I posted a similar thread yesterday. There seems to be so much information flying around it’s hard to unpick and most of the answers just result in more frustration. Please don’t lose hope though. We’re still in a better position for vaccinations than we were six months ago. Progress has been made albeit it feels painfully slow. In reality this is amazingly quick from a scientific and logistical perspective.
One poster gave me a fantastic answer and I hope they don’t mind me c&p (@lemontt 
). Don’t get me wrong, none of these explanations make me happy but I do feel I have a slightly better idea of what’s going on.
LemonTT
Looking at the headlines and social media posting it would be hard to understand what is going on. It’s all just jumbled assumptions and fake news.
With regards to planning, this has been going on for months. But part of the planning couldn’t be finalised until the authorisation details were complete. The MHRA and regulator have agreed use under certain arrangements and these are different for each vaccine. These were only known after authorisation.
Workforce: Assumptions could be made about the numbers and qualifications that might be needed but these don’t firm up until the last minute. With Pfizer more HCP and a lot of pharmacists were used because of the handling of the vaccine. Additional training requirements was set for vaccine handling and anaphylaxis. Additional clinical workforce had to be identified for supervised observations at the last minute due to anaphylaxis risks. With Oxford there is the potential to shift to using non HCP as vaccinators but this needs a regulatory change. It’s not quite in place yet in England. Until it is the GP and hospital sites are the best staffed.
Delivery Operations; The UK was really the first country that started to test the safety of moving the Pfizer vaccine around in refrigeration. This took a bit of time. The storage of the vaccine really limits the scope of its use. Lots of ducks need to be a row for this vaccine.
Site Operations: these were planned based on the known characteristics of the vaccines. But these changed. Most significantly in relation to observations which were originally required, then not and then reinstated but with the need for clinical observation. That all impacted on the space requirements and meant some sites couldn’t be used. The flow of patients wasn’t really known until it happened. Sites reported problems with patients turning up very early and en masse. This meant they needed more space and marshalls.
Vaccine supply to sites. Many sites are eager to do more and want to be supplied with more. But it’s important the current supply is fairly and evenly distributed. This is what is happening. The supply we have is sent out fairly not on demand. That frustrates some who run to papers. It’s also important to be aware that there is only one supplier. With flu there are multiple suppliers able to feed more sites, although this is uneven and inconsistent.
Vaccine manufacturer: the manufacturers are ramping up volume but are not at the peak. There are also notorious problems with vaccine manufacturing which will disrupt supply, see Pfizer. But discounting that factor the supply is building up worldwide along with demand. Orders are phased and we were never going to get 100m doses in one go. The UK expects peak Oxford supply in February.
Recording of information. GP and mass sites will use one system to record vaccinations which will be linked to a GP record or NHS number. The default will be GP record because most people don’t know their NHS number but do know their GP or other personal details. However some people live chaotic lives and we don’t have a national ID system. It’s likely that these people will be confused about their vaccination history and provide inconsistent personal details that can’t be matched. There aren’t many of these people but there are enough. When they present there is a risk to be mitigated. The mitigation is to vaccinate and give protection rather than sending them away.