20 December 2020

Dear colleagues,

Thank you again to all those who have continued the huge task of vaccinating patients and staff against coronavirus. The pictures on social channels and in the media have been incredible.  

This week we held supervised walk throughs of the care home vaccination model which included GP led pack down of vaccine to take it in to care homes. We are now rapidly rolling this out from tomorrow and further details can be found below.

The flu vacation programme also continues with many of you running clinics over the weekend.  We are very grateful for all you are doing for your local communities in these unprecedented times.

This special Sunday bulletin outlines a number of important developments with regards to the COVID vaccine rollout and in response to the government’s announcement on further restrictions with parts of the country going into Tier 4.

Nikki and Ed

COVID-19 updates and guidance

COVID vaccination in care homes

Over the next few days we will initiate the delivery of the vaccine through local vaccination sites to care home residents and their staff, starting with larger care homes. The roll out will begin during week commencing 21 December through wave 1, 2 and 3 sites, followed shortly by local vaccination sites in later waves. A letter has been sent to waves 1-3 sites with further details. The standard operating procedure for vaccination deployment in community settings has also been updated with a specific care home section.

We will be hosting a webinar on Tuesday 22 December at 1.30pm-2.15pm with further information.

Please order additional vaccine in order to vaccinate your care homes

We have written to all wave 1, 2 and 3 local vaccination sites offering additional batches of the COVID vaccine. If you would like a resupply please complete this webform on the local vaccination online site platform (Foundry) by 9.30am on Monday 21 December to request your delivery.  Note that you do not need to have a Foundry account for your site to complete the webform.

Our priority is to now vaccinate our care home residents and staff, and continue to vaccinate over 80s and health care workers. You can order a full pack (975 doses) and pack down yourself, or order packs of 75 doses to take straight in to your care homes.

If we do not hear from you, we will assume that you do not want to receive a vaccine resupply delivery. We will let you know about any further vaccine resupply opportunities as they arise. We will confirm your orders by email after they have been processed by Foundry. Please do not book patients into clinics until you have received email confirmation from us.

6th dose of the COVID vaccine

MHRA have produced further information on the 6th dose of the COVID vaccine and how this can be used. Consumables to support the use of the additional dose will be sent directly to designated sites, and added to second dose deliveries. 

Healthcare professionals must always use the correct volume of diluent, and after dilution must aim to secure five full 0.3ml doses of this Pfizer-BioNTech COVID vaccine in line with the manufacturer’s instructions and as outlined in the Information for Healthcare Professionals. After that has been done, there may be potential for a sixth full dose with some vials due to variances in fill volume and the syringe/needle hold up volume combinations used. This should be subject to health care professional judgement on a case by case basis.

The manufacturer has stressed care should be taken to ensure a full 0.3 mL dose will be administered to the patient from the same vial. Where a full 0.3 mL dose cannot be extracted the contents should be discarded. The vaccine does not contain a preservative so it is best practice for all doses to be used as soon as possible after dilution, although all doses from a single prepared vial must be administered within 6 hours of the time of dilution. If further advice is required, in hospitals and vaccination centres please discuss with your Chief Pharmacist, and in local vaccination services, your Lead Responsible CCG Chief Pharmacist and Lead GP.

National protocol

The national protocol for COVID-19 mRNA vaccine BNT162b2 (Pfizer/BioNTech) has been published. This protocol is for the administration of COVID-19 mRNA Vaccine BNT162b2 by appropriately trained persons.

Reintroduction of shielding advice in Tier 4 areas

From 00:01 on Sunday 20 December, the government has introduced Tier 4 restrictions to some areas (London and parts of the South East). The DCMO has confirmed that shielding advice for Clinically Extremely Vulnerable (CEV) individuals will be reintroduced in these Tier 4 areas. This shielding advice is identical to that which was in place nationally from 5 November to 2 December.

Those at highest risk in Tier 4 areas and advised by government to shield are eligible for support including free delivery of medicines (where friends, family, or local volunteers are unable to provide help) and statutory sick pay where unable to work from home. CEV individuals in Tiers 1-3 should continue to follow the government advice for those at highest risk specific to each of these tiers.

The government is writing to all CEV patients affected by the shielding advice in Tier 4 areas to inform them of this guidance. Letters will be sent in the week commencing 21 December and will be published here. These letters will emphasise the importance of CEV individuals continuing to engage with the NHS, and confirm that they will be prioritised for the COVID-19 vaccination in advance of the general population (as per current JCVI guidance).

The government is aware that the letters to CEV individuals may face postal delays over the Christmas period. Patients for whom the NHS holds an email address will receive the letter via email this week. The government is planning to use national and local media to communicate the advice to patients quickly.

As during the previous period of shielding advice, this will be an inevitably difficult and worrying time for Clinically Extremely Vulnerable people. We anticipate that patients may have questions about the advice they should follow. We are very grateful for your continued efforts in supporting those at highest risk from COVID-19 during the pandemic and will be in touch to provide further updates as necessary.

COVID-19 Vaccination Programme workspace