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How is the Oxford Covid vaccine being deployed in England?


The biggest vaccination programme in the UK’s history will receive a major boost on Monday, with the first use of the Oxford/AstraZeneca Covid vaccine. We answer some key questions around how it will be deployed in England.

Can I get my first shot on Monday?

Probably not. Any new vaccine use will begin cautiously, however loud the fanfare around the arrival of the Oxford/AstraZeneca jab. The importance of this vaccine cannot be overestimated, because it is stored at normal fridge temperature and can be taken out and transported to care homes and wherever else it is needed very easily. But the first doses will be given at just a few hospitals “for surveillance purposes”, NHS England has said. That is just in case of any glitches, such as the allergy issue that arose when the NHS started using the Pfizer/BioNTech vaccine. That has now been resolved, incidentally, with guidance that people with allergy histories are fine, unless they are specifically allergic to any of the ingredients in either of the vaccines.

The photoops on Monday are likely to take place in Oxford hospitals, because the university invented the vaccine. But the Royal Free hospital NHS foundation trust in London, Guy’s and St Thomas’, University Hospitals of Morecambe Bay, Brighton and Sussex and the George Eliot ospital NHS trust will all start using the jab on Monday. Then later in the week, GP-led vaccination centres around the country will be sent supplies. There are 700 of these in England at the moment; another 180, plus 100 more hospitals, will start deploying the vaccine later this week, says NHS England.

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Who is top priority to get the Oxford/AstraZeneca jab?

Care home residents and the staff looking after them are at the top of the list, as has been the case. But this has been difficult to do so far because the Pfizer vaccine is not easy to store and transport, because of a requirement to keep it at -70C in the longer term. This time, this group will be able to be the main focus. GPs are being offered £10 for every care home resident they can vaccinate by the end of January.

Who has been vaccinated so far?

Official figures from NHS England – as opposed to politicians’ pronouncements – show that about 750,000 people have been vaccinated in England in the first three weeks since the Pfizer vaccine came online, of whom 524,439 were over 80. The over-80s and NHS staff are the second priority group. Ministers say about 1m people have received a vaccine.


Will things speed up now that we have the Oxford vaccine?

Hopefully, yes, because at a rate of a quarter of a million people being vaccinated each week, it will take all year to get through the most vulnerable – basically everyone over 50 and people with underlying health issues. The health secretary, Matt Hancock, says he is aiming for 2 million a week soon and rising. Tony Blair, whose institute has produced a report on scaling up, says we should aim for 3 million a week.

There may still be hold-ups. There is enough of the Oxford/AstraZeneca vaccine in the country for 4 million people, but most of it is not yet in vials in its finished form and nor has it all been batch-certified, as required under the temporary emergency approval given by the UK regulator. Only 530,000 doses are ready to go into people’s arms on Monday.

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Why is the second dose being delayed and will it leave people at risk?

This is public health pragmatism. The goal is to bring down the numbers of people vulnerable to infection as fast as possible, which will push down the amount of virus in the population and allow some restrictions to be lifted sooner. The reasoning is that both vaccines reach a high level of efficacy after the first dose – over 80% for the Pfizer jab and 70% for AstraZeneca’s. In the case of AstraZeneca, it seems there is evidence that protection lasts up to 12 weeks and maybe beyond. The second shot serves not to increase that protection, but to keep it going for longer. With the Pfizer vaccine, there is no publicly available evidence that the protection continues beyond three weeks, because the trial volunteers all got their second dose at that time.


People who receive a delayed second shot of the Pfizer vaccine will not be at 95% protection, but if the government is right, they will enjoy a high level of protection nonetheless and there should be less virus around. However, we will all have to continue with social distancing and mask-wearing until most people have had two shots.



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