Guidance published by NHS England for around 280 designated primary care network (PCN) sites that will deliver COVID-19 vaccination from 14 December confirms these sites will receive a second batch of vaccine on either 4 or 5 January.
Vaccination must start the day after a delivery. Designated sites have been told they will need to deliver 975 doses within 3.5 days - but the guidance makes clear that the shelf life of batches could vary between three days and 14 hours and four days and three hours.
The guidance confirms that sites delivering COVID-19 vaccination must have a GP 'available on site for each vaccination session/clinic', and that each site's 'named, registered health professional' must be present when vaccine deliveries arrive - with drop-offs to take place between 8am and 6.30pm on weekdays and between 9am and 4pm on Saturdays.
The advice says designated sites 'should start vaccinating patients aged 80 years and over as advised by the Joint Committee for Vaccinations and Immunisations (JCVI) from 15 December'. It adds: 'This excludes any patients within this cohort who are totally housebound.
GPonline reported earlier today that care home vaccinations could begin as early as next week - and the guidance says: 'Once further operational advice on vaccine handling has been agreed you should also start to vaccinate care home residents. We will be working with sites during the week of 14 December to ensure safe set up of this delivery model.'
Sites delivering vaccinations can also consider prioritising patients within eligible cohorts if they have 'more than 975 patients over 80 years who may wish to be vaccinated'. The guidance says designated sites 'could consider' prioritising patients based on their age over 80, co-morbidities, and ethnicity.
The guidance also makes clear that a patient group direction (PGD) will be published later this week - and will therefore be in place before the vaccination programme starts. Earlier documents published by NHS England suggested the PGD would not be ready in time, raising the prospect of GPs having to assess and approve each patient for vaccination.
GP-led sites contacted this week by NHS England are part of a first wave starting vaccination from next week, with two further waves expected to be 'stood up' before Christmas.
A letter outlining guidance for first-wave sites from NHS England primary care medical director Dr Nikki Kanani and primary care director Ed Waller says those that receive a first batch of the Pfizer/BioNTech vaccine on 14 December can expect a 'corresponding vaccine delivery for dose two on Monday 4 January 2021'.
First-wave sites that receive their first batch - a pack of 975 doses in 195 five-dose vials - on 15 December should expect a delivery for dose two on 5 January. This confirms that patients will receive doses roughly 21 days apart - despite suggestions in earlier updates that patients may be offered a second jab 28 days after the first dose, in line with the requirement for other vaccine products that could soon be approved.
GP practices must have a 'collaboration agreement' in place by 13 December - or at the latest two days before they begin vaccination, the advice says.
The guidance also confirms plans for collection of hazardous waste from COVID-19 vaccination sites, IT arrangements, delivery of supplies, leaflets for patients, training requirements and plans for contacting patients and seeking consent.