A Hollywood film and a cunning plan: how Britain got its vaccine rollout right

In a small way at least, the 13.5 million people already given a COVID-19 vaccine in Britain have Gwyneth Paltrow to thank. Kate Winslet, Matt Damon and Jude Law played a part, too.

The four actors star in Contagion, a 2011 Steven Soderbergh film which imagines a devastating global pandemic. The film rocketed up the streaming charts last year as millions searched for hints about how bad the COVID-19 outbreak could get. Warner Bros said the movie jumped from its 270th most-watched film in December 2019 to second-highest by March 2020.

Jude Law in Steven Soderbergh’s pandemic thriller Contagion. Law plays a conspiracy theorist who pushes homeopathic remedies during the pandemic.

One fan was Matt Hancock, Britain’s Health Secretary. The cabinet minister was struck by a key Contagion plotline: an unedifying fight over scarce vaccine supplies. In one scene, an abducted doctor is only handed over in exchange for 100 doses of the lifesaving jab. In another, vials are in such hot demand that recipients must be determined by a lottery based on birthdates.

The lesson? Mass vaccination programs face their “highest stress” in the weeks after beginning. Hancock claims he had Contagion in mind when he asked bureaucrats to secure 100 million doses of the Oxford-AstraZeneca vaccine even though the advice was to buy 30 million. That was one of several critical decisions now paying dividends.

Prime Minister Scott Morrison raised eyebrows in Whitehall last year by arguing Australia was in the fortunate position of being able to sit back and watch Britain’s own rollout. Morrison didn’t say it directly but the implication was that he expected errors in the UK.

British Health Secretary Matt Hancock had Contagion, the movie, in mind.Credit:AP

But the rollout has been ploughing ahead at a remarkable rate. Some 13.5 million people have been given their first dose and 524,000 a second. One in every four adults in Britain have now been given at least one dose – a rate beaten only by Israel and the United Arab Emirates. The United States has so far vaccinated one in every 10 people.

The European Union has administered just four doses for every 100 people, compared to 20 for every 100 across the Channel.

That pace means the government will meet a promise made by Prime Minister Boris Johnson to vaccinate the 15 million most vulnerable people by February 15 – a goal initially written off as impossible.

The priority groups – older care home residents and staff, everyone aged 70 or over, all front-line NHS workers, and all those considered clinically extremely vulnerable because of pre-existing health conditions – together account for 88 per cent of the 115,000 deaths in Britain since the pandemic began.

With at least 90 per cent of over-70s now partly protected, experts are confident the virus has met a worthy opponent and the goal of preventing the vast majority of deaths and hospitalisations is within sight.

British Prime Minister Boris Johnson visits the lab of French biotechnology firm Valneva in Livingston, Scotland.Credit:AP

The program’s success is all the more remarkable given the government bungled so many other pandemic policies. While the slow, stale machinery of the British state was outmanoeuvred by the virus at almost every step over the past year, it has rallied behind the vaccine rollout.

“This is probably the largest peacetime logistics exercise we have ever seen,” says Dr Sarah Shiffling, a supply chains expert at Liverpool John Moores University. “And not with easy things to transport. It’s not like we are shipping bricks around the country. It’s quite a difficult thing to do.”

Vaccine programs can be broken down into three components: supply, distribution and administration, Shiffling says. And on each measure, Britain is vastly outperforming its European neighbours.

While other countries dither or are hamstrung by a lack of regulatory approvals, the UK has been the recipient of a reliable supply because it signed deals early, has onshore manufacturing capacity for the AstraZeneca jab and was cunning enough to insist on reliability of supply clauses. The European Union failed on these fronts and its citizens are paying the price.

On distribution and administration, Brigadier Phil Prosser has been roped in to bring military discipline to the logistics challenge. Prosser’s usual job is commander of the Army’s 101 Logistic Brigade and in wartime would be responsible for battlefield logistics. More than 5000 armed forces personnel are now deployed to the vaccine rollout.

Dr Anil Mehta administers a dose of the AstraZeneca vaccine to a homeless person at the Welcome Centre in Ilford, east London.Credit:AP

St John Ambulance is training about 30,000 volunteers to act as vaccinators, meet-and-greet agents or “patient advocates” to help ease the burden on already stretched doctors and nurses.

The government has also set up a diverse portfolio of vaccination locations, from pharmacies and GP clinics to stadiums and cathedrals. In the northern English city of Newcastle, all 31 GP practices have joined forces to mount an industrial-scale vaccination hub at the local basketball arena. The facility can inoculate 30 people every five minutes.

“We know how to reach people, how to get them in and the best way to target different populations,” Shiffling says.

Margaret Keenan was the first patient in the UK to receive an approved coronavirus vaccine. Credit:AP

Salisbury says world leaders and health chiefs should be watching Britain closely: “You have to be generous with praise because if you want to be successful in any vaccine campaign, you’ve got to bring three things together in the same place at the same time: supplies, people to do the vaccinating and people to be vaccinated. And so far the UK has coordinated those three together.”

Officials think the UK hasn’t just struck success in the complex process of manufacturing, transporting and administering the jab. They are also increasingly happy with the science underpinning their gamble to increase the window between a first and second shot from three weeks to three months, so that more people can get the jab sooner.

Australia has ruled out such an approach, arguing it does not face the same health emergency. But Salisbury is one of Britain’s earliest and most enthusiastic supporters of a wider window between the doses and suspects other countries might eventually adapt their strategy.

“It’s called ‘do the maths’,” he says. “If you vaccinate 1 million people and you give them two doses with a 95 per cent efficacy, you protect 950,000 of them. But if you give two million people one dose and even if the efficacy was only 70 per cent, that is 1.4 million protected.

“I think against the immunological and epidemiological purists, those numbers are the more important.”

The system will be tested over the next few weeks when people return for their second dose just as vaccines are expanded to the broader population. Johnson has set a target of vaccinating everyone aged over 50 and anyone aged 16 to 64 with underlying health conditions by the end of April.

New data on how inoculated people were subsequently infected or hospitalised is expected in the next few weeks, which will accelerate a national conversation about how quickly restrictions can be eased and what constitutes a tolerable number of new daily cases.

Salisbury says that debate will be global: “The likelihood of getting enough vaccine for enough people in low-income countries and then being able to vaccinate them and stop transmission leads me to see a longer run for all this,” he warns.

“I think we may move to a position of more realism, where for the most part in the future we vaccinate the vulnerable every year with a vaccine adapted to the circulating strains. I respect the enthusiasm now for all we are doing, but my longer vision is that this might become more institutionalised, like seasonal influenza.

“These are big ethical considerations but practical solutions will have to be found.”

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