By Katherine Hutchinson
In early November last year, reports began to emerge that a Covid-19 vaccine produced by pharmaceutical firms Pfizer and BioNTech had proven to be more than 90% effective in preventing the disease in clinical trials. This came as the first major bit of Covid-related good news in, well, ever.
Less than a month later the UK government became the first in the world to approve the vaccine, granting emergency-use authorisation. Days later, Margaret Keenan from Coventry became the first person to receive the vaccination, a week before her 91st birthday, and so began the nation’s largest ever immunisation programme.
Just before the turn of the new year, the country received its second dose of good news: the Oxford-AstraZeneca vaccine had also been approved for use and would begin to be rolled out within days. Not only would this mean that more people could be vaccinated in a shorter time frame, but there were also logistical benefits.
The Oxford vaccine is produced in the UK and so does not carry the same supply
risks as the Belgium-made Pfizer jab. It can also be stored at fridge temperature, unlike the Pfizer jab which must be held at -70 degrees centigrade, a problem for local health centres that don’t have the necessary storage equipment. Both, however, have proven to be safe and effective in preventing the disease.
It is safe to say that the light at the end of the Covid tunnel is much brighter now than it was just months ago, and it is all thanks to the mass vaccine operation taking place across the country. Each week sees hundreds of thousands more people getting protection against the virus. In Faversham this humongous task is being undertaken by staff at Faversham Medical Practice and Newton Place Surgery.
Between 8 December and 21 February, 534,820 vaccine doses (including both first and second doses) were administered in Kent, out of a total of 2,529,128 in the south-east. And 28,727 people in the Faversham and Mid Kent constituency had received at least one vaccine dose.
Since then, GP practices and vaccination centres have been given the go-ahead to begin inviting patients in cohorts 5 (aged 65 and over) and 7 (aged 60 and over) while continuing to prioritise cohort 6, which includes clinically vulnerable 16- to 64- year-olds, carers and young adults in residential settings. Patients in cohorts 5 and 7 are currently being invited by vaccination centres and pharmacies to get their first dose, but they can wait to be invited by their local GP if they prefer.
The logistical complexities of the vaccine rollout have meant that Newton Place Surgery and Faversham Medical Practice have been working in closer collaboration than usual. Together they form a Primary Care Network, set up to provide coordinated care services to the local community. This network has become more important than ever during the pandemic.
The Pfizer vaccine is extremely delicate and so cannot safely be moved between sites. This means that it can only be administered at one of the surgeries: Faversham Medical Practice. In order to give their patients access to the Pfizer jab, Newton Place staff take over four of Faversham Medical Practice’s consultation rooms three days a week, sometimes creating confusion among patients and inevitably adding extra pressure to the everyday running of the practice.
Vaccine scepticism has been one issue plaguing media coverage of the immunisation programme. Public figures, from the Queen to the Dolly Parton (who even changed the lyrics to her song Jolene to, “Vaccine, vaccine, vaccine, vaccine, I’m begging of you please don’t hesitate”), have released statements encouraging people to get the jab when they are offered it. Unfortunately, this hasn’t convinced everyone.
At the end of last month it was revealed that by 20 February more than a fifth of NHS healthcare workers in England had still not received the first dose of the vaccine, despite the government’s claim that all had been offered it. According to Dr Alastair Gould, a senior partner at Newton Place Surgery, uptake in Faversham has, thankfully, been good.
In the week beginning 22 February, 4,316 vaccines had been given to Newton Place patients and only 90 people (just over 2%) declined, with the vast majority being “very pleased” to receive it. For some elderly patients it would have been the first time out of the house since lockdown began in March last year.
The pandemic has taken an immense toll on the mental health of millions of people, and none more so than healthcare workers. Throughout, NHS staff have battled the disease tirelessly, with many enduring extreme workloads and unrelenting stress. The psychological damage of the past 12 months has been so great that an extra £15 million has been invested in strengthening mental health support for staff. Now, those same workers are responsible for implementing the unprecedented immunisation programme and the extra workload it entails.
Dr Gould describes the atmosphere at Newton Place as being relatively relaxed, in part due to the need for social distancing within the clinic, limiting the number of patients inside at any one time. Where the process becomes more intensive is in booking people in to receive the vaccine. The practices are often only given a few days’ notice of when they can expect new batches to arrive.
The Pfizer vaccine can only be stored for three days. Within that time staff must contact 1,170 people to come in to receive their dose. This comes on top of keeping normal appointments and surgeries running as efficiently as possible. Dr Gould says the ongoing success of the rollout across Faversham, alongside keeping normal services running as well as possible, is due to the combined efforts of administrative and healthcare staff.
The vaccination rollout has also been aided by the return of retired staff to the practices. Doctors, district nurses, practice nurses and nurse practitioners have all re-joined the workforce to help ensure the successful implementation of the immunisation programme across Faversham, providing vital support to staff. This added help will become even more crucial over the coming weeks and months as the vaccination clinics continue to put strain on routine services.
Control over the rollout has been centralised to a large degree, allowing for a fairly even spread of the vaccine across the nation. Local authorities have been working closely with NHS England to ensure the process runs as smoothly as possible. Although the decision to switch from a three to a twelve-week gap between first and second doses, initially cause controversy
Dr Gould reiterates the government’s justification for the decision, that going forward and administering as many single doses as possible would afford a greater
number of the most vulnerable people in the country at least some protection. The evidence surrounding the efficacy of the Pfizer jab after one dose is conflicted, and the British Medical Association initially described the decision to increase the gap between doses as ‘difficult to justify’. However, more recent data suggests a single dose of the vaccine does provide good protection, although definitive conclusions cannot yet be drawn. Results are much clearer for the Oxford-AstraZeneca jab, which may actually be more effective with a 12-week gap between doses.
The vaccination effort in Faversham is already having an effect on local Covid rates. In government data the town is split into two areas, east and west. In the week ending 27 February, only five cases were recorded in Faversham East, down 28.6% from the previous week and with a much lowercase rate than the national average. In Faversham West the outlook is even brighter with fewer than three cases reported, meaning rates are “suppressed”.
These low Covid rates in Faversham fall into a trend of steady decline seen throughout
January. They are a world away from the situation in early December when Swale saw the highest rate in the entire country, at 619.7 cases per 100,000 residents. Even less than two months ago the overall number of cases in Faversham stood at 93, which is 13 times higher than they were at the end of February.
This ongoing progress in the fight against the virus can largely be attributed to the public’s adherence to stringent lockdown measures. If all goes to plan, mass immunisation will be the final nail in the coffin of the Covid-19 pandemic. While the annual Hop Festival has sadly, already been cancelled, the work being done by staff at Faversham’s healthcare centres and across the rest of the country will hopefully mean that summer 2021 may yet be saved.