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COVID-19 Vaccination Newsletter 1 March 2021 (html version)

Please note that this newsletter reflects the current position as at 1 March 2021. Planning and delivery of COVID-19 vaccination is subject to considerable change due to many different factors outside of our control. Please check our website for the latest information.

In this edition:

Dear Colleagues

Our COVID-19 vaccination programme has now reached 50,000 first doses, and 56,000 total doses (first & second). This is excellent progress in delivering this vital protection for the people of Powys.

Last week the main focus for our vaccination programme included:

  • Continuing our first dose vaccinations for people aged 65-69. Over 80% of people in this group have now received their vaccination. The final invitations to people in this group will land on doormats this week.
  • Beginning our invitations for adults with underlying health conditions. Around 40% of people in this group have received their first dose vaccination. Invitations will continue during March.
  • Putting in place arrangements for vaccination for unpaid carers. Welsh Government published its national guidance last week on eligibility for vaccination for unpaid carers. A new eligibility tool is expected later this week for unpaid carers to check if they are eligible and request an appointment.
  • Continuing to deliver the second dose vaccination for people who received their first dose in the first weeks of our vaccination programme. This is in line with UK guidance that people should receive their second dose vaccination with 12 weeks of their first dose.

As mentioned in previous bulletins, we continue to be in a period where the UK vaccine supplies we receive in Powys are below the peak that we saw earlier this year.

During the week we also saw some significant developments in national policy and guidance:

  • Welsh Government issued their updated vaccination strategy, confirming that Priority Groups 5-9 will be invited by mid April, and the rest of the adult population will be invited by the end of July.
  • The updated national vaccination strategy also endorsed the latest guidance from the Joint Committee on Vaccination and Immunisation (JCVI). The JCVI has recommended that vaccination for the rest of the adult population should be based on age groups – 40-49, followed by 30-39, and then 18-29.
  • In their strategy, Welsh Government also clarified that eligibility for vaccination in Priority Group 6 is different from the seasonal flu invitation. A key difference is for people with asthma: people with Severe Asthma are included in Priority Group 6, whilst those with moderate or mild asthma will be invited based on their age group.
  • The strategy also includes the Welsh Government’s latest guidance on eligibility for unpaid carers, and for people with learning disability and severe mental illness (COVID-19 vaccinations: prioritisation of individuals with learning disability or severe mental illness | GOV.WALES)

You can read the updated national strategy on the Welsh Government website at https://gov.wales/covid-19-vaccine-strategy-update-february-2021

At a national level too, this weekend saw Wales exceed 1,000,000 vaccinations across the country. In just a few short weeks this is a tremendous achievement.

Looking ahead to this week and next, vaccine supplies do continue to be a limiting factor, and our expected period of reduced supply is continuing. This means that we expect our mass vaccination centres to only deliver second dose vaccinations this week, with, whilst first dose supplies being directed to GP practice. However, we do expect the supplies to increase again during the month.

Key priorities for the fortnight ahead include:

  • The final invitations will be in place for people aged 65-69. This will include a temporary two-day pop-up clinic in Ystradgynlais for first dose appointments for people aged 65-69 who have not yet received an invitation. Please do not call your GP or health board about this clinic – you will receive an invitation, and the clinic will be by appointment only.
  • Invitations will continue for people with eligible underlying health conditions. In order to ensure that our vaccination programme is as efficient as possible, different age groups of people with underlying health conditions will be invited to different locations: 50-64 year olds to mass vaccination centres, 18-49 year olds to GP practice, and eligible 16-17 year olds to mass vaccination centres (note that vaccination is currently only recommended for certain 16-17 year olds with clinical conditions).
  • The new online eligibility tool will be in place for unpaid carers, so that you can check your eligibility and request a vaccination.
  • Planning will continue ready for invitations to begin for people aged 60-64 – before proceeding to 55-59 and 50-54 before the middle of April.
  • We will continue with our second dose vaccinations. We expect to reach around 12,000 second doses by the end of next week.

More information about progress and next steps on each of these areas can be found later in this newsletter.

But also in the weeks ahead, we reach some poignant milestones in our life with COVID-19. During March we will see the first anniversaries of the first confirmed case in Powys, of coronavirus being confirmed as a pandemic by the World Health Organisation, of sadly the first death in Wales, and of the country entering our first lockdown on 23 March.

This has been a difficult year for us all. Together we have experienced grief, loss and sacrifice. But alongside this we have been touched by great team spirit, community support and astonishing resilience and friendship. My thoughts are with everyone at this time.

As we draw on those experiences from the year gone by, it is vital that we all remember that COVID-19 is very much still with us. Our vaccine gives is hope, but

COVID-19 continues to circulate in the county. This includes the new, more infectious strain of COVID-19 – the ‘Kent’ variant.  This is concerning because it is more easily spread, and it is more likely that exposure to the virus will lead to infection.

This is why it remains vital that we all continue to follow the advice to stay at home, follow social distancing rules and wear face coverings in indoor public places.

Vaccination does offer the hope of a brighter future – as well as reducing the risk of serious illness from COVID-19 - but for now it is crucial that we continue to do all we can to protect ourselves and others from COVID-19. Remember - Hands, Face, Space.

Thank you for everything you are doing to Keep Powys Safe – and please do feel free to share this information in your organisations, networks and communities.

Carol Shillabeer, Chief Executive, Powys Teaching Health Board

Vaccination Heroes: Community Transport

You can read our Vaccination Heroes story in the news section of our website.

Vaccination Heroes: Our Team of Vaccinators

You can read our Vaccination Heroes story in the news section of our website.

Update on Vaccination for people in Priority Groups 1-4

Over 90% of people in Priority Groups 1 to 4 have already received their vaccination. Some have not yet received their vaccination for clinical or social reasons, whilst some people will decline the vaccine. But if you know someone who has not yet been invited then please let us know so that we can make sure they are invited.

We now have a Priority Access Form for anyone in Priority Groups 1 to 4 who has not yet received their invitation. This helps us to fast-track you to an appointment:

People aged 80 and over who are registered with a GP in Powys: Over 80 in Powys and not received an invitation to vaccination? - Powys Teaching Health Board (nhs.wales)

People aged 75-79 who are registered with a GP in Powys: Age 75 to 79 - Powys Teaching Health Board (nhs.wales)

People aged 70-74 who are registered with a GP in Powys: Age 70 to 74 - Powys Teaching Health Board (nhs.wales)

Adults who are Clinically Extremely Vulnerable and registered with a GP in Powys: Clinically Extremely Vulnerable Adults - Powys Teaching Health Board (nhs.wales)

Remember that this group includes individuals with specific conditions:

  • solid organ transplant recipients
  • people with specific cancers:
    • people with cancer who are undergoing active chemotherapy
    • people with lung cancer who are undergoing radical radiotherapy
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
    • people having immunotherapy or other continuing antibody treatments for cancer
    • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
    • people who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
  • people on immunosuppression therapies sufficient to significantly increase risk of infection
  • problems with your spleen, for example splenectomy (having your spleen removed)
  • adults with Down’s syndrome
  • adults on dialysis or with chronic kidney disease (stage 5)

Other adults with underlying health conditions are due to be invited in Priority Group 6, for which invitations will begin soon.

Frontline health and care workers providing intimate care for people in Powys in the COVID-19 vaccination priority groups: Frontline Health and Care Workers - Powys Teaching Health Board (nhs.wales)

A priority access form will be added soon for anyone aged 65-69 who has not yet received an invitation.

If you know people who live in Powys but are registered with a GP practice outside Powys, then they will be invited for vaccination through the programme in the neighbouring county: Are you registered with a GP outside Powys? - Powys Teaching Health Board (nhs.wales)

Update on Vaccination for People Aged 65-69 (P5)

The final invitations for people aged 65-69 are now due to land on doormats this week. Appointments have been slightly affected by changes in UK supplies, so please accept our apologies that some appointments are slightly later than we had hoped.

People aged 65-69 are in Priority Group 5 for vaccination. Around 80% of people in this group have already received their vaccination. But, this is a large population group, and we still have around 1000 people to vaccinate.

If you are aged 65-69 and you have not yet received your invitation then it will arrive this week. Most people in this group will be invited to a mass vaccination centre - or, for people, in the Ystradgynlais area, we will be running a two-day temporary pop-up vaccination clinic. This pop-up clinic (organised by the health board) is for first dose appointments with AstraZeneca vaccine for people aged 65-69, and is strictly by appointment-only.

Please do not call your GP or the health board about appointments for people aged 65-69 including for the pop-up clinics, as invitations will be sent very soon.

Please note that we are not able to offer second dose appointments with Pfizer/BioNTech from pop-up clinics. This is because the very specific requirements for storage, transport and delivery of the Pfizer/BioNTech vaccine mean that we can only offer this from our mass vaccination centres.

Later this month we will put in place a Priority Access Form for anyone aged 65-69 who did not receive their invitation for COVID-19 vaccination.

Update on Vaccination for Adults with Underlying Health Conditions (P6)

Adults with underlying health conditions that are included in the national eligibility criteria are in Priority Group 6 for COVID-19 vaccination. Over 40% of people in this group have already received their vaccination, and invitations are continuing through March.

The national eligibility criteria are very specific. More information is available from our website at https://pthb.nhs.wales/coronavirus/covid-19-vaccination/adults-with-underlying-health-conditions/

People in this group are being identified by a range of routes, including from medical records. Because of the very specific nature of the eligibility criteria, some people may not realise that their medical history makes them eligible in this group.

The process of identifying people in this Priority Group will also reflect the latest guidance from Welsh Government on COVID-19 vaccination for people with learning disability and severe mental illness: COVID-19 vaccinations: prioritisation of individuals with learning disability or severe mental illness | GOV.WALES

One issue that can cause confusion is that eligibility for COVID-19 vaccination is different from eligibility for seasonal flu vaccination. For example, people with severe asthma will be invited in Priority Group 6, but people with mild to moderate asthma will be invited based on their age group.

In line with national guidance, this is because: “Those with severe asthma are at increased risk and included [in Priority Group 6]. Individuals with mild to moderate asthma are not at increased risk and not recommended for vaccination by JCVI [in Priority Group 6].” They will be invited for vaccination with their age group and we aim to vaccinate everyone over the age of 18 by the end of July 2021.

People with severe asthma eligible for vaccination in Priority Group 6 will meet the following national criteria:

  • They are 16 or over AND
  • EITHER they have had an emergency hospital admission for Asthma (at any point)
  • OR they have an asthma diagnosis and have had 3 prescriptions for oral steroids over a 3-month period (each prescription must fall within separate individual month windows), as an indication of repeated or continuous oral steroids.

The location of vaccination for people in this age group will depend on their age:

  • People aged 50-65 will normally be invited to a mass vaccination centre
  • People aged 18-49 will normally be invited to their GP practice
  • People aged 16-17 will normally be invited to a mass vaccination centre (and offered the Pfizer/BioNTech vaccine) – remember that vaccination is not routinely recommended for people aged 16-17 and is only offered to those with certain clinical conditions.

Later this month we will publish guidance for people who have an underlying health condition that makes them eligible in Priority Group 6 but who did not receive an invitation for COVID-19 vaccination.

Update on Vaccination for Unpaid Carers (P6)

Subject to certain eligibility criteria, unpaid carers are included in Priority Group 6 for COVID-19 vaccination. Later this week, Welsh Government will put in place a new process for unpaid carers to check their eligibility for COVID-19 vaccination in Priority Group 6, and request a vaccination. The new eligibility tool will be available on our website later this week.

Welsh Government last week published updated guidance on eligibility for unpaid carers. This highlights three important factors in deciding which unpaid carers should be prioritised for vaccination:

1.  The vulnerability of the person being cared for:

  • is 65 years old and over (groups 2-5)
  • is deemed extremely clinically vulnerable (group 4)
  • has a defined underlying health condition including mental illness (qualifying as group 6)
  • is a child under 16 with complex medical needs/ severe neuro-disabilities

2.  The nature of the care provided to those 16 and over:

  • includes, but is not restricted to, helping with eating, bathing, shaving, managing continence, dressing and walking. It may include intervening in challenging or risky behaviour. It may include providing significant levels of support and supervision at home or in the community and where social distancing is not possible

The nature of the care provided to children under 16 with complex medical needs/ severe neuro-disabilities:

  • is beyond the care and support parents ordinarily provide for a child. It is likely to include tasks like tracheostomy tube care, airway suction, repositioning to manage pressure areas and care interventions such as respiratory physiotherapy. It may include intensive personal care such as daily washing and continence care and /or managing behaviours that challenge.

3.      The unpaid carer is the sole or primary carer:

  • we recognise that caring for some people may require two people to assist with such tasks as positioning, hoisting, bathing and changing. There may be arrangements whereby two people evenly divide the caring responsibilities. In such instances, both unpaid carers may be considered as the primary carers

To be prioritised for vaccination, an unpaid carer should satisfy all three factors.

Young carers under 16 will not be offered the vaccination. This is because no children under 16 are being vaccinated, unless in exceptional circumstances due to severe-neuro disabilities.

Eligibility for prioritisation is not dependant on receipt of carer’s allowance, membership of a carers’ organisation or being known to social services.

Look out for more details on our website later this week including an online eligibility tool: https://pthb.nhs.wales/coronavirus/covid-19-vaccination/unpaid-carers/

Update on Vaccination for People Aged 50-64 (P7-9)

People aged 50-64 are in Priority Groups 7 to 9. Invitations will begin later this month unless you are eligible in an earlier Priority Group (e.g. Underlying Health Conditions).

Everyone in these Priority Groups is due to receive their invitation by mid April. This will begin with people aged 60-64 (Priority Group 7), then 55-59 (Priority Group 8) followed by 50-54 (Priority Group 9). Please be aware that in order to use all appointment slots as efficiently as possible there will be some overlap in invitations between different priority groups.

Keep checking our website for further details: https://pthb.nhs.wales/coronavirus/covid-19-vaccination/

Update on Vaccination for People Aged 18-49

Last week the UK’s Joint Committee on Vaccination and Immunisation (JCVI) published its interim advice on vaccination for the rest of the adult population. They advise that vaccination for the rest of the adult population should be prioritised by age.

Making this recommendation the JCVI said:

“There is good evidence that the risks of hospitalisation and critical care admission from COVID-19 increase with age, and that in occupations where the risk of exposure to SARS-CoV2 is potentially higher, persons of older age are also those at highest risk of severe outcomes from COVID-19. JCVI therefore advises that the offer of vaccination during phase 2 is age-based starting with the oldest adults first and proceeding in the following order:

    • all those aged 40 to 49 years
    • all those aged 30 to 39 years
    • all those aged 18 to 29 years

"An age-based delivery model will facilitate rapid vaccine deployment.”

In line with UK guidance, we aim to offer vaccination for everyone aged 18-49 by the end of July. Dedicated pages for these three age categories are now also available from our website.

More information about the interim guidance from the JCVI is available from their website: JCVI interim statement on phase 2 of the COVID-19 vaccination programme - GOV.UK (www.gov.uk)

Second Dose Appointments

We have already delivered over 5,600 second dose appointments. In line with UK national guidance we need to offer second dose appointments around 11 weeks after the first dose – and in some cases we have been able to offer these sooner.

Please attend your second dose appointment:

Second dose appointments are currently with Pfizer/BioNTech*. It is vital that you attend your second dose appointment. Please attend at your booked appointment time wherever possible.

What should I do if I cannot attend my second dose appointment (e.g. I am unwell, or have been advised not to attend due to COVID in my workplace)?

If you cannot attend at your booked appointment time then let us know as soon as possible (e.g. if you are unwell, or have been advised that you cannot have your second dose just now because of COVID in your workplace).

If you let us know that you cannot come, we are normally able to offer your appointment to someone else - if you do not let us know, there is more chance the dose could be wasted.

Why is it important that people cancel if they cannot come?

It is vital that no doses of Pfizer/BioNTech go to waste.

This is because there are limited supplies of Pfizer/BioNTech available.

We need to make sure we have enough vaccine to give a Pfizer/BioNTech second dose to everyone who received a Pfizer/BioNTech first dose.

If people cancel their Pfizer/BioNTech second dose appointment, can I attend for a first dose appointment?

No. We cannot offer second dose appointments to people waiting for their first dose.

This is because Pfizer/BioNTech is currently available for second dose appointments only**. If we gave you a first dose we would not be able to offer you a second dose with the same vaccine.

I received my first dose appointment on or before 26 December and have not yet heard about my second dose appointment. What should I do?

If you received your first dose vaccination on or before 19 December and have not yet received your invitation for a second dose please use our Priority Access Form to let us know.

*There are a very small number of clinical exceptions where some of the first patients to receive AstraZeneca are receiving their second dose vaccination, but please be aware that this is not currently routinely available.

** There are a small number of clinical exceptions for people aged 16-17 to receive Pfizer/BioNTech for a first dose appointment.

Online Q&A Session with Carol Shillabeer

You are invited to an online event with Carol Shillabeer from 5.30pm to 6.30pm on Wednesday 3 March 2021. This will provide an opportunity to update you on the COVID-19 vaccination programme in Powys.

How do I join?

You can join the session from most web browsers by clicking on this link.

When do I join?

You are welcome to join just before 5.30pm by clicking on the link above. The meeting will start shortly after 5.30pm to allow people time to join.

How do I participate?

This event will be provided through Microsoft Teams Live Event. It includes a Q&A function which allows you to ask questions. We regret that we may not have time to answer all the questions raised, but hope that the briefing will provide an opportunity to cover the main themes.

I am having trouble joining

The briefing will be recorded so that it is available for people who have trouble joining, or who are not available to join us at 5.30pm.

More information about being an attendee of a Microsoft Teams Live Event is available from the Microsoft website

I cannot attend – will I still be able to watch?

If you cannot attend on the day, you can watch the event at any time using the web link.

Have Your Say

Have your say on proposals for the future shape of vascular services in south east Wales (open until 16 April 2021) – these proposals mainly affect communities who access their acute hospital services in Gwent and Merthyr Tydfil:

Job Opportunities with PTHB

We have lots of great opportunities for people to join our team here at Powys Teaching Health Board:

Whether you want to join us as a COVID-19 immuniser, mental health inpatient team lead, digital communication officer or assistant psychologist – you can find all our latest vacancies on our website.

Further Information about COVID-19 vaccination:

More information about our COVID-19 vaccination programme here in Powys is available from the Powys Teaching Health Board website:

More information about the national COVID-19 vaccination programme in Wales is available from the Public Health Wales website:

The latest information about the number of COVID-19 vaccination doses delivered in Wales is available from the Public Health Wales dashboard – please remember that PTHB has the smallest population of all health boards, and is around a third of the size of the next smallest health boards (Cwm Taf Morgannwg, Hywel Dda):

More information about the Welsh Government’s strategy for COVID-19 vaccination:

Connect: