An NHS leader has expressed concern over what GPs should do with unused Covid vaccine after NHS England said under-50s should not be given a first dose in April.

Dr David Lewis, co-clinical director of the Central Liverpool Primary Care Network, said there was currently a “feast of vaccine” but not enough people to give it to.

He said this left the network with four options – invite people in for second doses, give jabs to the under-50s, give vaccine to other networks or waste the vaccine.

He said the first two options had been discouraged or forbidden by NHS England, which told health leaders on Wednesday that people under 50 should not be offered a first dose for all or most of April.

Dr Lewis said: “Right now we have a feast of vaccine. Thousands of doses arrived this week and more next week, but they have a very short shelf life so need using in the next two to three weeks – nobody’s fault.”

But in April there will be a “vaccine famine” owing to supply shortages of the AstraZeneca jab, partly due to a delay in a shipment from India.

He added: “We’ve followed JCVI (Joint Committee on Vaccination and Immunisation) guidance by inviting people at risk first, and not offering second doses until 11 weeks after the first, and we have made huge efforts not to waste any doses.

“We’ve invited all our eligible patients – everyone 50 years and over, and all adults with underlying conditions that put them at higher risk of Covid.

“We’ve done outreach vaccination for homeless people, people with learning disabilities, asylum seekers, in a community centre and in a mosque.

“We have a team of people phoning patients every day, but we still have appointments available, and spare vaccine.

“Now our options are: invite people for their second vaccine a bit early – strongly discouraged by NHS England and it goes against the principle of vaccinating as many people as possible; invite younger adults – NHS England have specifically forbidden us from doing this, even though we’ve got vaccine and vaccinators; give it to someone else – everyone is in the same situation; waste it.

“This would be a tragedy. We’d have to look people in the eye and say ‘Sorry, we could have offered you a vaccine last month but we don’t have any now so you’ll have to wait.

“‘Oh you’re a teacher? Well, I guess more convenient to get it after term ends’.”

Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading, said: “It’s to be expected that supply of Covid-19 will be variable, but to delay vaccination for the under-50s by a month is more than a bump in the road.

“To pretend that everyone at risk has been vaccinated is misleading.

“During the pandemic more men in their 40s were admitted to intensive care units than men and women over 85 and the Government were clearly expecting to proceed at pace with the vaccinations, otherwise they wouldn’t need to stop appointments being made in April.

“We don’t yet know exactly why the delay has occurred, but the ripple effects could last for months.

“It will undoubtedly make the meeting of the target dates for lifting restrictions more difficult than they otherwise would have been.

“By pushing back the under-50s’ first doses, their second doses are also being pushed back.

“If full vaccination becomes required for holidays abroad or even more mundane things like going to the cinema, millions of younger people may end up being excluded from participating for the whole summer.”

A spokeswoman for the NHS said: “The NHS has done an extraordinary job vaccinating more than 21 million of the most at-risk people in our country, and with more supplies coming online this week and next, anyone aged 50 and older or with underlying health conditions should book their jab.

“The NHS has been absolutely clear throughout the vaccination programme that doses must never be wasted, and when supply is constrained in April, sites will be expected to continue to vaccinate people most at risk as advised by the JCVI, and alert their local area’s vaccine lead to any spare doses.”