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U.K.'s Covid-19 Vaccine Program to Test Its State-Run Medical System

12/03/2020 | 08:15am EDT

By Jason Douglas and Stephen Fidler

LONDON -- Britain's authorization of a Covid-19 vaccine, the first in the West, sets in motion an ambitious plan that will test the capabilities of its state-run National Health Service: Inoculate everybody in the country over 50 within months.

The U.K. has been laying the groundwork for some time. Officials organized test runs to refine the logistics of delivering a shot that, in the case of the vaccine developed by Pfizer Inc. and BioNTech SE, has to be stored at an ultralow temperature. The government changed the law to allow student doctors, physiotherapists and dental workers to administer the jab. Scientists advising the government have drawn up a provisional list of who should get vaccinated first.

The scale and urgency of the task is such that the NHS, already under enormous pressure because of the pandemic, has appealed for retired doctors and nurses to rejoin the service and for thousands of volunteers to train as vaccinators and support staff.

The project will be "the biggest vaccination campaign in our history," NHS Chief Executive Simon Stevens said Wednesday.

One major help: Vaccine skepticism is lower in the U.K. than in many other Western countries. A survey by Ipsos in October showed 79% of Britons would get Covid-19 shots if available, compared with 64% in the U.S. and 54% in France.

Under a plan drawn up by medical experts, Britons have been prioritized for vaccination in nine tiers based on their risks of dying from Covid-19. First in line are staff and the more than 400,000 residents in nursing homes, followed by other health workers and the estimated 3.4 million people over 80. People are then be prioritized according to age in decreasing five-year intervals, down to people aged 50 and over.

A logistical wrinkle that officials say they are rushing to iron out: The vaccine comes in packs of almost 1,000 doses, and regulators haven't yet given approval to split them up into smaller lots that can be ferried to nursing homes. The very first vaccinations next week will therefore cover over-80s and other high-priority groups who can travel to 50 hospital hubs, Mr. Stevens said, with nursing-home residents reached as soon as possible thereafter.

Nobody under 50 is on the list, except for those classified as clinically extremely vulnerable and who will be vaccinated along with the over-70s, plus over-16s in at-risk groups, such as people who are morbidly obese or have diabetes. These people are in line to receive shots after the over-65s. Plans for vaccinating healthy people aged under 50 will be announced later.

Nadhim Zahawi, the government minister in charge of vaccine deployment, said Monday that the health service was "ready to go as soon as the vaccine is approved."

Past emergency mass vaccination efforts, such as for smallpox in the 1960s and swine flu in 2010, were delivered primarily by family doctors at thousands of practices across the country.

Family doctors, known in the U.K. as general practitioners, will again be pressed into service to administer Covid-19 vaccinations to people in their care, including frail residents of nursing homes and others too ill to travel. Doctors have been told to offer vaccinations seven days a week, including on public holidays, and to aim to administer at least 975 vaccinations a week.

The government has said regional vaccination centers capable of storing the Pfizer-BioNTech vaccine at the required minus-70-degree-Celsius temperature will be used to distribute the shot where it is needed. (For up to five days, the shots can be kept in temperatures between 2 and 8 degrees Celsius.) Hubs in hospitals will give the jab to NHS workers and others from next week.

The government has said it also plans to repurpose sports centers and conference halls into mass vaccination centers. Pharmacies, schools and municipal gyms and libraries may also be used, according to the Royal College of General Practitioners, which represents the U.K.'s family doctors and is advising them on vaccination logistics. Maintaining social distancing, ensuring adequate supplies of masks and other protective equipment, and finding enough trained staff will be key challenges, the college said in August.

St John Ambulance, a charity that provides first-aid services and training, plans to train 30,500 volunteers to administer the shots and support others in doing so between now and the spring. Around one-third of the volunteers will be trained to give the vaccination, with the remainder helping older and vulnerable people access the inoculation and checking on people after the jab, said Lynn Thomas, a hospital doctor and medical director of the charity.

Sam Rogers, a 26-year-old nurse, said his volunteer work with St John Ambulance usually involved treating falls and the occasional cardiac arrest at sporting events, village fairs and air shows. He will now be in charge of training as many as 400 volunteers to administer the shot. His day job has put him on the front line of the pandemic in a hospital emergency department in Dorset, England.

"Hopefully now this vaccine will give us some positivity, some light towards the end of the tunnel," he said.

The U.K. has ordered more than 350 million doses of seven experimental Covid-19 vaccines. It has ordered 40 million doses of the Pfizer and BioNTech jab authorized Wednesday, which is enough to vaccinate 20 million people. Its biggest order, for 100 million doses, is for the shot developed by AstraZeneca PLC and the University of Oxford. The U.K.'s medicines regulator is reviewing data on that vaccine, which officials hope could be available before the end of the year if it gets the green light.

A Covid-19 shot could be administered much like the annual flu vaccine is across the developed world. Doctors estimate it would take just a few minutes longer than a normal flu vaccine to put into people's arms. However, there will be a greater bureaucratic burden because people will need to receive two shots of the same vaccine, with a minimum of 21 to 28 days between each, and general practitioners will need to be informed that the shots have been administered.

Around 15 million people were vaccinated against influenza in the U.K. last winter, according to the NHS. There are around 66 million people in the U.K., of whom 25 million are over 50 and nine million are over 70.

By targeting those who are most vulnerable, the government is hoping to reduce pressure on hospitals and diminish the need for lockdowns and other restrictions. This, combined with better treatments, more effective testing and a measure of immunity in the community from those who have had the virus, could reduce the need for social distancing.

Public-health experts estimate that between 60% and 70% of a population would need to be vaccinated against Covid-19 for herd immunity to effectively halt virus transmission and shield those who can't be safely inoculated.

"We need people to take it. This vaccine isn't going to help you if you don't take it," U.K. deputy chief medical officer Jonathan Van-Tam said Wednesday, adding that a low uptake would mean restrictions would have to last longer.

Write to Jason Douglas at jason.douglas@wsj.com and Stephen Fidler at stephen.fidler@wsj.com

(END) Dow Jones Newswires

12-03-20 0814ET

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