Scottish health minister Jeane Freeman told the Scottish Parliament on 3 December that the 'particular logistical challenges' around the Pfizer/BioNTech vaccine - which must be stored at -70oC and comes in in 975-dose packs containing 195 five-dose vials that must be diluted before use - mean that delivering it to patients in care homes would be difficult.
But she told MSPs: 'Over lunchtime today following detailed discussions led by our chief pharmaceutical officer, we now have confirmation on the basis of the stability data that the Pfizer vaccine can be transported in an unfrozen state for up to 12 hours and can be stored undiluted for up to five days.
'I am also pleased to confirm that under certain conditions we can pack down to smaller pack sizes, both of which makes this vaccine more usable with minimum wastage for care home residents and for older citizens. So in effect we can take the vaccine to them or close to them and we will begin that exercise from 14 December.'
The announcement is the first confirmation that 975-dose packs of the only vaccine approved to date for use in the UK can be split up. This could simplify not only the rollout of vaccination to care home residents and housebound patients, but also may have profound implications for the rollout of vaccination to locations that may struggle to use large numbers of doses within a short timeframe.
Ms Freeman's comments come a day after the Joint Committee on Vaccination and Immunisation (JCVI) confirmed that residents and staff at care homes for older people were top of its priority list for vaccination against COVID-19.
The Welsh government has said that due to practical constraints around the Pfizer/BioNTech vaccine it 'cannot deliver this vaccine to care homes'. In England, the government has not ruled out delivering the vaccine to patients in care homes - but has announced that vaccination will begin next week in around 50 'hospital hubs', with deployment through 'local community services, including GPs' to follow.
A government statement on deployment of the vaccine said: 'Delivering the Pfizer-BioNTech COVID-19 vaccine is complex as it needs to be stored at very cold temperatures and moved carefully, so at first we will only be able to deliver it from “hospital hubs.” Defrosting the vaccine takes a few hours and then additional time is required to prepare the vaccine for administering.'
Care home residents
Asked today by GPonline for an update on plans for England following the Scottish health minister's announcement, the DHSC referred back to the following line from a statement on 2 December: 'As the JCVI has made clear, there will need to be flexibility in terms of operational challenges around delivery of the vaccine to those in care homes. In line with the advice, every effort will be made to supply vaccine and offer vaccinations to care home residents and we will deliver the vaccine according to clinical prioritisation and operational necessity.'
The BMA has said it does not expect designated GP practices across England - which are expected to deliver the bulk of COVID-19 vaccination for care home residents and in older age groups - to begin vaccinating patients 'for at least two weeks'.
A second vaccine - the Oxford/Astra Zeneca vaccine - is currently undergoing approval in the UK and would be simpler to roll out in community settings because it has a six-month shelf life if stored at 2o-8oC. The stance taken by the Welsh government suggests that in parts of the UK the highest-risk patients will have to wait for the rollout of this second vaccine, some doses of which are also expected to become available this year.
The government has said it expects 800,000 doses of the Pfizer/BioNTech vaccine to become available next week, with as many as 10m potentially available by the end of 2020. Patients require two doses of the vaccine administered between 21 and 28 days apart to achieve full protection.