- 19 Nov 2020
I’m grateful for the opportunity to set out our current plans to deliver a programme of COVID-19 vaccination to every one over the age of 18 in Scotland. As I will cover shortly, there remain some key areas of information we have still to receive or confirm, and I will continue to update members as these become available, and our plan develops.
Last week we all had the good news from Pfizer, this week more good news from Moderna, both announcing over 90 per cent effectiveness in Phase 3 clinical trials. These are just two of 12 vaccines undergoing Phase 3 trials worldwide, including three involving clinical trials here in Scotland.
Pfizer and Moderna will now share evidence from their trials with the regulatory and advisory bodies to allow clinical and scientific review, with advice then to each UK health department to determine on safety and effectiveness.
This is a critical point. I want to be very clear to members, and to people across Scotland, that the safety of the COVID-19 vaccine is paramount for us.
The global scientific, research and pharmaceutical community has come together and worked as never before. We’ve seen unprecedented investment worldwide in research, development and manufacture; people across the world – including here in Scotland – volunteering to take part in clinical trials; and driven and dedicated research teams.
That is why we are seeing these front running vaccines delivered in months, rather than the many years that vaccine development can sometimes take. It is impressive – but it is not at the expense of safety.
Each vaccine goes through a rigorous and independent three-phase testing process, long before it can be licensed as safe and effective for use.
Regulators like the European Medicines Agency or the Medicines and Healthcare products Regulatory Agency in the UK, review the trial results and decide whether to approve the vaccine or not. During a pandemic this timeframe can be compressed but it is never at the expense of safety.
Vaccinating the adult population in Scotland – that’s anyone aged over 18 – is 4.4 million people. We have, rightly, worked across the 4 Nations to secure the vaccines and to secure agreement on the population share of the doses purchased for each of the UK nations.
From December we expect to see the first delivery of vaccines to Scotland. We are planning on the basis both that the Joint Committee on Vaccination and Immunisation (JCVI) are able to review the clinical evidence and provide Governments with a recommendation, and that the vaccine receives a license.
As I’ve said, we’re hopeful that over the coming weeks into 2021, we will have more than one vaccine available to us, so that we can, with minimum delay, vaccinate as many people as possible, as quickly as possible.
But I need to be clear that there are a number of challenges and at this point, unknowns, to our delivery programme, which we hope, will in full take from December to Spring next year to complete.
The first of those is, clearly, the start date. We’re ready for December, but the first vaccine available has to be approved and supplies have to arrive. Thereafter, we need to see more vaccines become available and to understand the delivery schedules for each.
The Pfizer vaccine has specific requirements in terms of transportation, storage and accessibility for use in certain settings. Other vaccines will have their own requirements – they may be similar to Pfizer, they may be different. It will be important to understand those differences to inform clinical advice about deployment. Our national plan has to be able to adapt to accommodate where there are different requirements.
A vaccine must be used in a way that ensures those most in need of protection receive that protection first, so our planning will be informed by the independent scientific and clinical advice from the JCVI.
The JCVI has already offered interim advice on prioritisation, which we’ve used in our planning for the early but limited vaccine supply we expect.
In the first wave of our plan – from December through to February, we will vaccinate frontline health and social care staff, older residents in care homes, care home staff, all those aged 80 and over, unpaid carers and personal assistants, and those who will be delivering the vaccination programme.
The current interim advice from the JCVI is that we then work through those aged over 65 and those under 65 who are at an additional clinical risk, and we then move to the wider population.
I want to be clear that this is a national vaccination programme, which sets out clearly the parameters within which our NHS Boards will lead local delivery.
So nationally we will set out the policy direction; we will set out the delivery framework accompanied by information for those at the frontline; we will develop and deploy a national workforce model; provide national training national training; undertake procurement and logistics; provide national information and advice; tools to record data about vaccinations, so that they are there on peoples’ medical records; and from Phase 2, a national booking service
NHS Boards will then lead local delivery, identifying acceptable and accessible locations, both for mass vaccination and for local access.
Taking account of their population and geography, they will undertake recruitment and deployment of staff, and the management of local vaccination clinics.
Over the coming weeks and months we will be sending out information to everyone across Scotland explaining what the vaccine is, how we are prioritising who gets the vaccine, what to expect when you are vaccinated, and so on.
For those in the first wave of the programme, you will be contacted during December and January, either by mail, or for health and social care workers by your employer, and you will be told where you will receive your vaccine, how to make an appointment and what you need to know.
In truth Presiding Officer, this is a major public service exercise. We need the expertise and resource that our local authorities, community planning partnerships and third sector can bring.
And we need locations – fixed and mobile – so we can make this mass programme as accessible as possible, wherever you live in Scotland, and whatever your circumstances.
We need a workforce that is diverse in its skills and availability. Our planning assumption is that for vaccinators and support staff, we will need over 2000 by the end of January. So that – vaccine availability and delivery schedules yet to be confirmed – we will be able to vaccinate around one million people by that time.
We of course need registered clinicians to vaccinate and to supervise vaccinations. Nurses and doctors, but also the wider clinical workforce such as pharmacists, dentists, and optometrists.
We’ve now concluded an agreement with the BMA on terms and conditions for GP involvement in the programme, and are working through agreements with other independent NHS contractors.
But we also need a workforce that understands the importance of logistics, of minute planning for delivery, of location set up and building, of COVID safe locations, and of the importance of data collection and performance management.
Scotland has an excellent track record on vaccinations, but this is to be one of the biggest civilian logistical challenges in our lifetime. So we have strengthened our NHS planning teams, engaging with local authorities, local resilience partnerships, and the military.
We know from the beginning of the pandemic, when the military assisted in the delivery of NHS Louisa Jordan, and the deployment of testing sites, that they bring real value to support our efforts.
With so many vaccines in Phase 3 clinical trials, there is the potential for multiple vaccines being available over the next 12 months, and it is possible that these will have different characteristics that impact on how they are stored, handled, and delivered.
That requires real logistical expertise from one organisation can cover the whole country. So I am grateful that the military have responded once again, and stand ready to bolster our planning, bringing with them a wealth of logistical and operational expertise.
Presiding Officer – it is important to be clear about what we don’t yet know yet. We don’t know which vaccines will be approved for use, and when doses of those vaccines will reach us.
We do not yet have information about all the vaccine characteristics – for instance we don’t yet know whether the Pfizer vaccine will be approved for transportation, beyond the ultra-cold temperature currently used in order to allow us to vaccinate in multiple smaller locations, like GP practices and care homes.
Although we have some welcome news on the efficacy of the vaccine from the trials, we don’t know if this vaccine, the Pfizer vaccine, will stop you getting the virus, stop you passing the virus on, or prevent it from causing serious harm.
And it may take many months before we fully understand the level of protection on transmission and the impact on reducing the severity of the illness caused by the virus.
We know that the first vaccines will require two doses, 3 – 4 weeks apart. It’s possible that further booster doses, and even an annual programme might be required, given we do not know how long any protection will last.
For now, the important thing is that when we start to deliver these first vaccines, it will be on the basis that they offer some form of protection, even if we don’t at this stage, know exactly how much protection that is.
And it will be safe. So when we get in touch with you, please go for the vaccine. It offers you a level of protection we don’t have through any other means.
If you’re not in the first group called, please be patient. I know you will understand how important it is that we protect first those most vulnerable to serious illness and death.
A safe and effective vaccine does bring hope. It gives us all encouragement that where we are now, will end. But right now, we have to all keep following the necessary restrictions – tough though I know they are, keep washing our hands, wearing face coverings, keeping two metres distance. That’s how we protect ourselves, our loved ones and our NHS, as science itself brings us hope.