Why is the UK’s ‘World Beating’ COVID-19 Vaccination ProgrammeStalling?
Social scientist Colin Talbot analyses the summer slowdown of the Government’s mass immunisation campaign
Britain’s mass immunisation campaign against COVID-19 began less than a year after the disease was first detected when, on 8 December 2020, 90-year-old Margaret Kennan received her first of two doses of the PfizerBioNTech vaccine. But, since then, though often hailed as ‘world-beating’, how has the roll-out gone?
Secrecy, Supplies and Brexit
The thing Britain did well was to move fast and big. The chair of the UK’s Vaccine Taskforce, Kate Bingham, who was appointed to oversee the mass immunisation programme last May, has received praise for the success of the initial purchasing project. But it really wasn’t that hard. With an open cheque-book from the Treasury, Bingham and her team simply placed massive bets on the half-dozen or so most likely candidate vaccines. Orders for vast amounts of vaccines were placed and partially paid for – far more than the country could use if they all proved viable (which most of them did).
The Government is right to claim that it did this outside of, and faster than, the collective purchasing and distribution system set up by the European Union. But it has been disingenuous in claiming that we could do this because of Brexit. Both the purchasing and authorising the use of the vaccines was done while the UK was still effectively a member of the EU and the European Medicines Agency. Any other EU country could have done the same – they just chose not to.
One curious aspect of this purchasing effort was that the Government regarded it as a significant state secret: it was paranoid about releasing details of contracts, especially supply schedules agreed with the various vaccine producers. In January, both the UK and the Scottish Government published plans for their vaccine roll-outs, but the Scottish Government’s plan contained a timetable of when and what vaccine supplies it expected. This was important to help the Scottish health system ‘gear up’ for delivery.
However, the Westminster Government demanded that the Scottish Government withdraw its plan on ‘national security’ grounds: it feared that Britain’s ‘competitors’ for vaccine supplies – mainly the EU – could infer from the Scottish document what delivery schedule the whole of the UK had contracted for. Amazingly, the Scottish National Party-led Scottish Government agreed to this demand and subsequently republished the plan with the offending vaccine numbers removed.
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Getting it Into Arms
The next issue was distributing and administering the vaccinations. The danger was that the Government would make the same mistakes it did with the ‘Test and Trace’ system: bypass existing public services and bring in inappropriate private sector contractors to set up from scratch a vast, cumbersome, national organisation.
Fortunately, it was clearly convinced that we already knew how to do mass vaccinations and had the apparatus in place.
Every year between September and the following February, the NHS delivers more than 10 million flu vaccinations to the over-65s, pregnant women and children. Unlike Test and Trace, the Government decided to build on what was already there.
The vaccination programme was largely devolved to local CCGs (Clinical Commissioning Groups) and GPs in England. Despite some initial hiccups with supplies, it worked. Vaccination numbers rose to about 400,000 doses a day over the January to March period this year.
Although there was some inevitable chaos in the targeting of priority groups – with a certain amount of ‘postcode lottery’ on who received the vaccine – by and large that worked well too.
But there was one huge hurdle to come. Even though the Government had decided to extend to time between the first and second vaccine doses from four to 12 weeks, there would be an inevitable crunch point as those who had one jab became eligible for their second.
Doses jumped from around 400,000 a day to around 600,000 in mid-March, but then there was a drop in early April down to an average of less than 200,000 a day – caused, in most accounts, by a gap in vaccine supply. (Whether this was due to poor contracts, competition from other countries, or technical hitches is unclear). Then vaccination rates picked up again to around half a million a day for most of April and May.
Some of us who had been tracking the numbers already thought that this was too slow and that it should have been closer to 7-800,000. But worse was to come. From the end of May, daily rates started to dip and gradually fell from half a million to around 200,000 a day in July. Of those, only a quarter – 50,000 on average – are first doses
What is Causing the Slowdown?
There are about 20 million people in the UK – including 15 million or so who are aged under 18 – who have had no vaccination at all. Of those who have had one or two doses, a significant number can still get the Coronavirus and pass it on. Roughly speaking, about half of the population can still get the disease and spread it.
If the Government was to vaccinate everyone aged 12 and over – as many countries are doing – there are probably another eight million-plus people who need to be fully vaccinated. At current rates of delivery, that would take another three to four months, possibly longer given how low first dose rates are now.
So why has the rate of does dropped so low? Some are speculating it is a supply problem – but that is difficult to know because of the Government’s unwarranted secrecy.
It could be an operational problem. The Pfizer vaccine, which is the main vaccine given to younger people, needs to be stored at temperatures between -80 and -60 °C and only lasts a few hours at room temperature. There are anecdotal reports that large amounts of the vaccine have been dumped unused. This could be linked to poor take-up rates amongst the young or changes to the organisation of the vaccine delivery. The ‘drop-in’ and ‘pop-up’ approaches look good for the cameras, but do they really work in practice?
As someone who is ‘clinically extremely vulnerable’ and started shielding at the end of last February, I was as delighted as anyone about the development and roll-out of vaccines against the Coronavirus. But the fall in vaccination rates is alarming. Most puzzling of all is the lack of public interest in this.
The media has largely remained silent, except for the odd report blaming ethnic minorities and the young for poor take-up. The Labour opposition seems to have lost its tongue – perhaps afraid to criticise the one big perceived Government success during the pandemic.
It may be that they are suffering from a case of ‘they think it’s all over’ syndrome. It isn’t.
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