COVID-19 vaccination programme weekly update: 19 May 2021

Our National Vaccination Strategy was published on 11 January and is based on the detailed planning NHS Wales had been doing. Our strategy is focused on 3 key areas:

• Our priorities – we continue to work closely with the UK Government on supply. Based on what we know about supply and the priority cohorts set by the JCVI, we have set key milestones.
• Our vaccination infrastructure - making sure that people can access their vaccination offer - the places to go to get vaccinated, people to give the vaccination and the appointment and digital recording and reporting system set up.
• Keeping up to date and informed about the vaccination programme - we are committed to providing information to keep everyone in Wales updated about the vaccination programme.

An update to our National Strategy was published on 26 February 2021 to reflect on progress and provide further information about our current and future priorities.

Our priority list of people to receive the vaccine has been agreed by endorsing the UK’s independent Joint Committee on Vaccination and Immunisation (JCVI). The same priority list is being followed by all four nations in the UK and has the support of all 4 Chief Medical Officers (CMOs) within the UK.

As set in the progress section below, we have completed the first phase of the programme: 

• all older person care home residents and staff
• frontline health and social care staff
• those 50 years of age and over
• the clinically extremely vulnerable individuals
• those with underlying health conditions with put them at higher risk of serious disease and mortality

We are now in phase 2 of the programme. Subject to supply, our aim is to offer the vaccine to all eligible adults in Wales by the end of July. 

As we continue to operate on the principle of no one left behind, the NHS will go back and offer those in priority groups 1-9 who for various reason have not yet taken up their offer. 

That means, we are now vaccinating:

• everyone aged 18 to 29
• everyone aged 30 to 39
• remaining adults aged 40-49
• anyone who, for whatever reason, was missed in priority groups 1-9, so that no one is left behind

Our second dose programme is running substantively alongside our first dose programme. The second dose is essential for longer term protection so it’s really important that second dose offers are taken up.

Our infrastructure has been built from the ground up and is a blended delivery model. This is aimed at providing a mix of sites in order to maximise speed of roll out, ensure safety, meet the needs of the characteristics of the vaccines, be as conveniently located as possible and, importantly make sure we give equitable access across the country and all communities.

During the past week vaccinations were being administered in 462 locations across Wales, including:

• 54 mass vaccination centres
• 346 general practice locations
• 11 pharmacies
• 30 hospital locations
• and there were 18 mobile teams operating

Achievement of markers and milestones

We have completed phase 1 of our programme, which includes 2 milestones. 

Milestone 1

In our Vaccination Strategy we said that subject to supply we would: 

Offered the vaccine to all individuals in cohorts 1–4 by mid February. That includes all older person care home residents and staff; frontline health and social care staff; those 70 years of age and over; and clinically extremely vulnerable individuals.

We confirmed on 12 February that we had achieved this milestone.  

We also outlined 3 markers to deliver as part of our journey to achieving milestone 1 by mid-February:  

• marker 1 was to have offered a first dose of the vaccine to all frontline Welsh Ambulance Trust staff by 18 January
• marker 2 was to have offered the vaccine to all older person care home residents and staff by the end of January
• marker 3 was to have 250 GP practices deploying the vaccine by the end of January

These first groups are now being offered their second dose of the vaccine, which is important for longer term protection. 91% of care home residents and 80% of care home staf have now received their full course of the vaccine.

Milestone 2

We said we would, subject to supply: 

Offered the vaccine to all individuals in cohorts 1-9 by mid April. That includes all those aged 50 and over.

We achieved this milestone on 4 April. 

We also outlined 3 markers we expected to achieve during milestone 2 by mid-April:   

• 1 million vaccine doses administered by 7 March.  This was achieved ahead of the target date on 27 February
• 1 million first doses administered by 14 March. This was achieved ahead of the target date on 9 March.
• 1.5 million doses administered during Milestone 2. This was achieved

In summary:

• all those in priority groups 1-9 have been offered the vaccine and those in priority group 10 are being offered the vaccine
• high take up of both first and second doses in priority groups 1-4
• more than 2 million people have received their first dose of the vaccine in Wales
• 939,072 people have received their full course of vaccine. In total, more than 2.9 million vaccines have been administered
• 79% of the 40-49 cohort have received a first dose, 62% of the 30-39 cohort have received a first dose and 43% of the 18-29 cohort have received a first dose
• we are maintaining a high rate of vaccination in our programme alongside the Four Nations, as the following 7 day rolling average chart from 17 May shows. 
• overall, 80% of our adult population have had a first dose and 36% of all adults in Wales have completed the two-dose course

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There are always plans in place to ensure that no one is left behind, so it is never too late for someone in the first priority groups to come forward for their vaccination. 

Phase 2 of our Vaccination Programme is underway and our current priority is milestone 3 in our Strategy. 

We have said, subject to supply, it is our aim to offer everyone in the current 10 priority groups their first dose of the vaccine by the end of July.  

We remain on target to achieve this next milestone. More than two million people in Wales have received a first dose of COVID-19 vaccine. Almost three million doses of the vaccine in total have been administered in Wales in just six months.

All health boards in Wales are inviting 18 to 29-year-olds to come forward for vaccination. In line with JCVI advice, the NHS in Wales is working hard to ensure every dose of vaccine allocated to Wales is delivered promptly to vaccination centres and primary care contractors for use in the programme and to make sure the appropriate vaccine is available at the right time. 

We operate a just in time method of deployment ensuring every vaccine delivered to Wales is given to individuals as soon as possible. Health boards operate their own reserve lists and can use their own operational flexibility to ensure no vaccine is wasted, particularly if the vaccine has a short shelf life or when people cancel or cannot make an appointment at short notice. They can also use this flexibility to ensure people get the vaccine that is most appropriate for them.

Second doses

In February in response to the slowdown in the supply of vaccine, we took the decision to shorten the interval between first and second doses for some people receiving the Pfizer BioNTech vaccine. This helped us effectively manage the risk of people going longer than the 12 week interval between doses advised by the JCVI. 

As a result, Wales has since February, been ahead of other parts of the UK in the proportion of our population having both doses of vaccine. All nations are now at a similar point and we expect the pattern of second doses to follow that of first doses 11-12 weeks earlier. Whilst this means second dose coverage will fall slightly behind other UK nations in the coming weeks, no one will have to wait more than 12 weeks for their second dose. The pattern of first doses means we expect Wales to overtake other nations on second dose coverage again by around the end of June. 

Protecting the vulnerable has always been at the heart of our response and the speed of our roll out and our high take up rate means we are well on our way towards that important goal, with over 95% of people resident in older people care homes and our over 70s having received their first dose. In fact, over 91% of people resident in older people care homes and those over 70 have received their second dose to complete the course and protect them against COVID-19. 

The so-called India variant (VOC-21APR-02). Our Test Trace Protect teams continue to ensure we trace and monitor contacts of variant cases and are also further developing local plans if targeted or surge testing is required. The numbers in Wales of this variant are low and we have high numbers of people already vaccinated, including high numbers of second doses in our most vulnerable groups. But we are closely monitoring this variant in Wales and in line with the latest JCVI advice are working with our local incident teams and health boards to facilitate bringing forward, subject to supply, second doses of vaccination where it will reduce infections and hospitalisation.  The emergence of the so-called India variant (VOC-21APR-02) is a reminder that COVID-19 has not gone away and that it’s really important to take up the offer of vaccination when it is your turn, including getting the second dose when offered. 

By taking up the offer of vaccination, you are doing your bit to keep Wales safe. If you, or anyone you know, has not yet taken up the offer of the vaccine, it is never too late to change your mind and arrange an appointment. 

People’s safety always comes first. We will only use vaccines where it is safe to do so and the benefits continue to outweigh the risks. We are confident in the vaccines and certain that we must keep momentum. People will receive invitations to a vaccination appointment where the vaccine used is appropriate for their age or clinical circumstances. 

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that, as a precautionary measure, those under 40 years of age with no clinical risk factors who are not yet vaccinated should be offered an alternate to AstraZeneca. Health boards will make the appropriate vaccine available at the right time for individuals. However, the JCVI is very clear that in the 30-39 age group, any of the UK vaccines is always better than no vaccine, unless there are specific contraindications.

The JCVI advises that there continue to be no concerning safety signals for this extremely rare adverse event following a second dose of AstraZeneca vaccine. 

Everybody who has already had a first dose of the AstraZeneca vaccine should be reassured that they should receive a second dose of the same brand, irrespective of age, in line with JCVI advice. Medical exemptions may apply to a very small minority, for example the very small number of people who experienced blood clots with low platelet counts following their first vaccination or have experienced a severe allergic reaction to their first dose.

The AstraZeneca vaccine has already saved thousands of lives and remains safe and effective for the majority of the population. Over 1.2million people have received the AstraZeneca vaccine in Wales since January, with very few cases of the rare clotting with thrombocytopenia event.

Vaccines remain the best way out of this pandemic and provide strong protection against COVID-19 – it is important that when people are called forward, they should get their vaccination. 

It is important that we maintain the current high-levels of vaccine uptake to keep Wales safe. Every dose administered and every person protected really does make a difference. The vaccines are safe and effective and we urge everyone to take up their offer when it is their turn. Your second dose of vaccine is important for longer lasting protection against COVID-19.

Public Health Wales has helpful FAQs on their website about the vaccine and safety, they are also publishing daily and weekly surveillance data releases.

A range of information on our vaccination programme is available on our website, including guidance published relating to the priority groups. 

Welsh Government statisticians are also publishing some of the more operational statistics attached to the programme each week.