The estimate is detailed in the standard operating procedure (SOP) for primary care designated sites, published on 10 December, which also revealed that GPs will not be required to obtain written consent from patients prior to the vaccine being given.
The guidance said that a test exercise simulating large vaccination centres found it took ‘approximately eight minutes to vaccinate each patient (excluding any post-vaccination observation where required)’.
Some 280 PCN sites in England will be receiving 975 doses of the Pfizer/BioNTech vaccine on either Monday or Tuesday next week and have been told they need to vaccinate this many patients within 3.5 days. The fragile nature of the vaccine means that it is only effective for a limited time after it is removed from very cold storage temperatures.
The SOP estimates that four vaccinators can manage 100 patients in 200 minutes at 8 minutes per jab – fast enough to vaccinate 975 patients in three 12-hour days. But if time per jab rises to 10 minutes, four vaccinators can only just vaccinate enough patients in 3.5 12-hour days to use up all of the vaccine doses – leaving no room for error if patients fail to turn up or if any delays occur.
GPs set to take part in the programme next week have said that the last minute change in guidance on observation for the Pfizer/BioNTech vaccine has thrown plans into disarray, with some warning their site may no longer be suitable.
The MHRA’s new guidance was published following three adverse incidents, including two reports of anaphylaxis, on the first day of the vaccination programme.
With regards to patient consent, the SOP said that there was no legal requirement for this to be in writing. GPs will be expected to record verbal consent in the IT system and provide patients with written information about the vaccine after an appropriate conversation.
During vaccinating sessions GPs and other registered healthcare professionals should be responsible for obtaining informed consent, diluting and drawing up the vaccine and managing any medical emergencies, as well as vaccinating patients. They will also need to supervise non-registered healthcare professionals administering the jabs.
Care home vaccination
The SOP also provides advice for vaccinations in care homes and recommends that all vaccinators should be tested before they attend the home. It says that this would limit the risk of vaccinators being tested positive on arriving at the home, which ‘could have implications for the whole vaccination team leading to disruption of the planned session and potential vaccine waste’.
The number of visits to care homes should be limited in order to protect residents and the guidance suggests up to 4 visits – the first to deliver dose one with a second visit a week later to vaccinate any residents or staff who were missed, with the third and fourth visit to follow the same pattern for administering the second dose.
Care home managers should draw up a list of who will be vaccinated and ensure that they have shared details of the vaccine and what will happen during the visit with residents prior to vaccinations happening. PCNs have been told to inform the homes of which vaccines will be used and any advice about possible adverse reactions.
Care home staff, who will not all be on site during the vaccination visit, are able to access vaccines at either the designated site for their own GP practice or the site that is leading on vaccination for the care home where they work.
Meanwhile, practices that have decided not to take part in the COVID vaccination enhanced service have been told to cooperate with commissioners to ensure their patients are able to receive the vaccine.
The SOP also says that if unregistered patients contact a PCN vaccination site they should be assessed for eligibility and vaccinated if required. ‘They should not be turned away or signposted elsewhere,’ it adds.
The MHRA’s updated advice for the Pfizer/BioNTech vaccine earlier this week was published following three adverse incidents, including two reports of anaphylaxis, on the first day of the vaccination programme. The guidance also said that the vaccine should not be given to anyone with a history of allergic reactions.
Meanwhile, the SOP also reiterates advice from Public Health England in the Green Book that the COVID vaccine should not be given to people with symptoms of the coronavirus or who are waiting for a test result, or pregnant and breastfeeding women. Women of childbearing age should be advised to avoid becoming pregnant for two months after receiving the second dose of the vaccine.