COVID-19 vaccines and vaccine administration

This article provides an overview of the current COVID-19 vaccines available within the UK and provides insight into the training recommendations for vaccinators. As COVID-19 vaccine development is a fast-paced arena, the reader should continue to refer to national guidelines and publications, which are subject to updates based on the latest research findings. The ‘Green Book’, chapter 14a, contains up-to-date guidance on COVID-19 vaccines, the dose and schedule for the UK and recommendations for use of the vaccine (Public Health England (PHE), 2021a).

COVID-19 is an infectious respiratory disease caused by the novel coronavirus, severe acute respiratory syndrome 2 (SARS-CoV-2). Transmission is primarily via respiratory (droplet and aerosol) and contact routes. Transmission risk is highest where people are in close proximity to one another (within 2 metres). Airborne transmission may also occur in health and care settings where aerosol-generating procedures are performed (PHE, 2021b). Specific pre-existing comorbidities present an increased risk of severe infection and hospitalisation, including dementia, type 2 diabetes, chronic obstructive pulmonary disease and pneumonia (Atkins et al, 2020); increasing age and male gender also place individuals at higher risk of morbidity and mortality (Li et al, 2020). Emerging data suggests black, Asian and minority ethnicity (BAME) individuals are at increased risk of infection with increased incidence of morbidity, admission to an intensive care unit, and mortality, in comparison with white individuals (Pan et al, 2020). In the UK, the likelihood of a front-line healthcare worker reporting a positive COVID-19 test is increased in comparison with the general community alongside associated factors of supply of personal protective equipment, clinical setting and ethnic background (Nguyen et al, 2020). The high number of cases and related morbidity and mortality have laid bare the far-reaching impact of pandemic infection across the globe. As of mid-March 2021, there have been almost 120 million confirmed cases globally, including more than 2.6 million deaths (representing a global mortality of 2.2%). Europe and the Americas have been particularly affected and within the UK the current incidence of confirmed cases is over 4.2 million, with more than 125 000 associated deaths, representing UK-based mortality of 3.0% (World Health Organization (WHO), 2021a). The far-reaching impact of COVID-19 has demanded the development of safe and effective prophylactic vaccines, resulting in novel techniques for vaccine development, global collaboration and large cohort clinical trials, at a scale and pace not seen before. These developments will change the face of approaches to vaccination for years to come and will serve to contain the pandemic and limit the associated health, economic and social consequences of the disease. In the UK, three vaccines have been authorised for supply; two use an mRNA platform (Pfizer BioNTech COVID-19 mRNA vaccine BNT162b2 and Moderna mRNA-1273 COVID-19 vaccine) and the third uses an adenovirus vector (AstraZeneca COVID-19 vaccine) (PHE, 2021a).