Pharmacies are ready to help with Covid vaccinations but they are not clear when they will be called on or by whom, says Mohammed Hussain...
As 2021 starts we find ourselves still very much in the shadows of 2020. Viruses do not conform to neat time slots, so it is likely that the story of 2021 will continue to be the story of Covid-19. Our best hope is that the second half of 2021 will be a tale of recovery, enabled by the vaccines that are now being rolled out.
Vaccines are the key to unlocking the Covid-19 caseload that weighs heavy on the NHS across the UK. They are, however, only one element of the solution and the strategy should still be focussed on reducing virus transmission.
Covid-19 can mutate, and it is likely that repeated, perhaps annual vaccination akin to the flu jab, will be required to maintain protection. The Prime Minister has committed to vaccinating the most vulnerable 14 million people in the population and front-line health and care staff by mid-February – that’s an average of 2 million vaccinations a week.
This should be a huge national effort, recruiting all available providers: however, as a community pharmacist I have been sorely disappointed. The first vaccine to be approved in the UK from Pfizer-BioNtech did pose logistical challenges because of the need to maintain an ultra-cold chain, the need to minimise handling of the vaccine, and its limited viability once defrosted and mixed ready for use.
It was understandable therefore that pharmacies were not considered as viable sites.
The AstraZeneca vaccine, however, brought the promise of mass vaccination as it is much more akin to the traditional flu jab. We all know community pharmacies have made flu vaccination a huge success, vaccinating 1.7 million patients in 2019/20 and already having vaccinated 2.3 million in 2020/21 with 3 months still to go for this season.
Like many pharmacists we were keen to offer our facilities and resources in service of the nation in its time of need. We knew there would be problems when we examined the NHS England expressions of interest requirements for vaccination sites – the commitment to vaccinate 1,000 people a week, security guards, parking and so on.
Notwithstanding these challenges we applied to provide the service. Two weeks later we were notified that we would not be required as the model was to have massive community vaccination centres. You may recognise a theme here: the government made the same choices when it came to testing, preferring massive new laboratories over smaller existing providers.
Meanwhile, vaccinations started with many pharmacists (but not pharmacies) supporting the GP-led centres targeting NHS staff and the over 80s.
In our area we were fortunate that the local PCN has a good relationship with the pharmacy and invited me and the team to a walk-in vaccination service for NHS staff.
For most pharmacy staff though, there is no clarity on when they will be called or by whom. The vaccination of the community pharmacy workforce has been side-lined, with no clear strategy to manage this cohort. Pharmacy staff are front line staff and need to be vaccinated as a priority.
With the third lockdown across most of the country the urgency to vaccinate the nation has never been greater. Even the Daily Telegraph castigated ministers over their refusal to accept the offer from pharmacies to act as vaccination centres. It would appear pharmacies are good enough for the flu jab, but not the AZ Covid vaccine.
In a rare example of all the parties in pharmacy pulling in the same direction, with the PSNC, RPS, and many cross-party MPs and Lords questioning the absence of pharmacy from the strategy, we had another government U-turn and the first pharmacy sites were announced. The expectation is that up to 250 sites will be vaccine centres by end January and more to follow in February.
This is a welcome development, but there are over 11,000 pharmacies in England. Pharmacies are like the small boats at Dunkirk, they may be small compared to the community vaccination hubs, but they are dedicated, and their spread means they can contribute in all parts of the country.
I just wish the NHS and politicians would see this too.
Mohammed Hussain is a non-executive director at Bradford Teaching Hospitals Foundation NHS Trust and an independent contractor.