The Health Secretary, Jeane Freeman, addressed The Scottish Parliament on Thursday with an update on the vaccination programme which will be rolled out in Scotland when a vaccine becomes available. The government expects to have 320,000 doses in Scotland in the first week of December.
There are still some things which are as yet unknown – for example when any vaccine will be approved and exactly when it will be available – but the government is working on the logistics of vaccinating everyone over the age of 18 as soon as possible. Ms Freeman said they hope to vaccinate 1 million people in Scotland by the end of January.
There is still uncertainty around whether the vaccine will prevent people getting the virus, or prevent them from passing it on or prevent the virus from causing serious harm. The government is working on the assumption that by the time vaccines are available to people living in Scotland, much more will be know about all of this from the latest phase of clinical trials – and the Health Secretary said that it will be safe. She urged anyone who is offered the vaccine to go and get it.
The vaccine will require to be approved by the Medicines and Healthcare products Regulatory Authority (MHRA). After the announcement by Pfizer that their vaccine was almost 95% effective, MHRA Chief Executive Dr June Raine said: “The results reported by Pfizer today are very encouraging and add to their announcement from last week.
“We look forward to receiving the full results of the trials as soon as possible, after which we will rigorously assess the evidence of safety and effectiveness of the vaccine.”
As Pfizer have since advised the vaccine is now with the FDA in the US for approval.
Ms Freeman explained to MSPs at Holyrood there are a dozen vaccines in development, but the Pfizer vaccine is likely to be available first. She said:”Last week, we all had the good news from Pfizer, and this week we had more good news from Moderna, as they both announced over 90 per cent effectiveness in phase 3 clinical trials of their vaccines. Those are just two of 12 vaccines that are undergoing phase 3 trials worldwide, including three involving clinical trials here in Scotland. Pfizer and Moderna will now share evidence from their trials with the regulatory and advisory bodies to allow clinical and scientific review, with advice then to each United Kingdom health department to determine on safety and effectiveness.
“That is a critical point. I want to be clear to members and to people around Scotland that the safety of the Covid-19 vaccine is paramount to us. The global scientific, research and pharmaceutical communities have come together and worked as never before. We have seen unprecedented investment worldwide in research, development and manufacture, volunteers around the world—including here in Scotland—taking part in clinical trials, and driven and dedicated research teams. That is why we are seeing the front-running vaccines delivered in months, rather than in the many years that vaccine development can sometimes take. It is impressive, but it is not at the expense of safety.
“Each vaccine goes through a rigorous and independent three-phase testing process long before it can be licensed as safe and effective for use. Regulators such as the European Medicines Agency and the UK’s Medicines and Healthcare products Regulatory Agency review trial results and decide whether to approve the vaccine. During a pandemic, the timeframes can be compressed, but never at the expense of safety.
“Vaccinating the adult population—everyone aged over 18—in Scotland means vaccinating 4.4 million people. We have, rightly, worked across the four nations to secure the vaccines and secure agreement on the population share of the purchased doses for each of the UK nations.
“From December, we expect to have the first delivery of vaccines to Scotland. We are planning on the basis both that the Joint Committee on Vaccination and Immunisation is able to review the clinical evidence and provide Governments with a recommendation, and that the vaccine receives a licence.”
Who gets the vaccine first?
This has already been established by the Joint Committee on Vaccination and Immunisation (JCVI) which advises UK health departments on immunisation.
JCVI reported in September that the first groups who will receive the vaccine will be the oldest in the population, those in care homes and those who look after them, along with health service workers. But this broad outline may change in light of the full clinical data when that becomes available.
The current thinking is based on evidence which ‘strongly indicates’ that Covid-19 affects those who are older or who have underlying health conditions more seriously than other people.
We have been advised that the likely time scale if the first vaccine becomes available for distribution in December, is that the general population will be offered vaccination around the end of March/beginning of April.
This will be the largest vaccination programme conducted in Scotland and many people are already working on the logistics of delivering it. Clearly there has been learning from the flu vaccination programme conducted each year. Whether it means bringing people to the vaccine, or taking vaccine to the people depends on some final bits of the jigsaw such as the stability of transporting the vaccine at certain temperatures. But The Scottish Government has already identified 22 ultra low temperature commercial storage freezers which will be used to store it. Depending on final information the logistics of delivering the vaccine are already being discussed at high level in some detail.
The Health Secretary confirmed that this is a huge exercise. She said: “We need a workforce that is diverse in its skills and availability. Our planning assumption is that we will need over 2,000 vaccinators and support staff by the end of January, so that—vaccine availability and delivery schedules yet to be confirmed—we will be able to vaccinate around 1 million people by that time.
“We need registered clinicians to vaccinate and to supervise vaccinations, as well as nurses and doctors, but also the wider clinical workforce such as pharmacists, dentists and optometrists. We have now concluded an agreement with the British Medical Association on terms and conditions for general practitioners’ involvement in the programme and are working through agreements with other independent NHS contractors.
“However, we also need a workforce that understands the importance of logistics, minute planning for delivery, location set-up and building, and Covid-safe locations, as well as the importance of data collection and performance management. Scotland has an excellent track record on vaccinations, but this will be one of the biggest civilian logistical challenges in our lifetime, so we have strengthened our NHS planning teams, engaging with local authorities, local resilience partnerships and the military.”
The Pfizer flu vaccine requires two doses 28 days apart. One of the other pieces of government advice is that if you have not yet had your flu vaccine you should do so now. It will ensure that if you are in one of the early groups to be offered the Covid-19 vaccine you will be able to have that as quickly as possible.