Covid vaccine: unease among doctors as follow-up doses of UK jab delayed

Survey finds medics have concerns about scrapping of second appointments

Doctors are having their second dose of the Covid vaccine delayed, amid concern from medical organisations about the policy to widen the gap between injections and the threat to medics and their patients if they are not fully protected.

A survey of doctors across the UK by the campaign group Everydoctor found that medics in many places who had had their first dose of a Covid vaccine had since had their appointments for the second dose cancelled.

The government announced last Wednesday that it was shifting its vaccination policy to delay the period between administering the two doses from the recommended three to four weeks to 12 weeks, as it made frontline health and care staff a key priority group for vaccination.

The change aims to give as many people as possible some immunity from one jab as soon as possible, rather than half that number maximum immunity with two.

However, doctors’ organisations and patients have voiced unease about the strategy, which has led to many hundreds of thousands of people having their booked second appointments scrapped.

While there is evidence from trials of the Oxford/AstraZeneca vaccine, circulation of which began on Monday, of greater efficacy among people who were given the second shot later, Pfizer/BioNTech have said there is no evidence for the efficacy of a single shot of their vaccine beyond three weeks.

Dr Julia Patterson, the lead for Everydoctor, said doctors fear that delaying the second dose they need to obtain full immunity could lead to them becoming ill or infecting colleagues or patients.

In a self-selecting survey of 1,318 doctors, 175 (13%) said that while they had received one dose of a Covid vaccine, the appointment for their second dose – booked when they were first inoculated – had since been cancelled. Another 517 (39%) said they had still not been told when they would have their first dose.

“The Covid-19 crisis is escalating and we need to urgently protect those who are working on the frontline. If healthcare workers are left unprotected, they are at risk themselves, and they may also pass coronavirus on to vulnerable patients,” said Patterson.

“We were pleased to see last week that healthcare staff would now be vaccinated as a priority. However, five days on, many staff members are still in the dark about when they will receive vaccines.” Hospitals should now lay on clinics to immunise as many staff as fast as supplies of both vaccines allow, she added.

Just 388 (30%) of the doctors said they had received their first dose and were still due to have their second as planned, regardless of the change in approach.

Karoline Lamb, 84, said she was “absolutely fuming” that she might not be able to get the second dose of the Pfizer vaccine: “I was so elated when I had the first one. I had no side-effects and I’m booked in for the second one on 21 January, but I’m extremely worried it will be cancelled.”

Lamb, from Chalfont St Giles in Buckinghamshire, is concerned that the first dose risks “becoming ineffective”. “If I don’t get the second one within three weeks, I’m worried the first dose could do more harm than good. Had I known the government might not let me have the second dose in time, I would not have accepted the first one.”

Meanwhile, close to 3.5m doses of the Oxford vaccine are awaiting release after undergoing checks by medical regulators, the Guardian understands, amid calls for the rollout of the jab to be accelerated in what Labour has described as “a race against time”.

The government has said that it already has a batch of 530,000 doses to be administered this week and Sir John Bell, Oxford University’s regius professor of medicine, had said a further 450,000 were due to be available at the start of the week. Several million more doses of the vaccine are understood to have been manufactured in the UK but are yet to be bottled in vials.

The NHS will need to start delivering at least 2m jabs a week from next week if it is to fulfil the Boris Johnson’s plan to vaccinate everyone in the four highest-priority groups by mid-February. The four groups the prime minister said will have a first dose amount to 13.9 million people in England, according to Nadhim Zahawi, the vaccines minister.

Pascal Soriot, AstraZeneca’s chief executive, said on 30 December that his company would be able to provide 2m doses a week.

But Matt Hancock, the health secretary, appeared to play down the possibility of reaching that level when the figure was put to him on BBC Radio 4’s Today programme on Monday. Hancock said: “John Bell is a great man, but he is not responsible for AstraZeneca’s manufacturing facility.”

Labour’s shadow health secretary, John Ashworth, said: “Ministers should be going hell for leather to get 2m jabs a week distributed as soon as possible and then scale up further. We know this virus can mutate and could well do so again. We are in a race against time.”

An NHS spokesperson said: “The MHRA [Medicines and Healthcare Products Regulatory Agency], JCVI [Joint Committee on Vaccination and Immunisation] and UK chief medical officers have updated the second dose timing guidance, which the NHS has to follow, so as to increase the number of vulnerable people protected against Covid over the next three months, potentially saving thousands of lives. NHS staff are being prioritised for the vaccine now that more supply is coming on stream.”


Denis Campbell, Robert Booth and Rachel Obordo

The GuardianTramp

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