We started our practice Covid-19 vaccination programme in Bristol last weekend. There had been weeks of heightened anticipation and build-up where we had all been abuzz and desperate to start. Many patients contacted us, asking about their cohort groups and likely timelines for vaccination. We have no control over this and could only tell the patients to wait until contacted.
Our practice was ready to go for the week of 14 December when wave one practices started vaccinations. But our deliveries were stood down that week and then again a few weeks later. We had put our case to NHS England, like other practices in the country that had opted to vaccinate, giving information on our readiness to go, and cohort numbers for the over-80s and care homes. Logistical factors for delivery of the vaccine were cited as the main hurdle but it has been incredibly frustrating.
Finally we received confirmation last week that we could start. We contacted all our 600 over-80s cohort to book them in for their first inoculation with the Pfizer/BioNTech vaccine. At the start of the same week Ashton Gate mass vaccination centre had opened in Bristol and they were also contacting the over-80s, which could potentially create confusion. Most of our patients chose to book with the practice, citing geography and familiarity.
The night before the vaccinations I couldn’t sleep and was running through the whole operation in my head. There had been huge amounts of behind the scenes preparation. We had also completed Covid-19 vaccination learning modules a few weeks earlier and I went through these again and our practice video simulation detailing patient flow and clinical room usage. I was going to be one of two GPs involved in coordinating, troubleshooting and overseeing how vaccines were made up and administered.
The Pfizer vaccine comes thawed, with a five-day window to use it in, enabling us to store it in standard fridges. We will be using this for all patients who can come to the surgery. We expect to receive the Oxford/AstraZeneca vaccine this week and initially plan to use it for our housebound patients until we have enough stock to be able to also use it in the surgery, alongside the Pfizer vaccine.
We had excellent turnout with most of those who had been invited arriving for a steady stream of vaccinations. But there were no long queues and the weather was kind to us. We vaccinated more than 80 patients an hour and nearly 900 patients in one day. We were also able to make full use of each vaccine vial with no wastage. There has been a big drive to ensure each vial, which contains enough vaccine to make up six doses of 0.3ml each, is utilised to get the full number of doses from it. So some patients and healthcare staff are kept on standby to come in at short notice to be vaccinated. I was vaccinated by a neighbouring practice three weeks ago, when they had some doses left over, which they offered to frontline health staff.
And so it was that at the end of our first day of vaccinations we had five doses left in the last vaccine vial. Staff were exhausted – many had worked 11 hours – but there was a big push and determination to call in more patients to use up all the vaccine, down to the last 0.3ml. We ended up ringing a few local health and social care staff and a 79-year-old man who had been on a backup list. Just as it had been an emotional moment when the first vaccine of the day had been given, so it was that night when the last one was administered to him with all of us watching, too moved to speak. It had been a good day. This week we will do it all over again.
The same day, nearly 200 miles away, my 78-year-old father was having his Covid-19 vaccination in a hub in Ramsbottom, near Bury. He had been invited the day before and had rung me at work to tell me that his turn had come. He was so excited he could not speak. After his vaccination he sent me a text to say it had all gone smoothly and that he had worn a suit for the occasion. That brought tears to my eyes. My parents, who have always been independent, have been strictly shielding since March, as my father is on immunosuppressive medication. Being vaccinated means not just staying safe from Covid-19, but also a chance to be able to see their loved ones, especially the grandchildren, something that they have not been able to do for nearly a year.
So far we are on track to vaccinate the first four priority groups by mid-February, but this hinges on smooth delivery of vaccine stock. We hope to start working down each of the four groups from this week and administer the second doses over the next eight to 12 weeks.
The government’s target to vaccinate all adults by September is ambitious. To succeed, it will require unprecedented levels of coordination, staffing and round-the-clock clinics. Our practice is up for the challenge, but there’s a long way to go before we can return to any sort of normality. Until then, we cannot let down our guard until Covid-19 is truly under control.