To think they should be aiming for 1 million vaccines per day

[maddening]

Once the Oxford vaccine is approved, we have purchased 100 million doses, they could have 30 million 1st and 2nd doses complete by the end of Feb. We have 6800 go surgeries, there is talk of the army and football stadiums and sports halls being used. There are over 11000 chemists. And then the news is Sage discussing 1million per week? Wtf? 4 million 1st doses and million 2nd doses - so 4million every 2 months is never enough, surely they can't be seriously aiming for 1m a week?

@feelingverylazytoday

Can't help logistics as not my field So you don't really know what you're talking about then. Unlike the people who are organising the vaccination programme.

Well someone I know is organising the vaccination programme for her area. She works in a GP surgery (admin not medical). She’s tasked with sorting out the jabs for the federation of surgeries.....approx 60,000 patients.

She freely admits she has no experience, never done anything like this before, next to no guidance is feeling totally overwhelmed.

I really think the army need to be involved sorting out the logistical side of this. Work in conjunction with the gp surgeries who have the patient lists

Each person has to be consented, paperwork completed, vaccine, nurse wipes down area, sit for 15 mins minimum to be sure no allergic reaction.

Most of the process could be done by non-vaccinating volunteers - if you’re wanting to speed things up why on earth would you expect a trained nurse to be wiping down? And waiting for 15 minutes afterwards can be done in a socially distanced communal area (as is the procedure now when donating blood) - it doesn’t involve trained personnel watching you like a hawk on an individual basis, just making sure that you’re in the vicinity in case you get an allergic reaction.

[quote HildegardNightingale]@WiseUpJanetWeiss it also says 5 doses, but there may be sufficient for a sixth. So not written in stone.[/quote]
Yes that’s exactly my point. There is usually enough “wriggle room” for a sixth dose. Your calculation omits the 0.45mL already in the vial before dilution. Centres up and down the land are frequently getting a 6th dose out of the vials. We’re not making this up.

We have an app for flu jabs at work. It literally takes 5 minutes to
Do the whole thing including consent. So surely something similar could be se up. My hospital are only offering 5 minute appointment slots anyway.

@BernadetteRostankowskiWolowitz

This was what they said not me. They stated they would have millions ready before approval. They were even given funding by Government for this to be the case. I wonder what has happened. My trust were under the impression millions were on their way early Jan (pending approval) - this obviously isn't happening.

Most of the process could be done by non-vaccinating volunteers - if you’re wanting to speed things up why on earth would you expect a trained nurse to be wiping down?

Think I’ve answered my own question - just been googling vaccinator volunteers and it seems that you also have to be a healthcare professional to do the non-vaccination bit, because as well as the mundane stuff it will involve clinical screening etc. Also drawing up the vaccine in preparation for the vaccinator to give it, for those who said they would be drawing up their own vaccine. So it will be a tall order to get the numbers of staff required.

Bil was saying because of the paperwork and how ppe slows things down its about 10mins per person.

@Char2015 the US paid 1.2bn for the a third of the first billion doses (300 million). Have been told that they are first in line for the first batch, UK is second in line.

@notevenat20

We should be aiming to vaccinate at least as fast as Israel. Currently we are a long way off that.

The difference is, the heath service in Israel is much much better than the NHS. Currently they have vaccinated over 7% of the population in under two weeks. One third of the over 60s have had the first shot.

They aim to get as many over 60's and all healthcare workers done in the first three weeks, then will the second shots will be administed, so the numbers will slow down in week four.

I’m a vaccinator so I’ll answer some questions.

The training was my usual annual updates plus a half day course and very thorough assessment of drawing up and giving by a pharmacist and the shift coordinator before I was able to be signed off to give it. I was invited to do the training as an already registered vaccinator and I book shifts on my days off via the nurse bank. It’s paid as band 5. (I’m a 6 in my usual role).

It takes at least 15 minutes to reconstitute and draw up because there are no preservatives or antibiotics in it so as well as the mixing the vial has to be cleaned and allowed to dry every time the needle goes into it, so 7 times in total. And yes we can and do get 6 doses out of each one, it was 5 at first until they saw how much was being wasted.

Yes there is a PGD.

The actual giving involves making sure the consent form is signed and health screening questions, so that’s at least another 5 minutes. The actual injection is the quickest stage. Then 15 minutes of observation in a socially distanced room.

No, we can’t give it in testing centres when people come for a test because having active Covid is a contraindication. And no, we can’t ask people to wait in their cars and flash their lights if they need help, if you suddenly went into anaphylactic shock how would we know?

This vaccine needs a lot of staff - 2 nurses to draw up/give/check. Admin to input the data. A pharmacist. Coordinator. And we also have security because of the risk of sabotage/theft. We don’t have a doctor in the vaccination area but we are on a hospital site so can call the crash team as needed, community settings may be different.

The people I’ve given it to have been so happy and the relief is palpable. If we could immunise thousands a day we would but with the Pfizer it’s just not possible. I haven’t yet seen the AZ to see how it will come to us but I’m assuming some mixing will be involved.

Flying very interesting, thanks.
As a practice nurse whose surgery is not yet involved in this, why do you need two nurses to draw up / check?

Well not much chance. A neighbour is a former nurse. She has volunteered to do vaccinations.....answer back... sorry no as she will need to re register as a nurse (and pay the registration fee!)

Never let red tape get in the way of saving lives!

@Sunflowergirl1 I think she would feel differently if she made a drug error! The registration is designed to protect the public. If she hasn't worked out why she needs to be Registered then it's a good job that she's still not practicing!

Although I understand the frustration. I'm a doctor working in a non clinical field. GMC registered but more than a year out of clinical practice. I registered with NHS returners , spent days filling out forms, doing refresher online stuff. Then heard nothing apart from the odd thanks for your support email.

In November I got an email about vaccinating ( would be happy to vaccinate/ consent/ run around/ phone up patients) it was a don't do anything you're on the list we'll be in touch.

Nothing.

Friends are in the same boat, it's very frustrating.

@cptartapp

Flying very interesting, thanks. As a practice nurse whose surgery is not yet involved in this, why do you need two nurses to draw up / check?

It needs to be checked at every stage, the volume of saline, the air withdrawn, and correct amounts in each syringe. Then the ampoule gets checked again to make sure it is disposed of empty.

@cathyandclare I really do think it depends on the area you are in. I was contacted by my health board approx 4 weeks ago. They had my details from Bring Back Staff.
I had a 2 hour face to face via zoom training module (which was rescheduled because of problems their side) and have completed approx 8 modules on Lfe on-line. I’d already completed back to work modules ie basic life support in May when I came back to work at a Nightingale.
Yesterday I received an e-Mail requesting copies of the certs gained on-line.
It is a tortuous process.
Hopefully you will hear something soon.

@cathyandclare sorry another missive! Have you contacted NHS Professionals? They may be doing the staffing which is why you haven’t heard from Bring Back Staff?

@Sunflowergirl1your neighbour does have to register back on the NMC. She will go on the temp register. This does or did not incur the usual registration fee.

@HildegardNightingale I will mention it to her...she seemed knowledgable as she said she had been told she would need to pay. Maybe the person speaking to her didn't have the correct info?

My BIL was telling me that the problem they are having with the Pfizer vaccine is because its caused several severe reactions every vaccination clinic must be supervised by a doctor and cannot be purely nurse led.

This. You need a doctor, a resus trolley, you need to consent the patient, and the patients need to wait ten minutes afterwards to ensure they don’t have a reaction. It is WAY slower than flu vaccination.

Hopefully the Oxford one will be a bit more straightforward and we’ll be able to speed up.

Thanks @HildegardNightingale