-funded National Health Service.
Hari Shukla, 87 years old and one of the first to be inoculated at a hospital in Newcastle, northeastern England, said the two-shot vaccine made him and his wife feel that the crisis was going to come to an end.
"When I received the telephone call I was very excited that I got the opportunity of taking part and joining in," Mr. Shukla told the British Broadcasting Corp. on the eve of the rollout.
Coming just days ahead of the Pfizer vaccine's expected authorization in the U.S., the success of the U.K. rollout could be an indicator of the challenges faced by American doctors in getting it into the population.
Aversion to vaccines in the U.K. remains below antivaccination sentiment in the U.S. In an Ipsos poll in October, 79% of people asked in the U.K. said they would take a Covid-19 vaccine if one was available, compared with 64% in the U.S.
Among the first to be invited to receive one of the initial 800,000 doses of the shot that arrived from Belgium are people in their 80s who had existing appointments for other procedures, and whose age puts them at greater risk from the coronavirus.
The U.K. has ordered 40 million doses of the vaccine but the complex delivery process of the new shot -- which requires a precisely timed deployment through an elaborate cold chain -- has restricted the first stage of the rollout to 50 hospital hubs in England and a small number of other sites in the rest of the U.K.
More than 60,000 people have died from the virus in the U.K., with a significant proportion of those in nursing homes.
Plans to get the vaccine immediately to the most vulnerable in nursing homes are complicated by the need to keep it in sub-Arctic temperatures. Local doctors say they haven't received instructions on how to get the vaccine to care-home sites safely.
The shots use a new technology called mRNA, which carries genetic instructions to cells and must be stored in minus 70 degrees Celsius, or minus 94 degrees Fahrenheit, to maintain their integrity. Once thawed, clinicians have five days to use the vaccine if it is kept at between 2-8 degrees Celsius, Pfizer says. At room temperature, that window shrinks to two hours, according to the drugmaker's data.
Still, despite the obstacles, starting next week the British government wants to distribute the doses out via a network of local physicians, known as general practitioners. When more doses become available, it plans to open mass-vaccination centers in conference venues and gyms. The government changed the law to allow student doctors, physiotherapists and dental workers to administer the jab.
The NHS has also appealed for retired doctors and nurses to help out and for thousands of volunteers to train as vaccinators and support staff.
"It's been 100 miles an hour working really, really hard making sure all this is ready," Chris Hopson, chief executive of NHS Providers, which represents the system's members, told the BBC on Monday.
Local doctors say they have been told to use the doses they receive within 3 1/2 days.
Some doctors say they don't have enough patients aged over 80 on their books to use all the doses in time, and others worry about delivering so many vaccines and handling the accompanying paperwork on top of their usual case load.
Helen Salisbury says her practice in Oxford, central England, has been inundated with calls from people wanting to know when they can get vaccinated.
"There's quite a lot of pressure to get it to the people who need it most, the care-home residents and the very elderly, but there's no point taking it there if it's not going to be any good once it gets there," she said. "You've got to make sure that the cold chain but also the stability chain is up to it."
The shot's path into the arms of Britons entails complicated, delicate, ultra-cold-chain logistics after its manufacture in Belgium.
Arriving by truck in ultralow-temperature freezers, the vaccine comes packed in isothermic boxes containing dry ice. It then goes through a 12-24-hour quality-control process conducted by specialists in medical logistics to ensure the necessary temperatures for transportation have been maintained on the journey and the vaccine kept viable.
Boxes are opened and temperature data recorded before the doses are sent out, still frozen, to the distribution sites and stored again in ultralow-temperature freezers. The vaccines, which must be kept upright and away from long exposure to light, are ordered via an online system.
When ready to use, the vaccine must be thawed for three hours -- or for 30 minutes up to 25 degrees Celsius for immediate use -- and then diluted with sodium chloride solution.
Simon Stevens, chief executive of the NHS, said that if people remained careful about the virus the first vaccinations would mark "a decisive turning point in the battle against coronavirus."
Write to Joanna Sugden at firstname.lastname@example.org and Will Horner at William.Horner@wsj.com
(END) Dow Jones Newswires