Vaccinations and nepotism

[Mintypylonsfryingsurplus]

Obviously most of us want the vaccination and an end to this nightmare.
But I am aware of several people that have jumped the queue.
1st family Son works in GP surgery in non patient admin role 44 slight asthma never shielded worked throughout. Got vaccine due to leftovers. Great in a way as vaccines should never be wasted. Then got his Mum and stepdad a vaccine (late 60's no health conditions) a vaccine also. Yes they are older but live 32 miles from the surgery so not their surgery and drove a considerable distance. Was told to be there by 4pm in the am of that day.
I thought surely local people who use that surgery should be prioritised especially health care or other frontline workers?
Ok I thought just a one off.
Then one of my DH friend aged 39 again works in surgery occasionally covers reception through a glass booth/ appointment only got the vaccine too. Her partner again about 12 miles but a different county away aged 41 works from home got vaccinated a week later.
They were foolish enough to put on fb (now taken down) as some people were understandably a bit pissed off with this. Comments such as who you know, driving long way not in spirit of lockdown to the outraged as many elderly/ frail/ frontline still patiently in queue.
I am not judging as those that want it will get it eventually, and no vaccine should be wasted, I am just wondering if this is quite common to others too?
It does seem divisive?

They are fair and transparent- we know it happens and why. Chris Witty even said it was the sensible thing to do.

Of course it isn't fair, but if the doses would otherwise go in the bin then it's much better they are given to someone, anyone. The sooner everyone gets vaccinated, the sooner we'll all be safer.

Given that 'leftover' doses seems to be an acknowledged thing, I agree it would be fairest for each site to have a list of people who can come at very short notice.

I have been volunteering at a GP vaccination centre - in a village hall so no direct access to medical record systems etc. Here is what happened last Sunday.

The GP in charge, working voluntarily on her day off, spent the last hour carefully managing the number left in the queue vs how many more vials should be opened to avoid wastage (as once open they must be used within a few hours) . Worked out perfectly that there would be two spare doses. Rang the nearby care home and said send 2 staff down straight away. As it turned out two of the final patients couldn’t have the vaccine (married couple had both had their flu jab a few days before). So she unexpectedly had a further two spare doses.

It was 7:30pm on a Sunday. Having given up her whole day she quite fancied getting home to her family and young children. The village hall volunteers had arrived to lock up. Should she have spent time sending someone to the surgery to get two patients whilst people waited around, or wasted the doses? She stood on a chair and called out the priority groups one by one until she found two people from all the volunteers to have the doses. One was her sister who is in group 6.

Perhaps this will make her think of a back up plan for this scenario. However we are in the first weeks of this rollout. Lessons will be learnt. I cannot fault her for how this was managed.

Her sister lives about an hour from the centre but had been there volunteering all day. She is in her 30’s with a hidden illness that makes her a priority group. I can totally see how that story would grow legs about a young healthy family member coming from miles away to get a dose. It was nothing of the sort.

Not ideal but not a large percentage overall will be mismanaged.

At the end of the day these people would all get their jab eventally anyway. It means no wastage and a more of the general public are done.

I imagine they need to offer it to people who they know will come in to have it at short notice. Maybe putting a list together and ringing round patients is more likely to fail and vaccines wasted. Can't get too het up about it. The no shows are more annoying.

I believe New York had some issues because they were sticking to rigid priority groups and vaccines were being wasted. They've changed that approach now.

@Mrsmummy90

My husband is a dentist and his vaccine got delayed. He was told that the gps have been giving their young and healthy friends and family the vaccines.

If it's true, it's absolutely abhorrent.

Told by who?

The no shows are more annoying.
Depends if they pre-set appointments, because some areas have no post. Most give details for booking, but could affect a few who tried being very organised.

It’s not even mismanagement, these centres are planned within an inch of their lives. My best mate runs one here & she is literally working 24/7 to try not waste vaccine. It’s not very problematic if Oxford but they have left overs nearly every day with Pfizer. They urgently ring hospitals, pharmacists, dentists, anyone front line to come get one. But sometimes it is time to go home & there are two left. So they then go to the volunteers by category they fall into. Pot luck sometimes. It’s not nepotism. It’s just not wasting a valuable resource! Would you rather it be binned or go to a 40-60 year volunteer?! Who could still get quite ill & need hospital treatment?!

I think it’s fine. Everyone needs to be vaccinated and it’s happening very quickly IMO. If it’s slightly haphazard sobeit, I really don’t have a problem with people getting it out of turn.

@Mintypylonsfryingsurplus

Obviously most of us want the vaccination and an end to this nightmare. But I am aware of several people that have jumped the queue. 1st family Son works in GP surgery in non patient admin role 44 slight asthma never shielded worked throughout. Got vaccine due to leftovers. Great in a way as vaccines should never be wasted. Then got his Mum and stepdad a vaccine (late 60's no health conditions) a vaccine also. Yes they are older but live 32 miles from the surgery so not their surgery and drove a considerable distance. Was told to be there by 4pm in the am of that day. I thought surely local people who use that surgery should be prioritised especially health care or other frontline workers? Ok I thought just a one off. Then one of my DH friend aged 39 again works in surgery occasionally covers reception through a glass booth/ appointment only got the vaccine too. Her partner again about 12 miles but a different county away aged 41 works from home got vaccinated a week later. They were foolish enough to put on fb (now taken down) as some people were understandably a bit pissed off with this. Comments such as who you know, driving long way not in spirit of lockdown to the outraged as many elderly/ frail/ frontline still patiently in queue. I am not judging as those that want it will get it eventually, and no vaccine should be wasted, I am just wondering if this is quite common to others too? It does seem divisive?

I understand how your feeling on this. My DS is in a non frontline role for the NHS and only 27 but asthmatic and he was offerred one of the first ones in our trust. He felt guilty and queried if it was correct and in two minds whether to accept it, in case it took it from someone higher up the list. He was told that the vaccine would go to waste if he didnt take it up and it would be a while before he would be offerred it again if he refused so he took it. I work for the same trust and had my vaccine yesterday, the trust were very clear that no family or friends of employees could be offered it, so its a suprise about his family being offered it as well.

I think its a bit hit and miss as each LA seems to have different rules to administer the vaccine.

I do agree about your coments though.

Frankly I’m more annoyed that people being offered the vaccine can’t be arsed to either turn up or ring and let the surgery know so they have time to book someone else in. The vaccines have a shelf life and this is the bed way of dealing with that. Maybe don’t broadcast it on Facebook, I don’t know, do people risk Facebook statuses saying they couldn’t be arsed to go get vaccinated? I wonder why not.

I’ve been working a vaccine centre most of the week as a volunteer and haven’t seen anyone except healthcare workers get spare vaccine.
But we have very few no-shows: perhaps just one each session, so three in total a day.

WhitechapelLass
Well said. I'm a vaccine marshal in similar circumstances. I've no idea who got our spares - I certainly didn't, and didn't expect to. I think there were almost none, as only one person to my knowledge didn't turn up. But I suggest that those complaining should volunteer themselves to see all the work and stress involved. On the first day, I overheard the unnecessary abuse one poor polite organiser got from someone who thought they could have done better.

If someone were selling the vaccines, that would be a totally different matter.

Our spares are from people who don't turn up for whatever reason. There haven't been many and anyone getting one would have to be at the site within 20 minutes of us knowing there are leftovers. It would be great to have a backup of priority people, but the time isn't generally enough late at night for the first group to get there.

Any arm is better than the bin at the end of the day.

As it’s agreed that NHS and all frontline staff should have priority for the vaccine, then it makes sense that the people they live with have a higher than normal need for the vaccine too. They have no official priority, but arguably have as much need. The people closest to those on the frontline have made significant sacrifices, I can’t begrudge this tiny perk if the opportunity arises.

I work for the NHS in a non-patient facing role, I am not supposed to have it until after the 15 February because I have no conditions and I work in a non-patient facing role, but emails are being sent some days when there are leftovers (so planning to have mine next week), but I am pretty sure I cannot take any family or friends for a vaccine! Only for staff as far as I know, I don't know of anyone who has done that.

I deliberately booked my vaccine for late on Xmas eve in the hope that there would be a "spare dose" for DH-it worked. It was pfzier so had to be used in that hour I think. All the marshalls had already been vaccinated.

I also think it isn’t as simple as 2 no shows at 12pm meaning there will 2 spare doses at the end at 8pm. With (say) pfizer if you end up with 6 no shows through the day you simply would not open the last vial: no spares. That vial would get used another day for more ‘proper’ appointments that can be booked in. There is a constant juggling act of numbers and genuinely from what I have seen it is a small number of doses that are spare once everything comes together at the end.

@Covidasaurus

It’s better than wasting it. We are struggling here because when we have some left over we can’t win: if we give it to family, we are told it’s nepotism, if we don’t, it’s because ‘we know it’s not safe!’ And if we throw it away the press slate is.

But why not have a reserve list? Patients who are in priority groups who could get there in five minutes? I for one would be happy to park outside my GP every day on the off chance of getting a spare.

I can see reserve lists leading to problems though. What if someone says they'll be there in half an hour and then aren't.
Or if your reserve list is the elderly, getting very little notice of something like that could lead to a time draining long discussion.
Making it people who have no guarantees and can't reasonably be disappointed if they don't get it when they arrive seems like a good way to go.
I do like the idea of having local teachers and police etc. on the call up list though.

I'm group 2. Can't be in "stand by" to be at the GP within the hour because I have small children who I assume wouldn't be allowed to come with me. I'll get it when I do.
I don't mind that childfree adults and those with grown children have an advantage that I don't have. It's a bad mindset to engage in.

@Covidasaurus

It’s better than wasting it. We are struggling here because when we have some left over we can’t win: if we give it to family, we are told it’s nepotism, if we don’t, it’s because ‘we know it’s not safe!’ And if we throw it away the press slate is.

Maybe have someone/some people picked randomly in the morning to get any left overs and be told to be on standby. Or someone you know needs it on compassionate grounds (which are never considered in the original priority list). GPs are apparently allowed to discretion in allocating vaccines because in one town they are vaccinating homeless people, which I don't have a problem with, but it shows there is some flexibility in the priority list.

The choice isn't either waste a vaccine or give it a member of your family or a friend.

There are three prep steps

You get a defined number of doses allocated that arrive daily aka a pizza box
Defrosted to ‘fridge temp’
In theory you’ve got 120hours to prepare the concentrate from this point but in reality you have another allocation arriving the following day and you’d need to have a cold chain assurance process in place to be able to keep them for another day
6 people booked in per vial (even though you’re supposed to get 5 out, you can squeeze 6)
Once you make it up, you have 6h left or you have to bin it.
There are on the day cancellations- transport failures, people self isolating, relatives who were supposed to bring them being unable to bring them, weather issues, becoming unwell, developing a significant febrile illness (a contraindication to receiving) abs there are a small number of people who decide against it when they’ve been counselled as to side effects so there are an unknown number of doses to repurpose each day. I agree that a ‘ring list’ sounds wise, but it’s a logistical extra on something already being pushed through in own time by volunteers. People could in theory be miffed about the ordering of members of the list.

I fear that the end point if these sorts of threads and public outrage at people getting the nearest available willing recipients rather than binning the doses will be that we’re told to give to cat 1-2 only or bin it which would be a travesty.

From the pgd for the Pfizer

When removed from the freezer, the undiluted vaccine has a maximum shelf life of up to 5 days (120 hours) at 2 °C to 8 °C, and and additional 2 hours at temperatures up to 25 °C in preparation for dilution.

Use as soon as practically possible, and within 6 hours after dilution.

Do the Pfizer packs still have the issue of not being able to be split and transported?

I remember before Christmas there was a delay with getting in care homes as the packs were 900 (ish) doses so they had to work out how to share the packs round