The Best Christmas Present: Vaccinating the over 80s

 As expected, the first patient arrived early. We were having an early start anyway, but this is a generation that is always on time and appreciates punctuality.

He stood outside the sports hall, sheltering from the damp December rain under the makeshift gazebo. It was a dismal grey day weather wise, but the atmosphere inside was a lot brighter.

Two adapted sticks propped him up as a he tottered from the car park to the door. His face was etched in concern, and a there was a little bit of grumpiness ready to emerge if needed. He was gently ushered onto a plastic chair at the front of the waiting line, his face transforming as he recognised the familiar staff from our GP Surgery ready to check him in. Their smiling faces transmitted their enthusiasm and excitement onto his. The best type of infectivity. He beamed away, even showing off a little sitting Christmas jig.

It was the first day of the over 80s Covid-19 vaccination programme, just before Christmas, and for most the best present they were getting after a long, tough year. The story had started the week before, when we volunteered to be an early ‘wave’ for the vaccine.

We responded within half an hour of the email asking for interest , simply saying: ‘We’re in’. The NHS bureaucracy being as it is, it wasn’t as simple as that.

 7 days before ‘vaccination day’ there was yet to be confirmation, without which booking 1000 older people in is risky. After an emotional rollercoaster of a weekend, we were in, then out, then back in again, and we finally got the green light Monday morning so started the race to phone our patients. The call to offer a date for the vaccine was a lovely one to make for staff; the cynicism and scepticism of social media replaced by a solid gratitude from those who know the potential lifesaving nature of this injection. They are people who have spent months sheltering, unable to see those they love. They know what illness and disability means, and they don’t want any more of it than they need for their remaining years, thank you very much.

By 9am a steady trickle of people were entering into the vaccination hall. Blinking in the light of a promised new freedom they were nearly dazzled by it, being out of their houses and amongst people again. The buzz in the hall coming from health workers clad in their blue scrubs, was almost too much for people unused to seeing even a single person for months. They were emerging out of a hibernation- a hibernation not to protect against the winter, but against an unseen and sinister threat.

They came in different shapes and sizes, some pushed in on a wheelchair by an attentive relative, some bouncing in with well-preserved limbs, others thin and bent over. The spectrum of frailty amongst this age group is heart-breaking; the lucky ones could pass for working age; the unlucky are crippled with arthritis and muscle loss. Their appearances tell a story of their lives.

What became obvious was that lockdown had not been kind to many: I could see old friends who had aged more than just the 9 months, their bodies and their minds not as sharp as they were, but I could also see signs of light sparking again in their eyes on that day.

As they progressed through the stages of the process, some of their former energy returns. Smiles proved infectious, from the check in by receptionists, to the screening questions by a GP, through to the injection itself – energy is transferred, amplified and then returned with some interest.

The quips start, ‘Nice to see you doctor, surprised you’re not too busy for this!’.

‘No thanks doctor, I think I’ll get the expert to give me the injection…’.

Then it was into the next phase: the observation room. In this case a hastily converted and ironic ‘youth room’, the sports equipment stacked against a wall and replaced by the obligatory socially distanced pattern of chairs.

There needed to be a 15-minute observation time in the rare case of a serious allergy (time of writing 2/200,000). On the face of it this was an organisational nuisance, necessitating a large extra room; but happily it had the actual side-effect of another opportunity for a good chat.

The sound of Christmas carols trickled across the room, some of the patients getting the confidence up to join in, unlike the observation nurse who doesn’t need any encouragement to lead a song. Not 15 minutes of fame, but perhaps the 15 minutes if sociability for some time, a chance to say hello to an old friend – across a 2-metre gap of course. All of it accompanied by an icy winter breeze, ventilating against the ever present uninvited potential gate crasher – Covid-19, (also discouraging anyone from staying beyond 15 minutes).

After that they flowed out into the car park, to be met by a volunteer in a high-viz vest, big smiles again – ‘How was that?’. To which the answer was universally effusive; ‘Wonderful love’; ‘Very efficient’; ‘Better than the army!’.

Back in the main room, the trickle had progressed to a flow. Small bulges of patients arriving at same time occasionally caused a short queue to build up, but with an efficiency to make a car factory jealous, we tweaked parts of the process to smooth it out, so that no-one needed to wait more than a few minutes.

There was the occasional puzzled query, as floating doctor I entered into an occasional case discussion with the screening doctor, and the patient themselves.

One such lady came with her son, already visibly apprehensive:

‘She had an allergic reaction to penicillin in 1950, details a bit sketchy’. Taking it seriously, we put on our medical detective hats; ‘Did you need to go to hospital?’; ‘Did your lips swell up’?

Inevitably, ‘It was a long time ago love’. We decided the benefits were a lot greater than the risks, the clincher was her son reminding her that the vaccine could mean she would see her granddaughter again. I kept an extra eye on her through her journey, she was absolutely fine, and after her immune system does its wonderful work, she may be within touching distance of seeing her granddaughter in 2021.

At the end of the day, when the last observed person had departed to a ‘Happy Christmas’, the team gathered in the sports hall. The room not now echoing with the hum of multiple low-level conversations, but with the laughter of a team knowing that each and every one had done their job, and that their collective effort had put the first few bricks in the wall that needs to be built.

We brought out a few slightly warm bottles of prosecco along with plastic cups. Bouncing the cork off the basketball hoop at the side if the hall, we passed frothy cups along and toasted to the next day – and to come back and do it all again.

A short version of this article was published in the Guardian on 8th January 2021 'One patient says we're better than the army': A GP's diary on Covid vaccination day | Society | The Guardian