NHS staff are to be a priority for COVID-19 vaccination along with care workers and residents of care homes, the government said yesterday.

News of apparent success for the Pfizer mRNA vaccine threw into disarray the deal with GPs to lead the vaccination programme because of its requirement for refrigeration at 70 below zero. Government sources said the programme might have to be based in hospitals with the necessary equipment. They talked of retraining clinicians such as physiotherapists to deliver the vaccine.

The Royal College of GPs conceded there would be “logistical” challenges with a programme based on the Pfizer vaccine – although results for the Oxford/AstraZeneca attenuated vaccine are still awaited.

England deputy chief medical officer Professor Jonathan Van-Tam said he was “hopeful but not yet certain” that vaccination might begin before Christmas. He said: “Making vaccines is really difficult. Many things can go wrong during manufacture — indeed, each batch has to be quality assured before it can be released.”

Prime Minister Boris Johnson said: “We have talked for a long time, or I have, about the distant bugle of the scientific cavalry coming over the brow of the hill. And tonight that toot of the bugle is louder. But it is still some way off.” Government sources claimed they were preparing a ‘get out the vote’ style operation to ensure uptake of vaccines – with a special emphasis on ensuring patients returned for their second dose.

Royal College of GPs chair Professor Martin Marshall said: “GPs and our teams across the UK are hugely experienced in delivering vaccination programmes with high uptake rates. As long as our service is properly resourced, it makes sense for general practice to play a central role in delivering the COVID-19 vaccine. There are still questions that we need answers to. GPs and our teams are making more consultations than we were before the pandemic, delivering the largest flu vaccination programme ever, and preparing for usual winter pressures. We need to understand which tasks should be prioritised to make capacity for any involvement in the COVID vaccination programme – and how it should sit alongside the flu vaccination programme. There will also likely be logistical challenges to overcome, for example around supply and storage of the vaccine – which may require new or additional equipment for some practices.”

British Medical Association GP committee char Dr Richard Vautrey said: “With their proven track record of mass immunisation campaigns and strong relationships within their communities, GPs, practice nurses and other key staff are the right people to be leading this campaign once vaccines become available. With a number of approval processes still to go, we are a long way from guaranteeing that vaccinations in local surgeries will begin in December – but practices, working together in their areas, will stand ready. We know this will be a significantly challenging undertaking, particularly as staff are already struggling with ever-increasing workloads and staff burnout from the first wave of the pandemic. Therefore, practices will need support both nationally and locally, as well as patience and understanding from the public as they embark on this unprecedented campaign.”

Dr Layla McCay, director at the NHS Confederation, added: “We are pleased to hear it confirmed that alongside vulnerable patients, NHS staff and care home workers will be amongst the first people to receive the vaccine. This will provide reassurance and vital protection during their work with COVID-19 patients, and should help reduce the number of NHS staff off sick or self-isolating because of coronavirus – currently as many as 30,000 – which is adding significantly to the pressures services face and, in some areas, is leaving leaders with no option but to postpone and reschedule non-urgent treatments. A COVID-19 vaccination programme of the scale needed to beat the pandemic will clearly be a logistical challenge, and while welcoming the prospect of a safe and effective vaccine, our members are also keen to understand more about how, where and by whom it will be distributed and delivered in the midst of rising COVID-19 cases alongside winter pressures.”

The UK yesterday reported 21,350 new cases of infection and 194 new deaths. Wales came out of its “fire-break” lockdown although the latest data shows it having 945 infected patients in hospital, a larger number than even at the peak of the first wave when there were 910 infected patients in hospital.