The big news of the day is that the Oxford-AstraZeneca vaccine has been approved by the regulator for use in the UK, it is expected that this will be a real game-changer because it is far easier to store in a "normal" refrigerator rather than the ultra cold conditions needed for the Pfizer-BioNTech vaccine. The development of these vaccines is a scientific triumph but some aspects concern me.

The Pfizer-BioNTech vaccine which is currently in use was found to be 95% effective in the control of the coronavirus in a major trial, this was far higher than had been either predicted or expected.

The new Oxford-AstraZeneca vaccine trials are a bit more difficult to understand, for me anyway. I understand that the originally planned dosing regime of 2 full doses proved to be about 65% effective. However, it seems that a regime which was discovered by accident (or in error) of one full dose and one half dose was apparently 90% effective.

Combining this information it appears that the Oxford-AstraZeneca vaccine delivers an effectiveness of, on average, 70%. This apparently means that 70% of the people given the vaccine will not get Covid symptoms.

There is no doubt that 70% effectiveness in a vaccine is a good result but the problem, as I see it, is that it looks less good when a vaccine that is 95% effective is also available.

Let us imagine for a moment how we would feel if we were talking, not about a vaccine, but about a cancer treatment. As we know cancer can be fatal and, as we also know only too well now, a Coronavirus infection can also be fatal, particularly in some groups.

Are we now left with an extremely difficult situation, who gets what? If I was diagnosed with cancer and I was offered a treatment that was known, on average, to be 70% effective, how would I feel if I knew that there was a treatment that was 95% effective at fighting the disease. In all honesty I would not be very happy about being given the less effective treatment.

Is it possible that, knowing that there are now vaccines with different levels of effectiveness, members of the general public, when offered the vaccine, may well ask which one they are going to be given? Might they not be keen to consent to being given the "cheaper and less effective" vaccine, when they know that others are being given a "more expensive and more effective" vaccine?

There is no doubt that in the minds of the general public we are going to see strong views emerging about vaccine delivery, people are going to be asking why there are being given the "less effective & cheaper" vaccine and not the "more effective & more expensive" vaccine. They are also going to want to know how they have been selected to have one or the other.

There are going to be difficult discussions to be had and difficult concepts to be explained. I know myself that travel would not be a barrier. If I am offered the "less effective & cheaper" option locally I would very happily travel any distance in order to receive the "more effective & more expensive" vaccine. Basically if I am going to be given a new vaccine whose long term effects and effectiveness are not known I want to have the one which looks at the moment to be the most effective.

Then of course there is the nightmare scenario of the potential for vaccine distribution to turn into a postcode lottery. Is it just possible that the "more expensive & more effective" vaccine might be used predominantly in the south and south east? This might be explained by reference to the need for a "cold chain" for the Pfizer-BioNTech vaccine, less travel etc.

This would leave the "less effective & cheaper" vaccine to be used in the northern areas. Traditionally far more is spent per capita in the south than the north and if this did happen it should surprise nobody.

It would be interesting, even at this early stage, to know the delivery distribution of the approximately 600,000 "more expensive and more effective" Pfizer-BioNTech vaccinations that have been given. Any guesses anyone?