Worth a Shot: Accelerating COVID-19 vaccinations

The Adam Smith Institute’s latest paper, by Fellow James Lawson, independent researcher Jonathon Kitson, and Head of Research Matthew Lesh, explains how accelerating the United Kingdom’s COVID-19 vaccination programme is both deeply desirable and very possible:

  • The COVID-19 pandemic rages on with an average of over 40,000 daily new confirmed cases in the United Kingdom (UK), an all-time high. Over 400 people a day die with the virus, and lockdown measures necessitated by the virus continue to cause further harms. The fastest and safest way out of this crisis is mass vaccination.

  • In international terms, the UK was the first to begin vaccinating and is well-ahead of other European countries and narrowly ahead of the United States. Nevertheless, at the current rate Phase 1, one dose for vulnerable groups, will not be completed until late 2022. 

  • It is both possible and necessary to accelerate Britain’s vaccination programme. Israel has been vaccinating as much as 10-times faster than the UK per head.

  • The current Government target, one million doses per week, would mean Phase 1 would not be completed until August 2021, well after Prime Minister Boris Johnson’s target for “back to normal” by Easter.

  • The pandemic is hugely costly to both the Government and the economy more widely. Every additional week of the pandemic costs the taxpayer £6 billion, while reducing economic activity by £5 billion. There are also countless harder to quantify costs, for example, declines in pediatric vaccinations, cardiovascular admissions, and endoscopic services and mental health.

  • Speeding up the vaccination effort to 6m people a week could save as many as 50,000 lives.

  • The huge costs of the pandemic justify a “war effort” to accelerate vaccinations and end the crisis.

  • Britain’s vaccination programme is being hampered by an excessively centralised, command and control approach that has rebuffed help from the private sector, the armed forces and volunteers. 

  • If the Government wants to rapidly speed up vaccinations, protect the vulnerable and end the pandemic they should set a target of six million doses per week, matching Israel’s speed at scale. It will also be necessary to create a Number 10 ‘War Room’ dedicated to accelerating the vaccination programme, empowered to remove bottlenecks.

  • The COVID-19 pandemic is an extraordinary challenge. The UK has an opportunity to lead the world in putting an end to the crisis — but it will take a new ambitious approach to the vaccination challenge. 

How to increase supply and distribution

  1. Fully call up the Armed Forces and reservists with expertise in field hospitals and logistics; 

  2. Commission pharmacies with pre-existing venues and skills in administering vaccinations, as is done in the annual flu vaccination programme;

  3. Use closed hospitality and other venues such as hotels, which are equipped with commercial grade refrigeration to store the Oxford/AstraZeneca vaccine, with support from local medical professionals;  

  4. Use public venues, like places of worship, public housing, community centres, school gyms etc., with support from local medical professionals

  5. Create drive-in centres, as have been successfully deployed in Israel;

  6. Launch mobile vaccination centres, to ensure vaccines can be provided to more remote and harder to reach communities;

  7. Provide 24/7 vaccination services with Government subsidising overtime and late shifts;

  8. Allow walk-in services for “spare” appointments and doses, so any gaps or unused doses are used;

  9. Extend criteria immediately to include all priority group individuals, including those aged over 55 and younger with vulnerabilities, to ensure maximum use of available doses.

  10. Accelerate and expand use of the “Jabs Army” and volunteers, to provide sufficient vaccinators and logistics staffing;

  11. Simplify staff onboarding requirements, to avoid needless hindrance to volunteering;

  12. Increase payments to GPs and local health professionals per vaccination, to ensure maximum possible effort dedicated to vaccinations;

  13. Develop an online booking platform, to maximise the booking of appointment slots;

  14. Reward attendance at vaccination appointments if “no-shows” prove to be a bottleneck, with cash rewards (at traditional centres) or shared rewards (at repurposed hospitality venues, like a takeaway pint)

  15. Online delivery of home injection kits for those willing and able to do so (e.g. diabetics who currently self-administer injections, accompanied by a self assessment and video supervision to mitigate risks;

  16. Launch a marketing campaign to encourage appointment booking;

  17. Award prizes for best employees and centres, to identify and reward best practice and vaccinating at higher rates;

  18. Crowdsource ideas, from both the country broadly and from staff on the front line about how to accelerate vaccine delivery, including financial rewards for ideas that are introduced;

  19. Clarify delivery schedules and negotiation of increasingly rapid supplies for the Oxford/AstraZeneca and Pfizer/BioNTech vaccines;

  20. Provide market commitments for input materials, such as glass vials, to remove any supply bottlenecks;

  21. Immediately approve the Moderna vaccine for order and distribution, given its approval by the U.S. Food & Drug Administration, while UK processes complete; and,

  22. Proactively plan for and stock the Novavax vaccine, pending completion of its phase 3 clinical trials and UK approval processes; 

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