The Oxford jab approval should make a big difference to the speed of roll out of the vaccination programme, as long as the manufacturing capacity is there - not just for the medication but also for the ancillaries such as vials, needles and syringes etc. The key difference is the ease of storage; it’s just the same as for flu shots and GP practices have a wealth of experience of organising these local campaigns successfully over the years.
From a purely public health p.o.v. (i.e. greatest good for the greatest number of people), the decision to delay second jabs seems justified. I know, explicit trial evidence for this is lacking, but basic immunological principles established with other vaccines suggest that a late 2nd jab should work.
The great fear about just shielding the vulnerable and letting Covid rip through the rest of the population is that it is now so infectious that the eventually huge number of ill people will prevent the delivery of even the most basic of community services. There could well be too few workers left on their feet to stock supermarket shelves, run water treatment plants, keep power stations going, police the streets etc. This may sound alarmist, but you only have to look at the nearly exponential rate of rise of case numbers in London to see that it’s a real risk.
I don’t often say it, but I’m with the powers that be on this one.