Jab well done: inside a Covid vaccination centre

A queue is forming outside a modern, brick building on a North London side street, next door to Kentish Town’s Caversham General Practice. Several of those in the line could be as young as 20 and there’s barely a grey hair in sight.

A chirpy, middle-aged man strolls out from behind the glass door with a spring in his step. He picks up his phone: “Yep, the Oxford one… feeling good, thanks. Nice b-day present!”

I’ve arrived at Peckwater Health Centre, my local Covid vaccination spot. The youthful faces outside momentarily threw me, but they’re just a sign of how far we’ve come. The government met its ambitious target of vaccinating 15 million people by mid-February. Now those in their sixties and young people with medical conditions are getting the call-up for their jab.

In ‘normal’ times, locals shuffle into Peckwater for physio treatment, but it’s one of 1500 spaces across England to have been rapidly repurposed into a vaccination site. Since the NHS began its mass-inoculation programme, headed by its Chief Commercial Officer, Dr Emily Lawson, 1200 GP and pharmacy-led local vaccination centres have been established. A further 206 hospital hubs and 50 large-scale vaccination centres, located in venues such as football stadiums, comprise the rest. For those who are housebound, GPs and their teams are taking the vaccine to them.

Few people are far away from a site. In November, Lawson assembled military support from Brigadier Phil Prosser, commander of the army’s 101 Logistic Brigade. In addition to co-ordinating distribution, Prosser and his 50 military logistic experts were tasked with calculating the optimum location of centres to ensure every UK resident could access a jab within 10 miles of their home.

I’m met at Peckwater’s entrance by Fay Saunders, Deputy Practice Manager of the Caversham practice, who, alongside a clinical lead, is in charge of ensuring everything on the site runs smoothly. Her warm greeting is a contrast to the waiting room’s cold draught.  It’s snowing outside but all of the windows are wide open for ventilation. “Patient safety pre-vaccination is a big concern,” explains Saunders, “so there’s lots of infection control.” The room bears the familiar signs of social distancing: yellow tape and generously spaced out leather chairs. And as soon as a patient gets up to head for the vaccination room, a volunteer rushes over to scrub down their seat.

It’s the AstraZeneca jab on offer today. But which of the vaccines a patient gets is a lucky draw as deliveries vary from week to week. Some express mild disappointment when it’s not the 95 per cent effective Pfizer vaccine. Others want the Oxford one for “patriotic” reasons: a dose of Britannia delivered straight through their veins. Generally, though, adds Saunders, people happily take what they’re given. One shielder, waiting eagerly for her jab, says this is the third time she’s left the house since March.

If she wants an omen for the strength the vaccine will bring, the delivery number of this week’s batch is 007.

Getting the jab is a very quick process. In the first of the four small vaccination rooms, Dr Roberts, a GP trainee and volunteer, is administering doses on her day off. Patients enter one at a time. She checks the form they’ve filled in beforehand, pricks their arm, hands them a little blue card containing their vaccination details and warns them that they may develop flu-like symptoms for the first couple of days.

Meanwhile, Chris Reilly, a Practice Assistant at Caversham, who’s volunteering before his shift starts, is sat at the computer, ensuring every patient’s vaccination details get logged with their GP.

As relieved post-jab patients roll down their sleeves, Dr Roberts tells them they’ll get the call up for their second dose in 10 to 12 weeks. But some are returning sooner for a blood test, to take part in ongoing immunisation studies.

The staff running the vaccination centre don’t put in their own vaccine orders. They’re simply sent a delivery schedule a week in advance, by the North Central London Clinical Commissioning Group, and mobilise the clinic around what they’re given. By being a vaccination site, Saunders explains, “we make a commitment: you send us what you can and we’ll make it work. And, so far, we have.”

The Pfizer jab is notoriously high maintenance. It must be stored at ultra-low temperatures, so it’s delivered in special freezer vehicles – “ice-cream trucks,” as the staff like to call them.

Once it arrives, it’s kept in the same conditions as the AstraZeneca jab or any flu vaccine, in a standard medical fridge. But it has a short shelf-life of three days.

As soon as any of the jabs leave the fridge, and are brought into a vaccination room in small vials, they must be used up within a matter of hours.

Yet rumours of wasted supplies are something the Peckwater staff are keen to dispel. The site has done over 8000 vaccinations, and “hasn’t wasted a single vaccine.” Each vial contains 11 to 12 doses, explains Dr Roberts, “but we’re very cautious about opening a new one. Once it’s open, it will all get used.”

My hopes of being offered a leftover jab if I linger long enough are quickly diminishing. “We sometimes get people turning up here at the end of the day to see if they might get a vaccine,” says Saunders. “If they’re not eligible, then the answer’s ‘no’.”

There are “ample people, from eligible cohorts, living locally”, who haven’t managed to book an appointment yet, but are “willing and waiting,” says Saunders. “Whenever there’s excess vaccine, it’s never a struggle to call some up from the list and get a few more in that day.”

Over 30,000 NHS staff are working in Covid vaccination clinics across the country and Saunders makes no secret of the fact that everyone’s working overtime: “If we clock-watched and only worked the hours we’re contracted for, then we just wouldn’t get the job done.” By assigning the likes of Saunders to the vaccination programme, staff back in the surgeries are carrying a heavier workload too. Without the 100,000-plus volunteers on vaccination sites, the task would be impossible.

Volunteers at Peckwater are an eclectic mix, from retired medical professionals to a furloughed make-up artist doing admin tasks. Some were inspired to volunteer when they came for their vaccine: “I’ve had the jab, now let me do something useful,” some said.

There are perks to volunteering, says Reilly. One man, who was made redundant at the start of the pandemic, “did such a good job on the front desk that he’s now been hired by the practice next door.”

And, despite working round the clock, the vaccination programme has its upsides for NHS staff too. Many are pleased to see the back of remote working and have familiar faces coming through the door. “We’ve missed our patients!” says Saunders.

Something staff are greatly hoping to see in larger numbers though is ethnic minority patients coming in for their jabs. There’s a wide range of age groups at the site today but the demographic is overwhelmingly white. The low vaccine uptake among many ethnic minority groups, particularly in the black community, is even more of a concern given they’re a group disproportionately at risk from the virus.

Some patients, Reilly tells me, are taking it upon themselves to help tackle vaccine hesitancy. A Somali man came in last week, who asked the staff to film him getting his jab done. “He wanted to send it to others in his community to encourage them to do the same.”

Meanwhile, NHS staff across the country are working alongside religious leaders to build trust in the vaccination programme. In Birmingham, a local NHS team has worked with leaders of the Al-Abbas Islamic Centre to establish a vaccination centre in the mosque – to send out an unequivocal message that the vaccine is both safe and religiously permitted.

There will no doubt be vaccination setbacks in the weeks and months ahead, but the UK is on track to meet the next target of vaccinating all over 50s by early May. And the controversial decision to delay second doses seems to have been vindicated. Yet the country’s vaccine success wouldn’t have been possible without the ruthless efficiency and tireless work of staff at centres like Peckwater up and down the country. They should all be celebrated.