Continuing the success of COVID vaccinations comes with big challenges

Chris Hopson profile picture

21 June 2021

Chris Hopson
Chief Executive
NHS Providers


Martin Marshall profile picture

Martin Marshall
Chair
Royal College of GPs


There is huge focus on COVID-19 vaccinations as the NHS seeks to vaccinate as many people as possible in the quest to ease social restrictions on 19 July.

This is just the latest step in an extraordinary NHS achievement. In six months our defences against the virus have been transformed. Vaccines are not just saving thousands of lives, they also offer a vital route back to the freedoms we all miss so much.

This has been a triumph of detailed planning, collaboration and commitment, hugely ambitious in scale, speed and complexity, highlighting yet again the enormous mobilising power of our entire National Health Service. In England alone, more than 60 million vaccinations have been delivered, including double-doses for 60% of the population.

That's required unprecedented, effective, close-working between trusts, GPs, new Primary Care networks, local authorities, pharmacies, volunteers and the national team leading the campaign. The work has been, truly and genuinely, world class.

So the 19 July target to offer a first dose of the vaccine to all adults is both a finishing line and a staging post. We will have to live with the COVID virus for a long time to come, building a long term set of defences, as we've done with influenza.

This will require a sustainable approach to COVID vaccination. One that enables the GPs and trusts we represent to carry on vaccinating whilst meeting the other pressures they face. Tackling the care backlogs that have built up as a result of COVID-19 and treating the new mental health and long COVID patients the pandemic has created. Coping with the significant long-term workforce shortages and increasing demand that are putting intense pressure on GPs and other healthcare professionals, with many at risk of burnout, exacerbated by the load they've borne over the last 15 months.

The prime minister last week spoke of a planned booster campaign in the autumn. This and the possibility of an annual COVID-19 vaccination approach will bring new and different challenges.

The first challenge is to rapidly complete current scientific work to answer the basic questions around what vaccinations should be administered to whom, when, in the next stage, to maximise protection.

How long will protection from the original double doses last? Will boosters be necessary and, if so, should we administer a different vaccine to the original double dose? How do we incorporate new vaccines, once approved? And how will the process of tweaking the vaccines to meet emerging variants of concern actually work? Influenza vaccines are tweaked annually – will we do the same with COVID-19 jabs or should we be ready to move faster and more frequently?

We also need to know to what extent can we combine COVID-19 and flu vaccination campaigns. Combining – for example a COVID-19 jab in one arm and a flu jab in the other – would make a massive difference. And we need to decide whether we should be vaccinating children. The Delta variant has shown they are a strong vector of transmission and vaccinating them could help keep them in school without the disruption of periodic home isolation. But vaccination will bring the added complexity of obtaining the required consent.

Any of these changes – for example, a mix and match approach to vaccines, or adding more vaccines to our supply roster, or combining flu and COVID-19 jabs, or vaccinating children – will add significant complexity to the frontline delivery task.

We wouldn't be able to start any booster or re-vaccination campaign until these questions have been answered. Science will help determine who gets what, and when. But with the flu campaign due to start in September, decisions will soon be needed.

We'll also need to make the COVID-19 vaccination programme part of NHS "business as usual", building on the strong work we have done so far. The government and national NHS bodies would need to ensure we have enough supply of the right vaccines and set the framework for the way it is distributed, including as much advanced notice of vaccine supplies as possible.

Moving from a one off emergency response to ensuring the NHS can vaccinate everyone who needs a COVID-19 jab year in year out, means empowering local NHS bodies to make COVID-19 vaccination part of their everyday work. Given their ability to bring together GPs and Primary Care Networks, trusts, local government and the voluntary sector, integrated care systems could play a key role here.

We'll need to create the right sustainable workforce approach, maximising the use of volunteers but ensuring NHS professionals can also deliver their other work. We'll also need to invest in appropriate NHS premises, as we won't be able to rely on borrowing other community facilities as we've done over the last few months. The pandemic has shown the importance of having safe, modern, accessible premises available in general practice and across the NHS.

It is inspiring to see how much has been achieved in so short a time. This gives confidence that the NHS will surmount these new challenges to build a successful, sustainable, long term COVID-19 vaccination programme that sits alongside our other vital work. GPs and their trust colleagues are determined to tackle this challenge together. But we will need the right resources and support. As we move to the next phase of COVID vaccinations, we need to recognise the reality of what continuing success will require.

This piece was first published in the Times Red Box.

About the authors

Chris Hopson profile picture

Chris Hopson
Chief Executive
@ChrisCEOHopson

Chris Hopson is the chief executive of NHS Providers. He joined in September 2012 after a career in politics, commercial television and the civil service. Read more

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