Tens of thousands of doses of Oxford University/AstraZeneca's Covid vaccine may be binned because of confusion over which bureaucratic rules to follow, doctors fear.
As part of the mission to vaccinate 13million of the most vulnerable by mid-February and get the UK out of the endless cycle of lockdowns, medics will visit the homes of around 200,000 housebound Britons to administer the jabs.
Guidance currently says they must take one vial of the vaccine — which can contain up to ten doses — to each home.
After giving the injection, doctors involved in the roll out told MailOnline they would then have to throw away the remaining seven to nine doses because rules ban them from going door-to-door with leftover supply.
They pointed to guidance from the Specialist Pharmacy Service — which provides expert advice for Primary Care Networks, which are groups of GP surgeries — that says: 'Partially used vials must not be onwardly transported (the vial contains no preservative and there is a risk of microbiological contamination if the vial is transported).'
The Royal College of GPs says that doctors — who are administering jabs and helping to organise the vaccine roll out — should use the NHS's Standard Operating Procedure (SOP).
But this 46-page document gives no details on whether opened vials can be moved between homes, only saying each must be used within six hours.
The vial contains ready-to-go vaccine, with the lid simply needing to be punctured and the fluid put into a syringe before the doses are administered.
The UK's medicines regulator — which approved Oxford's vaccine on December 30 — pointed MailOnline to NHS England when approached over which guidelines doctors should be following.
They added it must be used within six hours and stored at between 2C and 25C (35.6F to 77F).
NHS England insisted the Oxford vaccine could be moved between homes 'where necessary', providing it was used within six hours of being opened.
The Government is aiming to get 13million Britons vaccinated by mid-February. But teams will have to travel to the homes of housebound members of society, and will possible be forced to discard doses. Pictured above is the vaccination centre in Birmingham.
One doctor, from the Midlands, told MailOnline the SPS guidance has put a spanner in the works for the vaccine rollout in their area.
The team are determined not to waste a single dose but say they will have no option but to dispose of leftover supplies because of the bureaucratic rules.
The doctor — who said they are yet to start binning doses because of difficulties around giving jabs to the housebound — is now instead urging all housebound patients to find a way to travel to clinics where possible, such as through the help of family members.
'If they gave us a gazebo and chairs we could start vaccinating neighbours and people on the street,' a senior doctor involved in the roll out told MailOnline.
They added that NHS England's claim made 'no difference' because 'we still have to follow [the guidance] and destroy doses because that's the guidance we have'.
The SPS says online it provides guidance 'for commissioners, providers of NHS services and healthcare professionals in their day to day work'.
SOP guidance also points doctors to the SPS for advice on how to administer doses of the vaccine when visiting the homes of housbound Britons.
Under the section entitled 'Housebound residents: Delivery of vaccination' it reads: 'Preparation and administration of Oxford/AstraZeneca vaccine as per guidance in SPS.'
The Government's plan for the largest vaccine roll out in British history says local vaccination services — including GPs — will be responsible for getting the vaccine to those who are housebound.
'They will also coordinate and deliver vaccination to people who are unable to attend a vaccination site, including visiting care homes, the homes of housebound individuals and other settings,' the 47-page document says.
A man pictured receiving his vaccination at the centre in Stevenage, Hertfordshire
Almost a quarter of a million people — 240,000 — aged 65 and over in England are unable to get out of their home, according to Age UK.
It is not clear how many of these are 70 and over or in the vulnerable group, who are first in line to get the vaccine.
Another 910,000 people in the same age bracket can't leave their home without assistance because of medical conditions including hip problems.
A spokesman for NHS England said: 'The Oxford/AstraZeneca vaccine is able to be transported between houses where necessary and subject to infection prevention and control procedures.
'This will enable those who are housebound to get vaccinated and after the vial has been punctured, the vaccine should be used as soon as practically possible, within six hours.'
When contacted by MailOnline, the Medicines and Healthcare products Regulatory Agency (MHRA) pointed to its guidance stating: 'After first dose withdrawal, use the vial as soon as practically possible within six hours. Discard any unused vaccine.'
It added: 'Final preparation of the product for administration is subject to NHS governance arrangements and standard operation procedures that ensure the safety, quality or efficacy of the product is not compromised.'