Covid-19 vaccines and vaccinations

People who need to receive their covid vaccinations at home are missing out because their eligibility is not being recognised by GPs, experts have warned.

There have been numerous reports of housebound people being told they are ineligible for a home visit in recent weeks, with some home care providers saying only a minority of their elderly clients have been vaccinated so far.

Chit Selvarajah, policy manager at the charity Independent Age, said: “We have heard from people who say they are housebound being told they weren’t considered as housebound and told to go to a vaccination centre as they are not eligible for a home visit.

“We don’t know how many people have been vaccinated but it’s likely to be very small numbers at the moment.”

No official figures have been published on how many people have been vaccinated in their own homes, but NHS England is offering GPs an additional £10 for every housebound patient they vaccinate, in an indication it is concerned about the speed of vaccinating this cohort.

Ruthe Isden, head of health and care influencing at Age UK, believes some older people have “slipped into being effectively housebound” over the last year, and are not yet registered as such on GP databases.

She said: “The pandemic has hit the fast forward button on ageing for a lot of people. They’ve aged a long way in a short period and seen their health really deteriorate, and often they are not going to proactively identify themselves as needing more help.

“It’s vital we are thinking systematically about reaching this group. At the moment, there seems to be considerable variation in how people are followed up.”

One homecare provider, Cera, has said many of the elderly people it cares for are either “too frail” to travel to vaccination centres or “fear infection” if they do so.

NHSE has said people are eligible for a vaccination at home if they are unable to leave their home at all, or require significant assistance due to illness, frailty, surgery, mental ill health or are nearing end of life. It is unclear how GPs should identify these patients.

HSJ has been told a similar pattern is developing in covid vaccine uptake that is usually seen in the uptake of the flu jab, with higher rates in younger, more mobile age groups.

Jacob Lant, head of policy and public affairs at Healthwatch England, said the “definition” of housebound should be broadened to include those who “feel housebound in the context of covid”.

The Department of Health and Social Care and NHSE were approached for comment.

The rollout of vaccines to people in their own homes appears to have been slow in part due to the storage and transport complexities of the vaccine itself.

One primary care network leader told HSJ: “We’ve ended up delegating the job as it was going to be so difficult to coordinate — collecting the vaccines from the site, needing two people to sign them out, the clinical commissioning group needing to check the cool box, et cetera… and all for 15 patients.

“We decided as a PCN to subcontract it to the community team… they do home visits and the covid virtual wards so might as well use them for this too.”
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https://www.hsj.co.uk/primary-care/...ed-for-vaccination-nhs-warned/7029535.article
 
Moved post

It appears that, in my part of the UK at least, you can now describe yourself as clinically vulnerable and book a vaccination appointment.

Someone I know did this, after being advised by their local authority not to wait for an invitation. Like me, they have ME plus another chronic illness, but are neither on the shielding list nor over 65. They were half-expecting to be turned away when they got to their appointment, but not at all.

I've checked the app over several days, and there seem to be quite a few appointments at each site still available even by late afternoon, so they don't appear to be struggling to provide for people who ought to be ahead of me in the queue. Someone who's volunteering at one of them told me they have more vaccine available than arms to put it in, so providing the situation is the same next week, I'll try and book myself in. (My MoT is being sorted this week – wheelie accessible vans are wonderful until the ruddy exhaust develops a leak, at which point you have to find a garage where they make the pipes up to fit non-standard vehicles!)
 
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My mums had to keep calling the district nurse, and now we find out that the GP sent my referral to the wrong district nurse service so they don’t cover my catchment area so won’t come out. :/

they also told us that the GPs themselves can come out and do vaccines. Why haven’t they done it? Now my mum needs to try to call and get another referral put in and wait some time again. Also Dr IQ is not allowing me to put in online consultations either as the GP practice is stopping them at 1 or 2pm every day (they used to be 24hrs a day, even on weekends).
 
So my mum called them again and my mum said what are you doing about clinically extremely vulnerable people who are housebound? They’re supposed to have been vaccinated by now. And the staff said “vaccines don’t travel, you have to come to us”! What is the meaning of this? Then she told my mum that they don’t have a system for clinically extremely vulnerable homebound people, you either come into clinic or if you can’t come in, you have to wait... unbelievable.
 
lunarainbows said:
So my mum called them again and my mum said what are you doing about clinically extremely vulnerable people who are housebound? They’re supposed to have been vaccinated by now. And the staff said “vaccines don’t travel, you have to come to us”! What is the meaning of this? Then she told my mum that they don’t have a system for clinically extremely vulnerable homebound people, you either come into clinic or if you can’t come in, you have to wait... unbelievable.
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I would email my M.P. if I were you.
 
That's all these clinically extremely vulnerable people who have been instructed to stay at home / self-isolate until the end of March, I presume. (We're still waiting, too). And GPs *do* do home visits to administer vaccines: I was talking to one who had been only last weekend. But it may be it doesn't work if the surgery only has the Pfizer vaccine because of the storage conditions required (it does seem to be a bit hit-and-miss which vaccine is delivered on any one day). And/or that they need to put together a sufficiently large visiting list so that all the vaccine can be used in one go, rather than doing a few people on one day and a few more on another. I think even the AstraZeneca one needs to be used up within 6 hours, IIRC.
 
Kitty said:
Nottinghamshire. The old system of smallish CCGs seems to have changed now, and despite containing several different local authorities, the whole county is under the same one and is using the same app for all the centres.
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I rang up earlier this week in my area (Cambridgeshire) since a work colleague had rang on Monday and been booked for a jab on Friday despite not having received a letter or anything (she has a respiratory condition not ME). When I rang the same GP surgery on Wednesday the surgery advised that they were waiting for a new batch and all slots were booked. They couldn’t book me until the next batch of vaccine arrived (how the system worked) but suggested I ring on Monday when the vaccination centre would have more arrive and be able to release more slots to give to my GP surgery. There was no challenge about me actually having it...it was just a logistical restriction.
 
arewenearlythereyet said:
There was no challenge about me actually having it...it was just a logistical restriction.
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Yes, much the same here. I guess the difference is that I'm not using the local surgery, but one of those centres that has been set up to operate seven days a week on a semi-industrial scale. This one is at former TV studios that I know quite well.

I wanted to avoid my GP surgery because it only has two disabled parking spaces. I can't even get out of my van in the standard-sized ones, so I'd have had to turn up really early to queue for a space – potentially blocking it from use by another disabled badge holder, who might be ahead of me in the appointment schedule.

The centre I'm visiting has a big car park, is on an industrial estate with easily accessible roads, and unlike the surgery, is also large, high-roofed, and airy. I've booked my appointment for Sunday, so fingers crossed!
 
Kitty said:
Yes, much the same here. I guess the difference is that I'm not using the local surgery, but one of those centres that has been set up to operate seven days a week on a semi-industrial scale. This one is at former TV studios that I know quite well.

I wanted to avoid my GP surgery because it only has two disabled parking spaces. I can't even get out of my van in the standard-sized ones, so I'd have had to turn up really early to queue for a space – potentially blocking it from use by another disabled badge holder, who might be ahead of me in the appointment schedule.

The centre I'm visiting has a big car park, is on an industrial estate with easily accessible roads, and unlike the surgery, is also large, high-roofed, and airy. I've booked my appointment for Sunday, so fingers crossed!
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Yes I will get vaccinated at a vaccination centre somewhere else I believe ... the gp will just be my booking agent :)

good luck
 
I'd just like to comment on the frequent claims in the media that all of the vaccines "prevent" severe illness and death. Unfortunately, this is not true. The clinical trials did not have sufficient sample size for any conclusions on this. However real-world data shows that while the risk is significantly reduced, vulnerable people who have been vaccinated are still dying.

Data from Israel
https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

Data from Scotland:


Only prevention of transmission will stop people from dying!
 
Snow Leopard said:
I'd just like to comment on the frequent claims in the media that all of the vaccines "prevent" severe illness and death. Unfortunately, this is not true. The clinical trials did not have sufficient sample size for any conclusions on this. However real-world data shows that while the risk is significantly reduced, vulnerable people who have been vaccinated are still dying.

Data from Israel
https://www.nejm.org/doi/full/10.1056/NEJMoa2101765

Data from Scotland:


Only prevention of transmission will stop people from dying!
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Seems to provide evidence for going with a single dose --- reduction in hospitalisations 95%? I wonder if this will encourage the the UK Westminster Government to further delay second doses i.e. to get more people a first dose.

Still, only sure approach to avoid severe illness/death is not getting the virus!

If you were responsible for the decision @Snow Leopard would this data suggest the optimal time for the second dose is e.g. 28 days -- or is it still not clear?
 
FMMM1 said:
Seems to provide evidence for going with a single dose --- reduction in hospitalisations 95%? I wonder if this will encourage the the UK Westminster Government to further delay second doses i.e. to get more people a first dose.
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The 94% figure is nonsense, lacks sufficient sample size to have any confidence for generalisation.
Have a look at the data in the appendix. The efficacy in the first few weeks of both vaccines (against hospitalisation) is in the 50-75% range)
But there is a lack of data for the AZ vaccine in general.

If you were responsible for the decision @Snow Leopard would this data suggest the optimal time for the second dose is e.g. 28 days -- or is it still not clear?
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There is a lack of long-term data, but nothing in the data suggests that later than 21-28 days is superior for the Pfizer vaccine.
 
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