NHS staff will no longer get the coronavirus vaccine first after a drastic rethink about who should be given priority, it emerged last night.
The new immunisation strategy is likely to disappoint and worry thousands of frontline staff – and comes amid urgent warnings from NHS chiefs that hospitals could be “overwhelmed” in January by a third wave of Covid-19 caused by mingling over Christmas.
Chris Hopson, the chief executive of NHS Providers, said: “If we get a prolonged cold snap in January the NHS risks being overwhelmed. The Covid-19 restrictions should remain appropriately tough.
“Trust leaders are worried about the impact of looser regulations over Christmas.”
Frontline personnel were due to have the Pfizer/BioNTech vaccine when the NHS starts its rollout, which is expected to be next Tuesday after the Medicines and Healthcare products Regulatory Agency (MHRA) approved it on Wednesday.
However, hospitals will instead begin by immunising care home staff, and hospital inpatients and outpatients aged over 80. The new UK-wide guidance on priority groups was issued by the joint committee on vaccination and immunisation (JCVI) amid uncertainty over when the rest of the 5m-strong initial batch of doses that ministers ordered will reach the UK.
NHS personnel will be able to take the vaccine into care homes to immunise residents later this month if, as expected, the MHRA agrees that the batches of 975 doses it comes in can be subdivided and the stability and safety of the drug be maintained.
Dr Chaand Nagpaul, the leader of the British Medical Association, said it backed care home residents getting the jab first. However, that means NHS staff will be left at higher risk of getting infected and potentially dying, he added.
“Doctors and other healthcare staff will recognise the need to vaccinate care home residents and older patients first, but will likely be frustrated at the government’s inconsistent messaging changing from yesterday to today.
“In the first wave, we saw far too many health and social care workers become incredibly sick with Covid – with many tragically dying – and therefore those working on the frontline need to be given the opportunity to get protected early,” he said.
NHS bosses have warned the 800,000 doses that comprise the UK’s first consignment from Pfizer’s manufacturing plant in Belgium may be “the only batch we receive for some time”, raising questions about how soon further supplies will arrive and how long frontline personnel and vulnerable groups will have to wait for their two jabs.
The change in priorities came as NHS Providers, which represents health service trusts in England, warned hospitals would struggle to maintain normal care in January if a fresh spike in infections after Christmas leads to beds again filling up with Covid patients, just as they are trying to manage their winter crisis.
NHS Providers and senior doctors made clear their anxiety that the government’s decision to allow up to three households to mix indoors in England between 23 and 27 December may prove ill-advised and backfire, because people will pass the infection on to vulnerable relatives. They pleaded with the public to exercise caution about how they socialise.
Dr Susan Crossland, the president of the Society for Acute Medicine, which represents hospital doctors, said they shared concerns “about the possibility of a Christmas wave of Covid in January, as well as the potent threat of this combined with ‘normal’ winter pressures exacerbated by cold weather”.
“In my opinion the relaxation of rules at Christmas is crass in the extreme. Combined with the bickering among politicians we have seen in recent days over the tiered system, it further weakens the importance of maintaining safety measures,” she said.
The NHS already being “on a knife-edge” due to intense demand and under-staffing means “it is the responsibility of everyone to limit contact and follow safety measures over the coming weeks and months to avoid mass stress burdening the NHS in the difficult winter months,” Crossland added.
One hospital boss said: “Normally people give their elderly relatives colds and flu and respiratory disease over Christmas and they end up in hospital in January. This year that’s more complicated. [There is a] very necessary relaxation over Christmas as people need a break, but recognise that there will potentially be an impact.” Their trust assumes January will be “really tough”, despite the vaccine’s imminent rollout, they added.
The World Health Organization on Thursday also advised that the threat of a “Christmas wave” emerging just after the new year should make people think twice before using the festive break from restrictions to attend gatherings with other people.
“We are looking, many of us, towards the holiday season, towards Christmas, whether it is called a third wave or a Christmas wave,” said Dr Hans Kluge, the WHO’s regional director for Europe. “The question we have to ask ourselves if we are going to come together, or we are thinking about an activity during which transmission can happen, we have to ask the question, is it really necessary?
“Because if the restrictive measures are being eased and the basic public health measures are not adhered to, whatever the country in the region or globally, absolutely there will be again an increase because the vaccine will come too late for this winter.”
A government spokesperson said: “This Christmas, families and friends can meet up in a limited and cautious way thanks to a balanced and workable set of rules. We agreed these UK-wide measures based on scientific and clinical advice on how best to minimise the risks, and following Sage advice we have introduced strengthened local restrictions to protect the progress gained during national restrictions and continue to suppress the virus.”
Meanwhile, Prof Jonathan Van-Tam, England’s deputy chief medical officer, has raised the prospect of people needing annual vaccination against coronavirus, in the same way they get immunised against winter flu. It is important to have further Covid vaccines available in case revaccination is required, he told the BBC.
“It is really unknowable at this point. But it is very much something that I see now as one of the goals only just over the horizon to get my head around, what if – and if – we will at any point in the future need to think about revaccination,” he said.