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The Royal Pharmaceutical Society has made this article free to access in order to help healthcare professionals stay informed about an issue of national importance.
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Community pharmacy-led COVID-19 vaccination sites in England have administered more than three million doses of the vaccine, NHS England has said.
This comes as pharmacy sites will soon be able to administer the Pfizer/BioNTech COVID-19 vaccine as well as the Oxford/AstraZeneca vaccine, as part of NHS England’s effort to increase vaccinating capacity.
Speaking during a webinar on 5 May 2021, Caroline Temmink, director of primary care vaccination at NHS England, said community pharmacy sites “have delivered more than three million doses of the vaccine”.
She added that two pharmacies “have now delivered more than 30,000 vaccinations each”: Andrews Pharmacy in Macclesfield, Cheshire, and W Cheeseman & Son in Bedfordshire.
Andrews Pharmacy was one of the first six pharmacy-led sites to start providing vaccinations on 14 January 2021.
Suzanne Blythe, clinical lead for the vaccination programme at Andrews Pharmacy, told The Pharmaceutical Journal that the pharmacy was expecting to have administered 32,000 vaccinations “by the end of this week” from its premises.
“Our pharmacy is quite a big property, but there were parts of the pharmacy that were used just as storage, and back in January we cleared out that area … so we’ve managed to keep [the vaccination programme] separate from our normal services to the public,” she said.
Blythe said the vaccination site has been open 12 hours per day, 6 days per week, with the clinical lead work shared between herself and Andrew Hodgson, the pharmacy’s superindendent pharmacist.
She added that the pharmacy’s vaccination programme has “been a real team effort”, with additional nurses, pharmacists and volunteers recruited to help with the programme.
“It’s really busy and long days but the patients find it really convenient,” she said. “It’s local to them so the feedback from our patients has been really positive.”
“Community pharmacy in general is just such an integral part of the health and social care family, and it’s a really accessible service for the public,” she continued. “GPs have not been able to see people face-to-face and we’ve still been able to provide our services and look after the health needs of our population.”
Alastair Buxton, director of NHS services at the Pharmaceutical Services Negotiating Committee, said pharmacies play “a key role in the COVID-19 vaccination programme, with the teams in vaccination sites working incredibly hard to provide what is a logistically challenging service”.
“We already know what amazing outcomes pharmacy teams can accomplish, but it has been great to hear that colleagues from the NHS have been blown away by the ability of community pharmacies to competently deliver the service to a large volume of patients, whilst also overcoming the operational challenges that are inevitable in such a programme,” he said.
According to the latest list published by NHS England on 23 April 2021, there are currently 339 pharmacy-led vaccination sites.
An NHS England letter, dated 30 April 2021 and signed by Temmink, announced that pharmacy sites will now be administering the Pfizer/BioNTech vaccine in addition to the Oxford/AstraZeneca vaccine.
“Most pharmacy sites have previously used the AstraZeneca vaccine. However, as the available supply for first dose vaccines changes there is a need to increase the Pfizer BioNTech capacity,” the letter said.
“This will become increasingly important as the programme prepares to vaccinate cohorts of people who are recommended to receive alternatives to the AstraZeneca vaccine as first preference.”
In April 2021, the Joint Committee on Vaccination and Immunisation concluded that it would be “preferable for adults aged [under] 30 years without underlying health conditions” to be offered an alternative to the Oxford/AstraZeneca vaccine.
The Pfizer/BioNTech vaccines will be delivered to pharmacy sites in a thawed state and stored at between 2–8 degrees Celsius before being used within five days.
Why will alternatives to the Oxford/AstraZeneca vaccine be offered?
Concern around the Oxford/AstraZeneca vaccine stems from the incidence of blood clots with concurrent low platelet counts in patients who have received this vaccine.
As of 5 April 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) reported receiving 100 Yellow Card reports of “major thromboembolic events (blood clots) with concurrent thrombocytopenia (low platelet counts) in the UK” after having the Oxford/AstraZeneca vaccine.
This means that the overall risk of blood clots is approximately 4 in every 1 million people who receive the vaccine.
But Jonathan Van-Tam, the deputy chief medical officer for England, said on 7 April 2021 that, while the risks versus benefits of the Oxford/AstraZeneca vaccine are “finely balanced” in those aged 20–29 years, in older age groups the risk/benefit ratio is “overwhelmingly in favour” of the vaccine.
The MHRA also said that the expected benefits of COVID-19 vaccines “far outweigh any currently known side effects”, and that “as with all vaccines and medicines, the safety of COVID-19 vaccines is continuously monitored and benefits and possible risks remain under review”.
This was supported by research, which found that the risk of patients developing a rare blood clot is 8–10 times higher in COVID-19 infections than after receiving any of the current COVID-19 vaccines.
READ MORE: Everything you need to know about COVID-19 vaccines
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