How Britain’s COVID-19 vaccination rollout will work

LONDON — Now that British regulators have become the first to authorize the COVID-19 vaccine developed by American drugmaker Pfizer and Germany’s BioNTech for emergency use, how will that country implement what potentially will be its biggest-ever immunization program? Here’s a look at what’s known about Britain’s vaccination plan:

How much vaccine does the U.K. have?

Not enough. The United Kingdom has put in orders for 40 million doses, which can inoculate 20 million people, as each person gets two doses 21 days apart.

Other vaccines will be needed for all the 53 million or so people eligible for shots. The U.K. plans to immunize only those 16 or older.

When will the rollout begin?

The plan is to start a phased rollout of the Pfizer/BioNTech vaccine early next week from centers including 50 “hospital hubs” in England.

Around 800,000 doses are slated to arrive from Belgium in the coming days. The aim is for the bulk of the first deliveries to be used on the most “at-risk” groups — nursing home residents and their caregivers as well as people over 80.

The National Health Service will take the lead in the rollout of the vaccine, which eventually will expand to pharmacies and specially built vaccination centers.

How will the rollout work?

Because the vaccine must be stored and transported at about minus-94 degrees Fahrenheit, there are clear logistical issues. Fortunately, the vaccine is stable at normal refrigerator temperatures, between 35.6 and 46.4 degrees Fahrenheit, for a few days. That means it can be stored locally ahead of being administered.

Another complication arises from doses coming in packs of 975 that cannot be divided at the moment, making it impossible to deliver vaccines to individual care homes. Simon Stevens, chief executive of NHS England, said he hoped authorities will approve a safe way of splitting up the dose packs so the jabs can get to care homes this month in the “first tranche of priorities.”

How long will the vaccination effort take?

Months. The British government aims to have the most vulnerable sections of the population vaccinated by April.

Because the U.K. won’t have enough of the Pfizer/BioNTech vaccine, it will need other ones. Two candidates are being assessed. The one from American biotechnology company Moderna had similar efficacy rates as Pfizer/BioNTech’s. Another vaccine, from the University of Oxford and British pharmaceutical company AstraZeneca, had a lower efficacy rate but is the cheapest.

The U.K. has bought 100 million doses of the Oxford vaccine. If approved, it is widely expected to be used on people who are not in the vulnerable groups listed in the first phase of Britain’s immunization program.

Will the U.K. make vaccines compulsory?

No. Taking the vaccine will be voluntary, but the government and public health bodies are urging everyone to get it. There will be no specific precautions required for anyone who has already had COVID-19, and there will be no mandatory testing for the virus.

Who will be vaccinated first?

The most vulnerable. The independent Joint Committee on Vaccination and Immunization, which advises the British government, said those most at risk of dying from COVID-19 should lead the priority list. So elderly people in nursing homes and their caregivers will be the first priority, followed by people over 80 and front-line health workers.

And then who’s next?

Everyone 75 and older should be vaccinated next, according to the Joint Committee, followed by those 70 and over and people deemed to be clinically “extremely vulnerable.”

During the first phase of the program, Britain has created nine separate groups down to those 50 and above. Overall, it hopes that between 90-99% of people most at risk of dying from COVID 19 will be immunized during the first phase.

What about access for other hard-hit groups?

As the rollout gathers steam, the JCVI is also advising local NHS providers, public health teams and community leaders to keep an eye out for any potential health inequalities linked to ethnicity, deprivation or access to health care. Studies have shown a disproportionate number of people from poorer households and from ethnic minorities have died during Britain’s coronavirus outbreak. The U.K. has seen nearly 60,000 virus-related deaths, Europe’s highest death toll in the pandemic.

How long before immunity kicks in?

Within a month. Data from the vaccine trials, which involved more than 40,000 people around the world, show a similar immune response, irrespective of age, race or country the volunteers lived in. Partial immunity occurs after the first dose, but British regulators expect people to become immune about seven days after the second dose. It isn’t yet clear how long that immunity lasts.

What’s the long-term plan?

The U.K. will set up a monitoring program for things such as side-effects, which are expected to be modest, lasting a day or so.