Report prepared 14 January 2022

Outbreak Management Advisory Committee

Covid-19 Vaccination Programme Update

The Local Vaccination Service (LVS) sites continue to deliver covid vaccinations in line with NHS England and JCVI priority groups. At present these include:

- National prioritisation of Booster vaccinations for all eligible cohorts, with a focus on care homes and housebound patients

- Immunosuppressed patients requiring a 3^rd primary dose as part of their course of vaccinations - and now immunosuppressed patient Booster vaccinations (4^th doses) at an interval of 3 months post their 3^rd primary dose

- Supporting the universal offer to 12-15 year olds

- We maintain an evergreen offer for patients coming forward for a first dose vaccination, and endeavour to accommodate these as opportunistic 'walk-ins' without the need to book an appointment

Current providers are:

• National Vaccination Centre run by Nimbuscare at Askham Bar, York

Plus the following CCG-commissioned Local Vaccination Services:

• Askham Bar LVS, York
• Haxby Health Centre LVS
• Tadcaster Health Centre LVS
• Selby Leisure Centre LVS
• Pickering Medical Centre LVS
• Galtres Centre LVS, Easingwold

There are also a number of smaller Community Pharmacy-led sites across York which are working in partnership with LVS's to provide more local access to vaccinations in areas of low uptake.

The above Providers offer services from their main sites, plus regular pop-up clinics (according to supply/demand) to provide more convenient and local access for hard to reach or vaccine hesitant groups across the area.

COVID Vaccination Programme Numbers - Summary

At 13^th January 2022, Vale of York CCG has 352,771eligible individuals for covid vaccinations (from the national IMS Reporting Tool). This number changes frequently as more JCVI cohorts become eligible (e.g. 12–15 year olds), and as guidance changes re. the required time needed between the various doses. Progress re. the first (partially vaccinated), second (fully vaccinated) and booster programmes is as follows:

At the beginning of December 2021, NHS England/Improvement asked GP Practices to prioritise the Booster programme in the run up to the Christmas holiday period and maximise the uptake of Booster vaccinations for the population who were eligible.

Our timeline analysis shows a significant increase in Booster vaccination uptake from mid-December, with demand dropping off on December 24^th. On 18^th December, the Vale of York population received 8,634 Booster doses – this is a significant increase on the daily vaccination rate over any other part of the programme to date. The CCG is extremely grateful to all staff who worked up to and over the holiday period across all of the vaccination sites.

We continue to work with local partners to promote/publicise access to vaccinations and deliver accessible services across the CCG area.

Vale of York CCG Booster doses by date during December are as follows:

Care Home Vaccinations

The CCG is progressing well with care home vaccinations.

As at 14th January 2022 we have residents vaccinated in the following numbers:

98% first dose, 97% second dose, 92% booster

Where it makes operational sense and is clinically appropriate, and consent is in place, vaccination services have co-administered the flu vaccination.

Staff covid vaccination rates are:

99% first dose, 99% second dose and 63% booster (excluding those who have a Medical Exemption from these figures).

The programme is affected by any infection outbreaks at a home, and we have seen sites request vaccination sessions be postponed. Providers continue to risk assess the decision to go into a home to vaccinate in these circumstances.

Vaccine Supply

At present the vaccine available is predominately Pfizer and Moderna – and the 15 minute observation period for these vaccines has now been waived (although patients are recommended to not drive for 15 minutes). Askham Bar has a small supply of Astra Zeneca vaccine reserved for patients with allergic reactions to Pfizer – and a referral process has been established to enable the CCG population to access this if clinically required.

In the lead up to the Christmas holiday period, in support of the national Booster programme, NHS England/Improvement delivered a significant increase in supplies of both Pfizer and Moderna vaccines across the country. In that context, vaccine supplies have been more than adequate over recent weeks, but the post-Christmas drop in demand for Boosters presents a risk of vaccine wastage, as there is unused stock across the region that expires around 20^th January. The CCG, vaccination sites, NHS England/Improvement and local stakeholders are working to offer and publicise vaccination clinics over the next week in an effort to reduce any wastage to a minimum.

Lower Uptake Cohorts

We know that our Vale population has older residents, who became eligible earlier and take up was high overall. For both our Vale and City residents we see excellent take up rates until we start to see levels fall off in the under 50s.

We work with practices and the contract tracers at City of York Council periodically to review at an individual level who hasn't taken up the vaccination offer and adapt our approaches.

The following table shows the vaccination uptake at ward-level across the City of York (partially vaccinated = 1^st dose, fully vaccinated = 1^st + 2^nd dose):

The wards with lowest uptake continue to be Clifton, Fishergate, Guildhall and Hull Road – although these numbers do seem to be slowly improving.

Experience to date has provided evidence that only when external factors are engaged do we see an increase in uptake, e.g. promotion of a 'covid passport' without which freedoms might be curtailed. We continue to change up our advertising and engage different methods, but the slowdown is embedded.

We are still seeing some first dose take up, but it is small numbers.

We continue to run a variety of advertising/awareness campaign across a number of platforms.

Influenza Vaccine Programme

The annual flu vaccination programme continues in both General Practice and pharmacies. There remain supply issues when all allocations are used and there is a delay in replenishments.

Current flu vaccination uptake figures across eligible cohorts (from the IMS Reporting Tool at 13^th January 2022) are as follows:

Stephanie Porter

Interim Director for Primary Care and Population Health

Shaun Macey

Acting Assistant Director of Primary Care