NHS staff now come after care homes for vaccine

[UnlimitedUnspecific]

The government have just changed their plans - now care homes will get the vaccine before the NHS, which in reality means instead of the NHS at this point since there are only 800,000 vaccines and 1.2 million people in care homes.

I am furious. The PPE provided to doctors and nurses doesn't properly protect them from the HUGE viral load of a patient ill enough to be hospitalised. Only yesterday the government admitted that the rate of Covid-19 infections caught INSIDE hospitals was far too high, and yet doctors and nurses will have to wait, what I expect will be weeks or months for a vaccination. In the meantime, their health and lives and those of their families, and those of other patients in hospital, other staff in hospital, people whose work takes them into hospital or transport workers serving hospitals - all at high risk.

(posted this on another thread already, but it will be lost in the comments)

Care homes can be shielded, NHS staff have a plastic pinny and a paper mask.

I bet it’s so hard

@OverTheRubicon @TheElementsOfMedical

Gosh I cried when I read your posts. Some people are just so lovely.

Many people in care homes will refuse. A lot of the older generation remember the Thalimide disaster and don't trust the speed at which the vaccine has been approved. At least that's the case where I work. Equally, there are many residents desperate to get the vaccine because they've not seen anyone but a carer 3x a day for a 15 minutes a time since March and are steadily loosing their will to live.

I hope the people in charge are aware of this and will ensure excess vaccines are not delivered to people who do not want them.

@Frequency It would be heartbreaking if vaccinations were wasted.

[quote OverTheRubicon]@MarshaBradyo When you say the JCVI is non political and non emotional - are you sure? My concern is that they are trying to minimise number of covid deaths, because that is what makes the headlines, and not looking at the overall impact on years of life, as NICE would when considering treatments.

Noone should have to die of covid. I fully support everyone following guidance or beyond to protect the more vulnerable (one of my own children is one, and my parents and grandmother). But given that people will, we should also accept that a 40 year old health care worker in good health who dies is likely losing 40 years of life (and likely leaving young children without a parent), Vs eight elderly care home residents with dementia, all with life expectancies under 3 years and all of whom will be difficult for them and require tremendous care. My grandmother is in a care home and says she wants to refuse her vaccine and give it to my sister, who is a nurse, on this basis.[/quote]
Over I didn’t get that impression when I looked at this document although it’s been a week or so since I did. Also the people on it are NHS / academia etc and I’m sure would act with integrity. Will add list below

here

Membership
Professor Andrew Pollard, Chair (University of Oxford)
Professor Wei Shen Lim, Chair COVID-19 immunisation (Nottingham University Hospitals)
Professor Anthony Harnden, Deputy Chair (University of Oxford)
Professor Judith Breuer (University College Hospital)
Dr Peter Elton (Greater Manchester, Lancashire, South Cumbria Strategic Clinical Network)
Dr Maggie Wearmouth (East Sussex Healthcare NHS Trust)
Professor Matt Keeling (University of Warwick)
Alison Lawrence (lay member)
Professor Robert Read (Southampton General Hospital)
Professor Anthony Scott (London School of Hygiene & Tropical Medicine)
Professor Adam Finn (University of Bristol)
Dr Fiona van der Klis (National Institute for Public Health and the Environment, Netherlands)
Professor Maarten Postma (University of Groningen)
Professor Simon Kroll (Imperial College London)
Dr Martin Williams (University Hospitals Bristol)
Professor Jeremy Brown (University College London Hospitals)

I don’t know what is best but I do know it must be very hard atm and I really feel for everyone in the thick of it

The minutes are all published too so it is clear to see the rationale behind the decision making.

I never understood why care home residents come first. As PP's have said, they are shielded. It makes far more sense to do Frontline NHS staff first.

My relative 90+ already had covid and was fine. Has dementia. Im like a pp not sure in that particular instance being top priority for a vax makes sense.
I think i read that 15% of 80+ yo die within a year. And as per what op is saying about icu actually being younger people.
Economy having the at home 70yo spending would make more sense.
Vaxinating nhs and care staff makes sense only where
They havent already had it with antibodies
-where it can reduce absence/isolation
Obviously we dont want more staff off with long covid

If it does prevent spread then our strategy is not the best one. As the care home residents are not superspreaders by their activity

Are people catching covid in hospital from the staff though? We know tests dont pick up if you develop it later so testing before you go in doesnt mean you wont come out in it later. So that 'covid negative' person is then contagious on a ward.

If someone has been exposed in hospitals all this time surely there cant be that many staff still getting it or getting seriously ill?

Im not sure do you think those with antibodies - especially if they had it mildly- will have the vax. ?
If say 10% are immune temporarily even thats over 6m

I get the argument about them suffering. But NHS staff are putting their lives at risk, just doing their job.

Someone said upthread that the barrier to administering the vaccine to care homes has been removed.

How?

What has changed in the past 24 hours? The vaccine is still massively fragile, still can't be moved, still can't be split up into smaller packs. What on earth has changed?

Why the about turn? So many of these 800k doses are going to be wasted due to them deteriorating!

This has been an insane 180 given that 400k NHS staff could have been vaccinated starting in the next 72 hours. Madness, utter madness.

The latest information going around now is there will be a small delay to care home residents receiving the vaccine so they can sort out logistical practicalities. Meaning no one will be receiving the vaccine for the next week or so as can't be seen to be going against priority list. However, senior staff believe it is being put off for as long as possible in order to await the Oxford vaccine which they believe will be approved next week so that this can be used in care homes instead. In which case there care homes will receive the Oxford and the Pfizer will be given to healthcare workers. The Oxford vaccine has already being produced in UK and will be a shorter turn around to get these delivered and ready to go out to care homes. Their are still high levels of concern here with the Pfizer vaccine being transported around the city to care homes. It's a changing situation here. No one, not even our Chief Executive, knows exactly how this is going to play out.

They're not sheilded @Toddlerteaplease. It's impossible to sheild them. I have two children of school/college age who are mixing at school. Their respective school/colleges have both had numerous cases. I still have to go to work. If every carer wityh school/college age children or partners working outside the home stayed away from work to shield the residents there would be no staff left.

It's impossible for me to distance from Betty while giving her a bed bath, changing her pad and apply ointments to sores. I can and do wear PPE but its effectiveness is limited. My care home was one of the first to lockdown. We've still had Covid cases despite never re-opening to the public. It can only be coming from staff and we're all following the PPE guidance to the best of ability with extra measures in place (they've closed the staff room for instance to stop carers from mixing on shift as much as possible. We now have to use the much more spacious residents lounge).

I'm a peer vaccinator in my trust for flu jabs. I presumed that they would be using us to help deliver this one. Not a mention has been made if it.

@FridayWineTime

Someone said upthread that the barrier to administering the vaccine to care homes has been removed.

How?

What has changed in the past 24 hours? The vaccine is still massively fragile, still can't be moved, still can't be split up into smaller packs. What on earth has changed?

Why the about turn? So many of these 800k doses are going to be wasted due to them deteriorating!

This has been an insane 180 given that 400k NHS staff could have been vaccinated starting in the next 72 hours. Madness, utter madness.

I said this but it was more a question.

What has changed to remove this barrier?

I don’t think anyone knows on here?

I’m so feel dismayed about the delay

@Toddlerteaplease

I'm a peer vaccinator in my trust for flu jabs. I presumed that they would be using us to help deliver this one. Not a mention has been made if it.

Is your trust one of the 53 hubs that will be receiving the vaccine?

The vaccine currently comes in packs of between 975 and 4,875 doses, which must be used within six hours of being transported - even if kept refrigerated. Many care homes have only dozens of residents, meaning that even the smallest package would be far too many doses and lay hundreds of precious jabs to waste. The MHRA has yet to officially rubber-stamp pack-splitting but is expected to do so imminently.

This is crazy - all those precious doses will go to waste!!

Me too @MarshaBradyo

Some of these posters seem willing to trample over every old person to get a vaccine . Thanks goodness there are some more rational minds making these decisions

I find the thought of waste absolutely unbearable 😢

What has changed in the past 24 hours? The vaccine is still massively fragile, still can't be moved, still can't be split up into smaller packs. What on earth has changed?

People have been re-examining the assumptions on which the original handling procedures have been based, looked at the risks which they were designed to mitigate, and looked at a range of options to see if they meet the safe handling requirements (which are not necessarily synonymous with the procedures as currently laid down)

For example, if you have one, staff only, room in which the thawing and preparation of doses is carried out, and then the vaccines are moved to the administration area, why does it become unsafe if those doses move a longer distance provided they are moved in suitable conditions? It may not, and the manufacturer's first stipulations will not be covering every real life scenario.

Given that roll out will be faster and could be just as safe with more agile delivery of smaller numbers taken to the places of need, thus is a worthwhile area to re-examine

@FridayWineTime

The vaccine currently comes in packs of between 975 and 4,875 doses, which must be used within six hours of being transported - even if kept refrigerated. Many care homes have only dozens of residents, meaning that even the smallest package would be far too many doses and lay hundreds of precious jabs to waste. The MHRA has yet to officially rubber-stamp pack-splitting but is expected to do so imminently.

This is crazy - all those precious doses will go to waste!!

Hang on this won’t happen will it?

Do people know for sure that this is what will happen

Likely MHRA will approve split before this waste occurs

This has been an insane 180 given that 400k NHS staff could have been vaccinated starting in the next 72 hours. Madness, utter madness.

The latest information going around now is there will be a small delay to care home residents receiving the vaccine so they can sort out logistical practicalities. Meaning no one will be receiving the vaccine for the next week or so as can't be seen to be going against priority list.

I asked about this earlier on the thread because I couldn't quite believe this was where we were at! Surely this is actually crazy, even those who would absolutely prioritise care home residents, to just have this stuff sitting in freezers doing nothing for weeks, while everybody scratches their head how to practically work it? Why isn't it better to actually put it to use, if, as was said earlier in the thread to reassure NHS workers who won't be seeing any of these initial 800000 doses, there's more vaccine coming imminently?

I genuinely don't understand how this helps anybody.

Carers and care homes were always first, because older people receiving care from carers are the most vulnerable group. The issue was logistics of the vaccine, they have decided they can split the shipments safely.
The vaccine program is about targeting those with most risk most quickly. The main reason to vaccinate NHS staff is to protect their vulnerable patients. It's why teachers aren't on this list at all despite being at a significant risk of infection we aren't working with vulnerable people and as a group we aren't at a particular risk of serious illness.
There are 400,000 people who will be vaccinated thus month probably, looks like lots of people hoping to be part of the program this year might be disappointed. BUT we're likely to have 3 vaccines on stream by the end of next month and all groups on the vulnerable lists vaccinated by early summer- this is an incredible feat of science and the most optimistic outcome when it was being discussed in March.