Further work needed before Covid vaccine can go to care homes, says Boris Johnson

Authorisation needed to split up 975-dose boxes into batches small enough for distribution

Further authorisation is needed from regulators before residents and staff can receive the coronavirus vaccine in care homes, Boris Johnson has revealed.

People in care homes are top of the official list of priorities for receiving the vaccine, alongside the over-80s, because they are considered by the Joint Committee on Vaccination and Immunisation (JCVI) to be most at risk of death or serious illness from coronavirus.

But the prime minister revealed that the Pfizer/BioNTech inoculation cleared for use by regulators today cannot yet be sent to care homes, because the cases it comes in are too large. Further authorisation is needed from the MHRA before the 975-dose boxes can be split up into batches suitable for distribution to homes.

Welsh health minister Vaughan Gething had already announced that it would not be possible to deliver supplies of the vaccine to care homes in Wales in the initial stages. 

Mr Johnson set no timetable for care homes to receive supplies, though NHS England chief Sir Simon Stevens told a Downing Street press conference that he hoped it would be this month.

Sir Simon said that the first jabs would be administered in around 50 hospitals as early as next week, before later being extended to groups of GP practices coming together in 1,000 local vaccination centres across England.

Distribution of the vaccine presents “immense logistical challenges” because it must be kept at -70C before reaching the location where it will be administered, said Mr Johnson.

Although the MHRA (Medicines and Healthcare products Regulatory Agency) has cleared the vaccine as safe for use, it has not yet approved a method for breaking up the large boxes arriving from Belgium, where it is produced.

“You can’t at this point just distribute it to every individual GP surgery or pharmacy as we normally would for many of the other vaccines available on the NHS,” said Sir Simon.

“The way we will do it is that next week, around 50 hospital hubs across England will start offering the vaccine to the over-80s and to care home staff and others identified by the JCVI.

“Typically they may be people who were already down to come into the hospital next week for an outpatient appointment. So, if you’re going to be one of those people, next week or in the weeks that follow the hospital will get in touch with you. You don’t need to do anything about it yourself.

“That will then be followed in the subsequent weeks with GP practices coming together in each area to operate local vaccination centres, and that will grow to over 1,000 places right across England where GPs will be in touch with their at-risk patients, inviting people to come forward for vaccination. As the extra vaccine comes available, we’ll be able to turn on more of those GP-led clinics.

“And then, if the MHRA, the independent regulator – as we expect they will – give approval for a safe way of splitting these packs of 975 doses then the good news is that we will be able to start distributing those to care homes.”

As more vaccine becomes available in January, jabs will eventually be offered in local pharmacies and GP surgeries, he said.

Sir Simon said the vaccine would be supplied to care homes “as soon as we have the regulatory sign-off”, adding that he expected that “with a fair wind” this could happen as part of the first tranche of immunisations taking place during December.

Mr Johnson said: “Of course we want to get it into care homes to protect the most vulnerable as fast as we possibly can. The JCVI has rightly said that care and residents must be a priority.”

But he said that rules around transport were “extremely important”.  

There was a risk, if it was improperly handled and fell below -70 degrees, that the Pfizer/BioNTech product would no longer be effective. And it was important to avoid the waste involved in sending almost 1,000 doses to a single care home.

Deputy chief medical officer Jonathan Van Tam said it was intended to get the vaccine into care homes “as soon as it is legally and technically possible”.

He said: “This is a complex product with a very fragile culture. It’s not a yoghurt that can be taken out of the fridge and put back in multiple times. It’s really tricky to handle.

“We will get there as fast as we can and we are trying extremely hard.”