Coronavirus UK: How many vaccinations does Britain need to break the cycle of lockdowns?

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The number of vaccines Britain gives out before lockdown rules can start to be loosened will depend on the ‘risk appetite’ of the Government and how well they work in real life, scientists say.

There are around 31.7million people on the official waiting list for a jab, which includes everyone over the age of 50, people who are younger but seriously ill, and millions of NHS and social care workers.

Currently the UK is giving out 300,000 doses per week, a figure which is expected to speed up when clinics start using the game-changing Oxford University and AstraZeneca jab which was approved yesterday.

MPs and experts are calling for the vaccines to be given out at lightning speed in a desperate bid to stop the spread of the new coronavirus variant, which new evidence suggests may be so infectious that lockdowns can barely contain it.

Labour’s Shadow Health Secretary, Jonathan Ashworth, today urged ministers to ‘move heaven and earth to roll out vaccination starting with two million jabs a week’. 

Even at this ambitious speed – almost six times the rate vaccinations are currently being given out – it would take until April to get one dose to everyone on the priority list.

But there is hope some restrictions could be lifted before the list is completed, with Matt Hancock saying No10 can lift restrictions ‘when enough people who are vulnerable to Covid-19 have been vaccinated then’.

One scientist, however, told MailOnline it was impossible to put a logical number on when this would happen, and it would depend on how much risk the Government is willing to take. If lockdowns are lifted too soon, there could be a surge in severe cases, hospital admissions and deaths in groups who are at moderate risk but not priority for a vaccine, such as the middle-aged.

The NHS says people over 70 and those with the most serious long-term health conditions are at ‘high risk’ from Covid-19. These, combined with health and care workers, make up a group of 14.3million people, who could be given a single dose each within seven weeks at the ambitious rate of 2m per week, so by mid-February.

But lifting lockdown rules by then would involve putting younger groups, such as those in their 60s, 50s and 40s, at risk from a then-uncontrollable virus, and it would mean the people already vaccinated wouldn’t have the full protection of two doses, which both vaccines require.

Herd immunity, in which so many people are vaccinated that the virus can’t spread any more, will be impossible with the current strategy, scientists warned, with US infectious diseases director Anthony Fauci saying he doesn’t expect the country to ‘approach normality’ until the end of 2021, even with 80 per cent of the population getting vaccinated.

It is more likely that the UK’s restrictions will be phased out over a longer period to stop the virus spiralling among younger people, who still have a small risk of hospitalisation, death or long-term complications.

Scientists said today they expect the current cycles of lockdown to carry on into the late spring or even the summer even if the vaccination programme goes to plan, meaning England faces many more months of misery. 

The British approval this week of the Oxford University and AstraZeneca vaccine has been hailed as a turning point in the Covid-19 epidemic.

Cheap and stable enough to keep in a normal fridge rather than a -70°C fridge, unlike the already-used Pfizer vaccine, the jab will hopefully allow injections to be sped up across the country. 

Matt Hancock said on Sky earlier this month: ‘When enough people who are vulnerable to Covid-19 have been vaccinated then of course we can lift the restrictions.’

In a separate interview yesterday, Mr Hancock told LBC Radio that he now has a ‘very high degree of confidence that we are going to be out of this by the spring’.

But exactly how many people the Government will want to vaccinate before it starts scaling back its system of lockdowns is not yet clear.

Based on the current priority list for vaccines, which includes everyone over the age of 50, NHS and care workers and those with serious health conditions, there are up to 32million in line for a jab – about half of the UK population, so 64million vaccinations if each person is given the recommended two each.

Vaccinating only half of the population means that eradicating the virus completely, or aiming for herd immunity – in which so many people are vaccinated that the virus can’t spread – will be impossible.

Therefore, ministers must decide how much risk they are willing to accept and time the lifting of lockdown rules accordingly.

Lifting the restrictions will likely cause an explosion of infections among younger un-vaccinated people, and only trial and error will tell whether the vaccine keeps hospital admissions and deaths down.  

Dr Simon Clarke, a microbiologist at the University of Reading, said it was not possible to put a scientific number on when it would be safe to stop the lockdowns.

He told MailOnline: ‘It will be influenced by whether or not any or all of the vaccines are able to prevent transmission of the virus and confer herd immunity. This remains completely unknown.

‘It really does depend on the risk appetite of politicians – how much pressure are they prepared for the NHS to take?’

Dr Clarke added: ‘It’s all very well vaccinating everybody over 65 and other people with long term health conditions, but the average of admission to intensive care is 60 and there are more men in their 40s in ICU with Covid than there are over-85s.’

Another expert, Dr Gabriel Scally – who is a member of Independent SAGE and a public health professor at the University of Bristol – said the UK’s vaccination plan will not stop Covid-19 from circulating.

He said: ‘I think it’s going to be a very rocky road. We know the vaccine will not be 100 per cent effective, we know some people will not be affected by it and we know it’s not being given to children and young people; there can be no question of herd immunity – it’s not possible in these circumstances.’

The Government is so desperate to get vaccines out and slow down the spread of the coronavirus, particularly the new variant, which is even more infectious than earlier versions, that it has started abandoning the second doses of the jab that are recommended by the manufacturers. 

The UK medical regulator is now recommending Covid jabs are given in two doses three months apart, rather than over the intended four-week period, to allow millions more people to be immunised over a shorter time period.

The strategy will apply to both Pfizer/BioNTech’s vaccine and the newly approved jab by Oxford/AstraZeneca, despite limited data around the effectiveness of the initial doses. 

But Pfizer said there was ‘no data’ in its studies to show its vaccine protects against Covid when taken 12 weeks apart.

In a thinly-veiled swipe at the UK, the US firm warned that any ‘alternative’ dosing regimens should be closely monitored by health authorities.

‘Data from the phase three study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent,’ Pfizer said in a statement.

‘There are no data to demonstrate that protection after the first dose is sustained after 21 days.’

Labour MP and Shadow Health Secretary has called for the vaccine to be rolled out as fast as is humanly possible.

He said: ‘This is now a race against time and there isn’t a moment to lose. We need ministers to move heaven and earth to roll out vaccination starting with two million jabs a week to save lives and hit the government’s spring promise of easing restrictions… 

‘We can’t limp into the next crucial period of our battle with coronavirus, the government must urgently provide the resources necessary to ensure the speedy and smooth deployment of a vaccine to save lives, keep businesses open and to reduce the pressure on the NHS.’

Dame Clare Gerada, a former chair of the Royal College of GPs, which represents family doctors, agreed and told the BBC: ‘We really now need a massive operational system. We need a 24/7 system with GPs, mass vaccination centres and hospitals – this needs to be scaled up.

‘It’s got to be football stadia, all these large venues that we’ve got currently lying dormant. If we can really get a mass operational system up-and-running, then I can’t see why we can’t be getting the whole population immunised by the spring.’

Scientists warned today that England will be stuck in its relentless cycle of coronavirus lockdowns until at least the end of spring even if the vaccine roll-out goes to plan. 

Professor Paul Hunter, an infectious disease expert at the University of East Anglia, said on BBC Radio 4 this morning: ‘It is going to be a very, very difficult few months until we get, hopefully, relief as we move from spring into summer when many people will have been vaccinated and the warmer weather will be here.’

Dr Simon Clarke said he expected lockdown rules would keep going ‘until April or May’ before the effects of mass vaccination would be strong enough to relax restrictions.

And Dr Gabriel Scally said he expects the rules to carry on for ‘months and months’, with some form of national lockdown inevitable because even Tier 4 ‘doesn’t seem to be working’.

Their comments come after the Government yesterday plunged 20million more people into the toughest lockdown rules after allowing them to meet with families over Christmas, meaning there are now 44million people living in Tier 4 – in which all non-essential shops and hospitality businesses must close – with the remaining 12million living in Tier Three. Only the Isles of Scilly, with a population of 2,000 off Cornwall’s coast, is in Tier 2.

Boris Johnson and his ministers are pressing forward with plans to stick to the local lockdown system despite the situation rapidly getting worse all over the country. 

Experts said SAGE will likely be pressuring the Government to order another national lockdown but there is a ‘political imperative’ not to officially call another one – it may come area by area until the whole country ends up in the toughest rules. 

One of SAGE’s own advisers, Warwick University mathematician Dr Mike Tildesley, warned today that the current progress of the outbreak will end with ‘ultimately, probably, a national lockdown before we get to the end of January’.

The combination of this wait and the fact to vaccinate that the faster-spreading variant of the virus is taking over as the dominant strain is more resistant to lockdowns, means rules may have to be tougher and longer-lasting than ministers want to let on.

Dr Paul Hunter said on BBC Radio 4’s Today this morning: ‘One issue was this new variant which, despite the fact that we were in lockdown in November, was still increasing in those areas where it was prevalent and increasing quite quickly… all the indications are that actually that this new variant may well continue to increase despite most people being in Tier 4 and it is extremely concerning.’

He added: ‘It is a very difficult situation because if we relax what’s going on at the moment then the disease will increase more rapidly and we can’t guarantee that even if we are all in Tier 4 that the instance would reverse.

‘The one light on the horizon is the licensing of the Oxford/AstraZeneca vaccine but there is a big issue – and the WHO’s chief scientist said two days ago – we still don’t know whether these vaccines will actually stop transmission.

‘It is going to be a very, very difficult few months until we get, hopefully, relief as we move from spring into summer when many people will have been vaccinated and the warmer weather will be here.’

Dr Gabriel Scally, a member of the Independent SAGE group, which is calling for a total national lockdown to stop the second wave, told MailOnline the virus is now out of control in England.

He said this morning: ‘What we have seen from Tier 4 across the country is that, in most cases, Tier 4 doesn’t seem to be working. It hasn’t brought infection rates down and in most areas it hasn’t even stopped the increase.  

‘Despite Tier 3 and Tier 4 areas, the virus has been uncontrolled and continued to grow.

‘The Government needs to get it under control but it isn’t taking proper measures; they’re being reactive – they’re waiting until the numbers get so bad they have to do something, instead of being preventative.’

Dr Scally said it was vital that officials fix the ailing NHS Test & Trace system, which doesn’t routinely test people who are self-isolating, and give schools more money and more local buildings to help them stay open and allow social distancing.

He added: ‘I think it’s going to be months and months before we’ll be able to relax to the sort of degree that we want to be able to.’ 

Dr Simon Clarke said there were signs that Tier 4 rules are ‘not stringent enough’ and that more rules would have to be brought in if infections keep climbing.

‘This will last until April or May, I think,’ he told MailOnline. 

‘I’m very concerned about this mass roll-out of vaccines. It’s a great thing to do, but done properly. This has the potential to be a botch-job.’

Dr Clarke said he was worried about the fact that the Government has decided to delay second doses of the Pfizer vaccine for people who have already had their first and were promised another within a month. Ministers have instead chosen to use spare doses to give one dose to more people, going against the instructions of Pfizer.

Even if the vaccine roll-out goes to plan and the jab works as well in reality as it did in clinical trials, Dr Clarke said, it would not be a silver bullet to end the epidemic.

He explained: ‘We have been warned by JVT [Jonathan Van-Tam, deputy chief medical officer] – and this isn’t the first time this has been said – that when we get into the summer, don’t assume that social distancing and mask-wearing will stop; we still have to control the virus because it’s still there… 

‘There is a political imperative not to have a national lockdown, or not to call it that, but the direction of travel is clear – everywhere is in Tier 3 or 4. Only a few weeks ago that people were throwing their hands in the air about being put in Tier 3.

‘SAGE may be advising them [ministers] to tighten Tier 4. Whether they add things to Tier 4 or call it Tier 5, it doesn’t really matter. They will be putting pressure on them to make things less comfortable.’

An adviser on SAGE, Dr Mike Tildesley, said he expects there to be another – third – national lockdown within weeks.             

In a stark warning on BBC Radio 4 today, he said: ‘Cases are rising in a really concerning way, so I suspect that unfortunately we will see a ramping-up even further of restrictions, probably more of the country being in Tier 4 or ultimately probably a national lockdown before we get to the end of January.’

Boris Johnson last night warned of a new ‘reality’ with mutant Covid rampant on Wednesday as he plunged virtually the whole of England into brutal lockdown until the spring – with the UK recording 981 deaths in its worst daily toll since April and vaccines now the only hope of escape. 

The PM voiced his ‘bitter regret’ during the announcement, which pasted the toughest lockdown rules across all regions.

He could not say when the rules would end, warning on ITV that he couldn’t even be sure they would be lifted by April, after Matt Hancock claimed the country could be back to normal by the spring. Mr Johnson said: ‘I am not going to give a deadline.’

All remaining areas – barring just 2,000 people on the Isles of Scilly, who remain in Tier 1 – are being escalated to Tier 3, including Liverpool, which had a rapid testing pilot previously touted as an example of how to cope with the disease and keep cases down. 

Meanwhile, secondary schools have seen their return delayed even further in January, with most pupils now shut out until at least January 18 – two weeks longer than originally planned – while testing systems are put in place. 

Hundreds of primaries in the ‘highest infection’ areas will also not fully reopen from January 4, while secondaries will have to wait until the next tier review in two weeks to learn whether they must stay shut indefinitely. 

Wales, Scotland and Northern Ireland are already in the midst of their own clampdowns amid fears over the more infectious ‘mutant’ strain that is running riot. 

The seriousness of the situation was underlined last night as the UK recorded another 50,023 cases – a jump of a quarter over the same day last week – and 981 deaths, the highest since April.   

At a Downing Street press conference, Mr Johnson and deputy chief medical officer Jonathan Van-Tam made clear that hopes for a return to normality now hang on massively scaling up the vaccine rollout, after the Oxford University/AstraZeneca jab received approval from regulators.

However, even if the government manages to crank up vaccinations to two million doses a week, it will still take months to cover enough of the population to ease restrictions safely. 

Matt Hancock has admitted that just 530,000 jabs will be available on Monday when they start being administered. 

In another miserable signal, Mr Johnson warned that the public ‘should not, in any way think that this is over’ due to the positive news on vaccines as ‘the virus is really surging’.  

‘We have to face the fact that we’ve got two big things happening at once in our fight against Covid – one’s working for us and one’s working against us,’ the PM said.

‘On the plus side we have got two valid vaccines, and we’re racing to get them out – and on the bad side there is a new strain of the virus which is spreading much faster and surging across the country.’

Referring to the new tier measures, Mr Johnson said: ‘At this critical moment, with the prospect of freedom within reach, we’ve got to redouble our efforts to contain the virus.

‘No-one regrets these measures more bitterly than I do, but we must take firm action now.’

He added: ‘We must face the reality, the sheer pace of the spread of this new variant, requires us now to take even tougher action in some areas, and that does affect schools.’ 

Professor Jonathan Van Tam, deputy chief medical officer, said: ‘Unfortunately it is a pretty grim and depressing picture at the moment.’

He added that the NHS had yet to see the impact of mixing during the festive period.

‘The situation in the UK is precarious in many parts already, the South East and London,’ he said.

‘It is almost certainly true that the NHS has not yet seen the impact of the infections that will have occurred during mixing on Christmas Day and that is also unfortunately rather sobering.’

Professor Van Tam added that members of the public had ‘just got to play your part from bringing us back from this very dangerous situation’. 

Pointing to rapidly increasing infections thought to be driven by the mutant Covid, Mr Hancock told the Commons yesterday: ‘Sharply rising cases and the hospitalisations that follow demonstrate the need to act where the virus is spreading.’

He said the majority of new cases recorded yesterday ‘are believed to be the new variant’.

Mr Hancock added: ‘Unfortunately, this new variant is now spreading across most of England and cases are doubling fast.

‘It is therefore necessary to apply Tier 4 measures to a wider area, including the remaining parts of the South East, as well as large parts of the Midlands, the North West, the North East and the South West.’

Delivering more bad news, Mr Hancock said almost all the country will be in the top two local lockdown brackets. 

The approval of the AstraZeneca vaccine was a desperately needed boost after the country racked up a record 50,000 daily cases on Tuesday.

Mr Hancock insisted a rapid rollout of the jab now offers ‘high confidence’ the pandemic will be past within months.

The UK has ordered 100million doses of the vaccine. Supplies were due to arrive on Wednesday or today and the first jabs are set to start on Monday. 

Two doses are needed to get long-term protection, but Mr Hancock revealed that the stocks could be spread more widely than anticipated as the MHRA has advised that the gap between the first jab and the second jab can be extended from four weeks to 12 weeks.

The same rule will be applied to the Pfizer jab already approved in early December, despite there being no evidence that it will work as well if used this way and the manufacturer hitting back against the policy.

This has raised the prospect that more Britons could be given a single dose soon to ease the pressure on the NHS from rampant infections. Former Prime Minister Tony Blair has been calling for all available stocks to be used for single doses, with the booster follow-up being delayed.

However, Mr Hancock dodged saying whether he believed the numbers being vaccinated could be scaled up to the two million a week scientists say is needed. 

And alongside the positive news he delivered a stark warning that the country still faced a tightening of the brutal lockdown from Thursday.

Mr Hancock said the Oxford/AstraZeneca decision meant Britain can ‘accelerate the vaccine rollout’ and ‘brings forward the day when we can get our lives back to normal’, adding: ‘We will be able to get out of this by the spring.’

He told Sky News: ‘It is going to be a difficult few weeks ahead.

‘We can see the pressures right now on the NHS and it is absolutely critical that people follow the rules and do everything they can to stop the spread, particularly of the new variant of this virus that transmits so much faster.

‘But we also know that there is a route out of this. The vaccine provides that route out. We have all just got to hold our nerve over the weeks to come.’

Asked if he could provide a timeline for when under-50s without pre-existing conditions may be vaccinated, Mr Hancock told Times Radio: ‘It depends on the speed of manufacture, I wish I could give you a date, your invitation right now, but we can’t because it depends on the speed of the manufacture.

‘This product, it’s not a chemical compound it’s a biological product so it’s challenging to make, so that is the rate-limiting factor in terms of the rollout.

‘Now that we have two vaccines being delivered we can accelerate, how fast we can accelerate will be determined by how fast the manufacturers can produce.

‘But what I can tell you is that I now have a very high degree of confidence that by the spring enough of those who are vulnerable will be protected to allow us to get out of this pandemic situation.

‘We can see the route out and the route out is guided by this vaccine and that’s why this is such good news for everyone.’

Former PM Mr Blair welcomed the fact that the government seemed to be following his blueprint of using the available stocks to give a single dose to as many people as possible.

‘The trial results make the case for using all available vaccines to vaccinate people with the first dose, without holding back a second dose for each person, overwhelming,’ he said. 

‘The first dose gives a high level of immunity – enough to halt hospital admissions – and the second dose is in any event at its most effective 2/3 months after the first, by which time we will have extra supplies of the vaccine to cover second doses.

‘In addition, the Government should consider urgently: acceleration of the vaccination programme. Of course, 1m vaccinations a week is remarkable by normal standards. 

‘But given the rates of transmission and the costs of lockdown, we need to do much more. Given the advantages of the AstraZeneca vaccine in terms of simplicity to administer – like the flu jab – we should surely be using every available potential resource including all pharmacies, occupational health capacity and those suitable to be trained fast to administer vaccines and increase the rate of vaccination.

‘And we should think about greater flexibility in the plan, with vaccination of groups most likely to transmit the virus and hotspot areas as well as age and vulnerability.’

The Oxford/AstraZeneca jab, which has been described as a ‘game changer’, was given the green light by the Medicines and Healthcare products Regulatory Agency (MHRA). 

A Department of Health and Social Care spokesman said yesterday: ‘The Government has today accepted the recommendation from the Medicines and Healthcare products Regulatory Agency (MHRA) to authorise Oxford University/AstraZeneca’s Covid-19 vaccine for use.

‘This follows rigorous clinical trials and a thorough analysis of the data by experts at the MHRA, which has concluded that the vaccine has met its strict standards of safety, quality and effectiveness.’  

AstraZeneca said it aimed to supply millions of doses in the first quarter of next year as part of an agreement with the Government to supply up to 100million doses.

AstraZeneca chief executive Pascal Soriot said on Wednesday: ‘Today is an important day for millions of people in the UK who will get access to this new vaccine. It has been shown to be effective, well-tolerated, simple to administer and is supplied by AstraZeneca at no profit.’