I dont think they divert supply once it’s delivered. It would be another logistical step and thing to be organised and often it’s not clear far in advance if there will be surplus as people often don’t book far in advance.
As people talked about earlier on the thread, it seems they are keeping an eye on overall uptake in a geographical area, as well as age uptake. Those areas who are reportedly running a clinic for 1st doses for 35s (and you wonder if they are all 35s or there just are some who are included) might be areas where uptake in older groups has been lower and there has been hesitancy. They could be areas of the city with higher proportions of people at risk with things like high BMI or other risk factors such as higher proportion BAME populations, or men working in occupations identified as at risk. The JCVI guidance issued yesterday talked about using an age based distrbution system for operational simplicity reasons and that this system would allow faster overall vaccination, but also gives GPs much more control now in terms of exercising discretion for their local context, and to make judgements in calling people forward to mitigate risk in local areas. Men 45+ shown to have higher risk of hospitalisation than women by almost double rates. If coupled with high BMI and work that has taken place outside the home through lockdown the risks are higher. Some areas have younger populations, but more if the older group have declined the jab leaving the area overall more vulnerable. Rolling out to younger groups, while older people in other areas of higher jab rates remain unvaccinated can make sense. The lower take up area ends up with roughly equal numbers vaccinated and jabbing some younger people quicker, partly compensates for those who declined form older groups. In areas with high take up, the 40s who are waiting are keen....they will take the jab as soon as it’s offered...perhaps this week or next week, but the decision makers know those areas will remain high in take up and don’t need the level of input and earlier rollout than some other areas.
The rollout is broadly based on age groups. The national booking system is allowing all to book who are 45+ now. I think we will see more local variation as we move through phase 2 once supply increases. GPs are being given just a bit more flexibility to call people forward. They can do so based on occupational risk or ethnicity or using techniques which will boost take-up in groups that might be hesitant. For example there was a suggestion of calling a whole household together where it is a multi-generational home and some have been hesitant...this could work to help the hesitant come forward if coming with their household members.
I think there is an encouragement to be more creative and permission to be so, within the broad realms of the age rollout. And we should remember too, that GPs just don’t have large quantities if jabs for 1st doses anyway. These clinics for 1st jabs will very much be the minority. Most GP led clinics are 2nd jabs.
Those keen for 1st jabs should expect to book on national booking site and to travel some distance if they want it sooner and not to wait for GPs to get more supply after 26 April, as over the next day or 2, GP led invitations will dry up in most areas as they have used up all they have to offer to 45+ first dose people for now.