Slides from an NHS England webinar for primary care staff obtained by GPonline reveal that GP-led vaccination sites will be asked to invite people in Joint Committee on Vaccination and Immunisation (JCVI) cohort 6 for a first dose of COVID-19 vaccine in the weeks commencing 15 and 22 February.
Patients in cohort 5 - those aged 65 and over - will be invited by the NHS national booking service to attend a mass vaccination centre or community pharmacy, to avoid local confusion and competition between different delivery sites. GPonline understands, however, that GPs can accept patients in cohort 5 for vaccinations at local sites if they ask for that option.
Second-dose vaccination clinics will 'go live from 1 March', the slides confirm. They explain that patients will be offered a second dose of COVID-19 vaccine '77-84 days post first-dose clinics'.
Stock of COVID-19 vaccine will be reserved for vaccination sites' second-dose clinics based on data submitted by practices through the Pinnacle system, and will take account of 'any second doses administered outside the guidelines and any mutual aid stock moves'.
Sites will be provided with a delivery schedule as soon as possible and 'will have the option to request changes to the proposed allocation, up or down, in full boxes only'.
Cohort 6 patients are not the same as the annual flu groups, but are made up of at-risk clinical groups, carers and young adults in residential settings - a point officials are understood to have stressed in the latest webinar. The JCVI defines this cohort as 'all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality'.
The decision to split cohorts 5 and 6 between different sites comes after GPs wrote to MPs last week to highlight an ‘avalanche’ of calls to practices from patients confused about where they should go for vaccination following the opening of mass vaccination centres.
But GPonline understands that NHS England is prepared for some 'crossover' between the two groups if patients in cohort 5 ask to be vaccinated at local sites rather than potentially travelling further to a mass vaccination centre.
GP-led primary care network (PCN) sites delivering vaccinations have also been reminded to go back and offer vaccines to people in cohorts 1-4 to ensure that no patients are left behind.
Nearly nine in 10 people aged over 70 in England have received a first dose of COVID-19 vaccine as the NHS nears its target of administering 15m first doses UK-wide by 15 February. Among over 80s, 91% of people in England had received at least one dose of COVID-19 vaccine by 7 February.
NHS England announced last week that PCNs running vaccination sites would be paid an additional £10 for administering the COVID-19 vaccine to housebound patients on top of the current £12.58 item of service fee for both doses of the vaccine.
The JCVI defines patients who are clinically vulnerable as those with:
- chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and severe asthma
- chronic heart disease (and vascular disease)
- chronic kidney disease
- chronic liver disease
- chronic neurological disease including epilepsy
- Down’s syndrome
- severe and profound learning disability
- solid organ, bone marrow and stem cell transplant recipients
- people with specific cancers
- immunosuppression due to disease or treatment
- asplenia and splenic dysfunction
- morbid obesity
- severe mental illness
The Green Book also says that that younger adults in long-stay nursing and residential care settings and adult carers (those in receipt of a carer's allowance or who are the sole or primary carer of a person who is at high risk from COVID) will also fall into this cohort. It adds that the list is not exhaustive and GPs will need to use their 'clinical judgment' to take account of the risk of COVID-19 and any underlying health conditions.