Minister Ashford’s statement on COVID-19 – 07 January 2021

Thank you Chief Minister,

As people will be aware our vaccination programme is both a national priority and a priority for the department of Health and Social Care.

I can confirm that the vaccination programme is on schedule as per our timescales and plans and this week has seen 1141 individuals vaccinated in the first priority group.  This is an increased number from the expected 975 as like other jurisdictions we have found we can get 6 doses out of a vial rather than the expected 5.  We will be continuing over the next week vaccinating 1141 per week over three days. Now some may ask why three days not seven.  The decision has been taken to do 1141 over three days of vaccination rather than spreading the 1141 over seven days. We have to also remember this is a medical procedure it is not a production line.  There are medical protocols and procedures that must be adhered to. This is a brand new vaccine and it is important that we ensure that operating practices are correct and that we deliver this in a safe way.  That means we are learning on the ground as we go.  That means we must constantly assess and change our protocols based on the actual experience of the roll out itself ensuring patient safety at all times.  Pfizer is a very complex vaccine in fact some have said the most complex that has ever had to be handled in this way it is therefore essential that it is handled with care in line with the manufacturers recommendations and clinical guidance.  Those receiving the vaccination would expect nothing else. We have to remember at the moment we are also using only Pfizer vaccine which logistically much more challenging.  From the process of defrosting the trays, having to use an entire tray at a time, the storage requirements and even the mixing requirements all mean that care must be taken.  Once the Oxford vaccine comes on stream we will be able to scale up further as there are less logistical challenges with that vaccine. We also have to remember that the vaccines are a two dose vaccine and it is important that we ensure that all times we have adequate stock in storage in our possession to ensure that we can deliver the second dose when it is medically appropriate to do so and not find we do not hold the stock to deliver people those crucial second doses, something I will come back to and touch on shortly.

It is important for people to remember we receive our vaccine on a per head of population basis from the UK.  As with other countries we will receive our stock in staggered deliveries over the next nine months, it is important to remember we do not receive all of our entitlement at once.  In terms of timescales I can confirm we are currently on course as planned to have vaccinated everyone in the 50’s and above categories by the end of May with the rest of the below 50 population vaccinated by the end of September.

I can also confirm that we have now received our first try of Oxford vaccine however we have not yet received the crown indemnity or the protocols around use and delivery from the UK that are required in order to administer the vaccine. We hope that these will be imminent after which once the protocols are clinically approved we can start rolling out this second vaccine which is much more mobile than the first with our first priority for its use being Care Home residents.

Another query I know some of our media friends are interested in is I can confirm that we will be sticking with the manufacturers guidance in relation to the second doses of the vaccines.  So I can confirm with the Pfzier vaccine the second doses will be delivered 21 days after the first and in relation to Oxford the second dose will be 28 days after the first. Our manufacturer indemnity requires us to work to the manufacturers recommendations and after review by our clinical teams it is the view of our clinical body that this is also the correct thing to do from a medical point of view.

I know there have been many questions from people around where they fall in the vaccination programme particularly those in other key worker groups other than health and social care settings.  As with all vaccination programmes we follow the guidance of the Joint Committee on Vaccination and Immunisation which is the professional body with the appropriate clinical experience to make guidance and recommendations around the priority groups for vaccine roll out.  When it becomes your turn for the vaccine you will receive a letter to be invited to come to be vaccinated.  Please be patient it is important that we do this in a controlled and ordered manner.  To be clear the vaccination programme is designed to get protection to those most likely to suffer serious effects or life threatening effects of Covid19 first.  That is why it is essential we continue to rollout the vaccine in population cohort group order.  The vaccination programme priority grouping is not based around who is likely to contract Covid but on who would suffer the most serious or life threatening effects should they contract it.  Once again to confirm based on the current roll out all those aged 50 and above and those in the most vulnerable categories are expected to have been offered the opportunity to have a vaccine by the end of May. It will then be rolled out across the rest of the population from May – September.

I emphasise again that we will be sticking to the priority groupings and that people will be written to and invited when it is there turn.  Can I also take the opportunity to publicly thank all those involved in the vaccination roll out.  This is one of the biggest logistical challenges we have ever faced and is the biggest vaccination programme in human history. So thank you to everyone involved and also all those who have come forward to help.

The letters from the over 80’s category inviting them to come for their vaccination will start going out from tomorrow. At point only those who can make their way to Nobles are being invited further information will be sent to those that fall into this category and are housebound shortly.  If you fall into this category can I ask that you wait until receiving your letter before calling 111 to try to arrange an appointment.

Another question that has been raised is around patient transfers.  I have explained at this podium before that this is not as simple as it may appear with the vaccine for effective efficacy required to be a two dose vaccine delivered days apart.  Also immunity is not instant and takes several days after vaccination to develop both after the first and second doses. DHSC has been working on the logistics of how we vaccinate patient transfers and I can announce that for all those patients who are travelling to the UK in the next 6-8 weeks initially that already know of an appointment with immediate effect consultants who make a referral to the UK and agree a Patient transfer will now also be able to organise for the patient to be referred for a vaccine at the same time as the patient transfer referral is made.  Once this is done patients will be advised and can book their vaccine.  It is important to stress that this needs to be clinically led and a clinical decision as not all patients may do to their condition be able to have the vaccine.

A Couple of other areas I want to touch on if I may Chief Minister. Firstly elective surgery people will remember that we suspended elective surgery for a two day period in order to preserve bed capacity at Nobles. This was reviewed clinically last night and it has been operationally decided to extend the suspension for a further 7 days.  At the moment the situation around any potential wider community spread of Covid19, while looking optimistic, is still unknown so at a time when the hospital is dealing with the normal annual winter pressures it is important we still ensure that bed capacity should we need it. I thank people for their patience on this.

Also the operational decision has been taken to suspend respite and day services for 7 days.  These services deal with individuals who are high risk to the virus exposure and also are some of the most vulnerable people in our society in settings where social distancing is impractical and impossible to police.  There will be exceptions based on clinical judgement around cases where the lack of service provision would bring about severe detriment. At a time when we still are not certain around the possible transmission in the community it is important we do all that we can to protect those individuals from any virus contraction. I need to be clear we wish to keep this disruption to service users and families to a minimum and unlike the last lockdown this is for 7 days only and if the situation remains the same around community cases then we will look to reopen services.

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at Isle of Man Government News 2021-01-07.