Coronavirus (COVID-19): vaccine deployment plan: update - March 2021

Where we have got to so far

Our COVID-19 vaccine deployment plan

The COVID-19 Vaccine Deployment Plan that we published in January 2021 set out our COVID-19 vaccination programme plans for how we will work as fast as supplies allow to vaccinate everyone in Scotland over the age of 18 and those aged 16 and 17 who are frontline health and social care workers, unpaid carers or have underlying health conditions. In total, this equates to just under 4.5 million people across the country.

Phase 1 of our programme focuses on vaccinating JCVI priority groups 1 to 9. This document reflects on progress against the plan published in January and sets out the next steps ahead. This includes phase 2 of the vaccination programme, during which we will be offering a vaccination to all remaining adults (those between the ages of 18 and 49) who haven’t already been offered a vaccination in phase 1. The offer of a vaccination will remain open for all those who are eligible.

How we have prioritised

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that current evidence strongly indicates that the single greatest risk of death from

COVID-19 is increasing age, and that the risk increases more rapidly with increasing age. Additionally, the JCVI considered frontline health and social care workers who provide care to vulnerable people a high priority for initial vaccination. More details about this are set out in the JCVI’s advice on who should be initially prioritised for vaccination.

In summary, the JCVI advised that 9 groups of people should be initially prioritised for vaccination.

These are (in order of priority):

1. residents in care homes for older adults and their carers
2. all those 80 years of age and over and frontline health and social care workers
3. all those 75 years of age and over
4. all those 70 years of age and over and clinically extremely vulnerable individuals
5. all those 65 years of age and over
6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality, and unpaid carers
7. all those 60 years of age and over
8. all those 55 years of age and over
9. all those 50 years of age and over

This approach to prioritisation in the first phase of the vaccination programme was supported by all 4 UK Nation Chief Medical Officers, in line with the advice from the JCVI, who agreed that this approach is most likely to achieve the initial aims of reducing mortality (death) from COVID-19 and maintaining our health and social care systems. In line with JCVI advice, we are also offering vaccination to unpaid carers in group 6. Following recent advice from the JCVI, group 6 has also been expanded to include people experiencing homelessness and rough sleeping.

Our COVID-19 vaccination programme has robust governance in place including a Programme Board which has ensured that we continue to be guided by expert clinical and policy advice. The JCVI provides advice on vaccination prioritisation and we are continuing the roll-out of the vaccination programme in line with that advice. When we receive advice from the JCVI, we then consider the impact of this in a Scottish policy and operational context. As the JCVI states, their advice is not exhaustive and cannot cover every detail.

That is why, for example, we provided further detail on the types of workers that were included in the frontline health and social care worker category (included in JCVI priority group 2). Another example was when the JCVI, having noted that many homeless individuals were likely to have underlying health conditions which would place them in JCVI priority group 6 and that these conditions were likely to be under-diagnosed or incompletely recorded in primary care records, advised that local teams exercise operational judgment and consider a universal offer to people experiencing homelessness and rough sleeping, alongside delivery of the programme to priority group 6, where appropriate.

In doing this, we seek to maintain a consistent approach across the four UK nations, and we expect our Health Boards to work within the nationally agreed prioritisation schedule to manage the distribution of vaccine supplies to those that fall into the priority groups.

Our progress

In our deployment plan, we said that we would aim to offer everyone in JCVI priority groups 1 to 9 a first dose of vaccine by early May 2021. Despite it currently being likely that we will have lower supply of vaccine during April than we expected, subject to supply we now expect to offer first doses to all 9 JCVI groups by mid-April.

Since the vaccination programme began on 8 December 2020, at the time of publishing this update (as at 7:30 am on 24 March 2021):

First doses

• in total, 2,249,612 people in Scotland have received the first dose of COVID-19 vaccine, covering 49.5% of those 16 and over. This includes:
  • 263,555 people aged 80 or over
  • 195,696 people aged 75 to 79
  • 280,234 people aged 70 to 74
  • 164,357 people who were advised to shield, part of the clinically extremely vulnerable group (part of priority group 4)
  • 292,790 people aged 65 to 69
  • 322,248 people aged 60 to 64
  • 614,898 people aged 16 to 64 with underlying health conditions
  • 85,692 unpaid carers
• these figures include care home residents and frontline health and social care workers
• in total, 26,231 residents in older adult care homes, 92,300 specified frontline healthcare workers and 91,325 frontline social care workers. have received the first dose of vaccine

Second doses

• in total, 249,252 people in Scotland have now also received the second dose of COVID-19 vaccine, covering 5.5% of those aged 16 and over
• this includes 84% of residents in older adult care homes and 74% of care home staff who have now received both the first and second doses of vaccine

Figure 1 shows the cumulative doses of COVID-19 vaccine (both first and second doses) administered in Scotland as at 24 March 2021.

The currently available COVID-19 vaccines should be administered in a course of two doses, and it is important to receive the second dose of the vaccine within a certain time period for maximum and longer duration protection against COVID-19. Now that many people have received their first dose, second doses of vaccine are also being administered and will be an ongoing feature of the vaccination programme. 

The latest guidance in the Green Book states the appropriate time between doses for the available COVID-19 vaccines. Health Boards are responsible for scheduling these second vaccination appointments. Detailed modelling of first and second dose scheduling requirements means they are prepared and ready with vaccine supply for second doses. Health Boards will ensure that everyone who has received their first dose of vaccine will have an appointment to receive their second dose of the same vaccine within the appropriate timescale as advised by the JCVI.

Figure 1 – Cumulative doses in Scotland by day, as at 24 March 2021

Going beyond our original plans

In our deployment plan, we said that we would aim for 80% vaccination take up by those in JCVI priority groups 1 to 9. This means we were planning for around 80% of people who were offered vaccination to take up the invitation. Since the vaccination programme started in December, we could not have hoped for a more positive uptake of the vaccines. Latest progress as at 24 March 2021 shows we have now provided first dose vaccinations for: