What exactly is the Pfizer vaccine, who will get it, and is it safe?
Britons were the first people in the world to get a coronavirus vaccine as distribution started on December 8.
But what exactly is the Pfizer jab, who will get it, and is it safe? Here we answer the big questions:
What we know
Who will get it first and why?
Those aged over 80, care home workers, and NHS front-line staff will be targeted first, starting on what the Health Secretary dubbed "V-Day".
Margaret Keenan, a 90-year-old grandmother from Coventry, became the first person in the world to receive the Pfizer Covid-19 vaccine on December 8.
Mrs Keenan, who has a daughter, a son and four grandchildren, said: "I feel so privileged to be the first person vaccinated against Covid-19, it's the best early birthday present I could wish for because it means I can finally look forward to spending time with my family and friends in the New Year after being on my own for most of the year."
The NHS became the first health service in the world to begin rolling out Pfizer's Covid-19 vaccine. Jabs were administered at dozens of hospital hubs across the country from December 8.
William Shakespeare, 81, was the second person to be vaccinated in Coventry and Michael Tibbs, 99, was the first person in the South West to receive the vaccine at Queen Alexandra Hospital in Portsmouth.
Mr Hancock said on December 8 that more hospitals would be added to the list that can start vaccinating people "later today".
Responding to Conservative MP Holly Mumby-Croft, he said: "We've started at 70 hospitals across the UK. Those are the ones that are best able to deal with the difficult logistics of having a vaccine that has to be stored at minus 70.
"But I understand the desire for every hospital to get on that list and we will be publishing a further list later today."
NHS front-line staff will no longer be prioritised for the coronavirus vaccine, after confusion over the number of doses the UK would receive before the end of the year.
NHS staff were to be first in line for the jabs after it was deemed too difficult to get the vaccine to care homes. But amid the uncertainty over supplies of the new jab, care homes were bumped back up the list.
Chris Hopson, the chief executive of NHS Providers, said that an initial 800,000 doses "could be the only batch we receive for some time".
Speaking in the Commons on December 8, Mr Hancock said that there are "huge logistical challenges" in rolling out the vaccine, however, the next consignment is scheduled to arrive next week."
Next week the NHS will expand its vaccination programme, with the Pfizer jabs rolled out beyond 70 hospitals to around 300 GP hubs, targeting those aged 80 and over.
Between 1.2 and 1.6 million further doses of the Pfizer vaccine are due to be delivered to the NHS next week, it emerged on Tuesday night.
The remainder of the four million doses destined for the UK before the end of the year will arrive in a consignment the following week, according to The Times.
The Joint Committee on Vaccination and Immunisation (JCVI) initially said care home residents and staff should be first in line for the shots, followed by those aged over 80 and general health workers.
However, due to the difficulties anticipated with getting the vaccine to the elderly, NHS staff were told to prepare to be vaccinated by getting their winter flu jab before the end of November, as there needed to be at least a week between the two vaccinations.
The Pfizer/BioNtech jab must be shipped in dry ice at -103F (-75C) and only lasts for five days once stored in a fridge at usual temperatures of 35.6F – 46.4 (2-8C) which makes it impractical to roll out in care homes.
Senior NHS officials claim the jab can only be transported once more after it arrives at a central hub, and has to be moved in batches of 975 – meaning the vaccine will be wasted if it is sent to smaller care homes which have only a few dozen residents.
However Pfizer has said the jab can be sent to care homes, as long as the vaccine travels for no more than six hours after it leaves cold storage and is then put in a normal fridge at 2C to 8C.
Although, the Scottish Health Secretary announced that the Pfizer-BioNTech vaccine will be delivered to care home residents in Scotland within a fortnight.
Jeane Freeman said talks held on December 3 had confirmed the Pfizer/BioNTech vaccine can be transported in an unfrozen state for up to 12 hours, and can also be broken down into smaller packs in "certain conditions".
Ms Freeman told MSPs this makes the vaccine "more usable with minimum wastage for care home residents and our older citizens".
She said: "In effect we can take the vaccine to them, or close to them, and we will begin that exercise from December 14."
The National Care Forum said the only viable solution for care home residents is to get the jabs "over the threshold".
When will the general population be allowed the jab?
NHS England has told GP surgeries to start staffing vaccination centres ready for December 14 and they are expected to be ready to administer 975 doses to priority patients within three-and-a-half days.
After care homes, the JCVI has recommended the population be vaccinated in five-year groups starting with the over-75s.
The Joint Committee on Vaccination and Immunisation (JCVI) has also stated that key workers will be prioritised in the second phase of the vaccine roll out. Therefore, transport workers, first responders and teachers will be among the first to receive the jab after the most vulnerable.
Roughly one third of the population in Britain is over 50 and Britain has only secured 40 million doses of the Pfizer vaccine so it is unlikely that anyone in the general population will be included in the first round of immunisation.
Around 1.4 million people also work for the NHS, and they will also take priority.
If the Oxford vaccine is approved by regulators it may be possible to speed up the move to immunising greater numbers, but that is unlikely to happen before the Spring.
The Chief Executive of the National Health Service, Sir Simon Stevens, also revealed more about who would receive the second doses, sharing they would be reserved for those getting the first dose in December.
Sir Simon shared: “We need to be very careful through December and into January and then as vaccination expands to the wider population”.
The NHS has recently promised Britain will receive as many as four million doses of the Pfizer vaccine before 2020 ends. This comes after concerns that much of the public would miss out during the first vaccination wave because of limited supplies.
The Chief Executive also said that patients are likely to be people who were scheduled to attend outpatient appointments, which will eventually be followed by over 1,000 vaccination centres over time.
Sir Simon said the bulk of the vaccination programme will take place from January to April next year.
Read more: The priority list for the Pfizer vaccine - and how it will be rolled out
What plans is the NHS making to vaccinate the population?
Hospital hubs are being set up for NHS and care staff and older patients to get vaccinated and vaccination centres are being established across the country for when the mass vaccination programme begins.
The NHS has been preparing for a mass vaccination programme for several weeks with up to 1,500 GP practices and drive-through centres ordered to open from 8am to 8pm every day, each dispensing at least 1,000 jabs a week.
Under the current plans, local clusters of about five practices covering approximately 50,000 patients, known as Primary Care Networks, will combine to organise vaccine delivery and the NHS is hoping to immunise one million people per week.
It could mean transforming one surgery into a vaccine hub while moving the normal services usually performed there to neighbouring practices or hiring new premises altogether.
GPs have been told they can scale back other work as the vaccination programme takes precedence and will be paid £12.58 for each vaccine dose administered. Medical and nursing students, retired medics, pharmacists and vets are being drafted in to help manage the huge enterprise.
Pfizer has confirmed that people in the UK will not be able to bypass the NHS roll-out and buy the vaccine privately.
St John Ambulance is also training more than 30,000 volunteers between now and spring 2021, to support the NHS in delivering the national vaccination programme.
How does the vaccine work, and how is it administered?
The Pfizer vaccine is an entirely new kind of jab. While the Oxford vaccine uses an inactive cold virus to produce the coronavirus spike protein – the little stick on the outside of the virus which allows it to attach to human cells – the Pfizer vaccine carries ‘messenger RNA’ which instructs the body’s own cells to build the coronavirus spike protein.
Once the body starts producing these proteins, the immune system sees them as foreign, and initiates a T-cell and antibody response, priming it to fight off a real infection.
So, in effect, the cells of the body are turned into little coronavirus factories. Although it might sound alarming, it does not change DNA and it cannot be passed on to future generations.
Those who are vaccinated will receive a jab in the arm, and immunity begins to build from day 12. A booster shot is then given at day 21, and full immunity is achieved by day 28. So it will take a month from the first jab to be fully protected.
It means that even those immunised next week will not be completely protected until January.
Studies have shown the jab is 95 per cent effective and works in all age groups. It means that 19 out of 20 people who receive the jab will be protected.
It is unknown how long immunity will last, but studies of people who have caught coronavirus show antibodies and T-cells last at least six months and probably longer.
Jonathan Van-Tam, the Deputy Chief Medical Officer, said phase one of the rollout would eradicate 99 per cent of Covid-19 deaths.
Will it stop transmission?
It is unclear whether the Pfizer jab will stop transmission of the virus as the trials did not look at that aspect. It could be several months before it is known whether it will stop people infecting others, although there is early evidence suggesting the Oxford vaccine does this.
If it does prevent transmission there will be a greater argument for vaccinating large numbers of the population to reach herd immunity. If not, it may be better to immunise those most at risk.
How hard is distribution?
The main drawback with the Pfizer/BioNtech jab is that it must be shipped in dry ice. The company has designed special containers which keep the vaccine secure and track the temperature using special GPS sensors to make sure it does not get too warm on its journey.
The time between approval and deployment is expected to take roughly a week, due to travel and extensive safety and quality control checks so the first vaccinations will take place next week.
The vaccine is made in Belgium, and Health Secretary Matt Hancock has said that the doses will be rolled out as quickly as they can be made. So far the UK has 800,000 vaccines and approximately 10 million are expected by the end of the year.
Once dispatched from Belgium, the vaccine must follow a quality-assurance process to ensure nothing has happened in transit. Once cleared, the NHS can order it and will be delivered within 48 hours.
Defrosting the vaccine takes a few hours and then additional time is required to prepare the vaccine for administering.
Read more: How the UK will get Pfizer's Covid vaccine from factory to patient
How did Britain get it first?
There are more than 100 vaccines in production around the world, but Britain took a gamble on the seven most promising and fortunately the Pfizer/BioNTech jab was the first to release successful results.
Britain also has contracts with Oxford/AstraZeneca for 100 million doses of its vaccine, with Moderna for seven million of its doses, with GlaxoSmithKline and Sanofi Pasteur for 60 million doses, with Novavax for 60 million doses, with Janssen for 30 million doses and with Valneva for 60 million doses.
However, it is the speed of the regulator that has allowed Britain to jump to the front of the queue.
In spite of Brexit, until the end of December, vaccines must still be authorised via the European Medicines Agency (EMA) and that authorisation will automatically be valid in the UK.
However, under a new regulation the Medicines and Healthcare products Regulatory Agency (MHRA) is allowed to temporarily authorise a vaccine candidate if there is strong evidence of safety quality and effectiveness .
The MHRA has been conducting rolling reviews of the vaccine trials, assessing safety along the way so could make a decision far more quickly. It means Britain will get the US/German jab before America or Germany.
Was it rushed through – don't vaccines normally take years?
The vaccine has indeed been produced at an unprecedented speed. While most vaccines normally take around a decade, the coronavirus jab has made it from the drawing board and into people’s arms in just 10 months.
The head of the MHRA, Dr June Raine, said that – in spite of the speed of approval – no corners have been cut.
Batches of the vaccine will be tested in labs "so that every single vaccine that goes out meets the same high standards of safety".
Most of the side effects are very mild, similar to the side effects after any other vaccine such as muscle aches, headaches, soreness at the injection site and fatigue. They usually vanish after a couple of days.
Extreme reactions to vaccines usually occur very quickly after vaccination, and those getting the jab will be required to wait 15 minutes after immunisation to make sure there are no sudden side effects. The NHS will also be monitoring those vaccinated and any problems will be flagged early.
The European Medicines Agency (EMA), criticised the speed of British regulation and said its own longer approval procedure was more appropriate. The agency said it would not take a decision on the vaccine until December 29.
When will the other vaccines be ready?
The Oxford/AstraZeneca vaccine reported successful results and the MHRA is currently deciding whether to approve the jab. Approval is likely to come before Christmas. Britain is expecting to take delivery of four million doses before the end of the year. However, concerns have been raised over how successful the Oxford vaccine will be in protecting the wider British population.
Moderna became the third vaccine producer to seek approval for its jab, which is also a messenger RNA vaccine similar to Pfizer's. The company has said it is keeping most of its stock for the US, so supplies are unlikely to arrive in Britain before the Spring.
US company Novovax is currently in phase three trials of its vaccine in the UK, which is expected to be available by mid-2021 while Jansen also recently began phase three clinical trial of a two-dose regimen of the vaccine, which includes UK volunteers. The UK Government has said it expects this vaccine to be available by mid-2021 if it is approved.
Sanofi and GSK started their phase one and two clinical trials in September and hope to move into a phase three trial before the end of the year.
Valneva's vaccine, which will be produced in West Lothian, in Scotland, is expected to enter clinical trials by the end of the year, and approval is not likely before next summer.
Is Pfizer safe for pregnant women?
The Joint Committee on Vaccination and Immunisation has announced pregnant women will not receive the jab, as the potential risks remain unknown. At present, there is a "lack of evidence"; though the research is still ongoing.
The official advice states: "Data on vaccine impact on transmission, along with data on vaccine safety and effectiveness, will potentially allow for consideration of vaccination across the rest of the population. As trials in children and pregnant women are completed, we will also gain a better understanding of the safety and effectiveness of the vaccines in these persons."
Can I pay for the covid vaccine?
No. Pfizer has confirmed that people in the UK will not be able to bypass the NHS roll-out and buy the vaccine privately.
As it stands, you will have to wait your turn for the NHS vaccine rollout.
Those aged over 80, care home workers, and NHS front-line staff will be targeted first.
After care homes, the Joint Committee on Vaccination and Immunisation (JCVI) has recommended the population be vaccinated in five-year groups starting with the over-75s.
The JCVI has also stated that key workers will be prioritised in the second phase of the vaccine roll out. Therefore, transport workers, first responders and teachers will be among the first to receive the jab after the most vulnerable.
GPs have been told they can scale back other work as the vaccination programme takes precedence and will be paid £12.58 for each vaccine dose administered. Medical and nursing students, retired medics, pharmacists and vets are being drafted in to help manage the huge enterprise.
What we don’t know
How often will the vaccine be required?
At the moment it is unclear how long immunity lasts. Early studies suggested antibodies wane very quickly in people who have been infected with coronavirus and there have been reports of people getting the disease a second time.
However more recent evidence suggests that T-cells, a separate part of the immune system, may last longer.
In Severe acute respiratory syndrome (Sars), T-cells can remain active for up to 17 years. The government will be hoping that immunisation will last for at least a year.
Will those vaccinated be exempt from self-isolation or social distancing?
Minister for the Cabinet Office, Michael Gove said there are no plans to introduce a ‘vaccine passport’ which would give people access to places such as pubs and restaurants once a coronavirus jab becomes available.
However, Parliamentary Under Secretary of State at the Department of Health and Social Care, Nadhim Zahawi, has said the Government is "looking at the technology" and hinted some venues would not allow people in without confirmation they had been immunised.
The Government is unlikely to consider vaccine passports until the jab is available to the wider population.
Will being in a higher tier mean you get the vaccine sooner than those in Tier 1?
At present, it appears the tier system will not influence who gets the jab. Those most at risk from all areas will be prioritised first.
