The government said that everyone who receives their first dose of either the Pfizer/BioNTech or Oxford vaccine from today will receive their second dose ‘within 12 weeks’. Previously the recommendation had been for people to have their second Pfizer jab three weeks after the first and the Oxford trials administered the second dose four weeks after the first.
The government is hoping that vaccinating greater numbers with the first vaccine dose will help to reduce severe illness and pressure on the NHS.
A statement from the four UK CMOs said that in order to vaccinate as many people as possible, most individuals would receive their second dose towards the end of the 12-week period. The DHSC said that, aside from those who have an appointment for their second dose of the jab this week, the NHS would be contacting patients who have already been vaccinated to rearrange appointments in line with the new timeframes.
It means GP practices face a huge challenge to contact the hundreds of thousands of patients that have already been vaccinated as the programme shifts its focus.
The UK government has invested heavily in the Oxford vaccine and pre-ordered 100m doses. The change in advice from the JCVI and availability of a more stable vaccine that can be stored in standard vaccine fridges means that GPs and primary care teams will likely be asked to rapidly scale up vaccination efforts in the coming days.
The DHSC said the Medicines and Healthcare products Regulatory Agency (MHRA) had approved the Oxford vaccine following ‘thorough analysis of the data’ from ‘rigorous clinical trials’ to ensure it met ‘strict standards’ of safety, quality and efficacy.
Speaking to Sky News this morning health secretary Matt Hancock said that roll out of the Oxford vaccine will start on 4 January.
The BMA called on the government to provide GP vaccination sites and hospital hubs with ‘investment and support’ to accelerate the vaccine roll out, adding that GPs should be given the flexibility to ‘reprioritise other services’ to focus on the task.
A DHSC spokesperson said: ‘Having studied evidence on both the Pfizer/BioNTech and Oxford University/AstraZeneca vaccines, the JCVI has advised the priority should be to give as many people in at-risk groups their first dose, rather than providing the required two doses in as short a time as possible.
‘Everyone will still receive their second dose and this will be within 12 weeks of their first.
‘From today (Wednesday) the NHS across the UK will prioritise giving the first dose of the vaccine to those in the most high-risk groups. With two vaccines now approved, we will be able to vaccinate a greater number of people who are at highest risk, protecting them from the disease and reducing mortality and hospitalisation.’
Accelerating roll out
The decision comes as the number of cases of COVID-19 continues to surge. On Tuesday the number of daily positive cases hit a record high of 53,135.
Mr Hancock told Sky News that the vaccine’s approval was ‘very good news for accelerating the vaccine rollout’.
He added: ‘I am now, with this approval this morning, highly confident that we can get enough vulnerable people vaccinated by the spring that we can now see the route out of this pandemic.’
BMA chair Dr Chaand Nagpaul said: ‘It is now crucial that supplies of this vaccine are given to as many GP practice sites and hospital hubs as possible and that this happens as quickly as possible so that we can begin vaccination en masse.
‘With 100 million doses of this vaccine already ordered we need to see a step change in distribution so that doctors can protect their patients and communities, beginning with those most at risk, and crucially this must include health and social care workers as they confront the virus on the front line.
‘While this vaccine may not have the same logistical hurdles as those associated with the Pfizer jab, the task of vaccinating such large numbers of patients in a short space of time is a huge challenge.’
The statement from the four UK CMOs said: ‘For both vaccines, data provided to MHRA demonstrate that whilst efficacy is optimised when a second dose is administered both offer considerable protection after a single dose, at least in the short term. For both vaccines the second dose completes the course and is likely to be important for longer term protection.’
In clinical trials the Oxford vaccine was shown to be 70.4% effective across two dosing regimens. Higher efficacy of 90% was found in a regimen which used a half first dose and a standard second dose. In those that received two full doses the vaccine was shown to be 62% effective. No one taking part in the trials became seriously ill with COVID-19.
Current advice from Public Health England is that people should receive the same vaccine for their second dose, although it does allow for a different jab to be administered if the first vaccine is unavailable.
The JCVI’s priority list for vaccinations puts care home residents and staff in the first group, followed by those aged over 80 and healthcare staff. NHS England has been prioritising care home vaccinations this week in a bid to vaccinate all residents in homes with more than 50 beds by the end of the year.