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Mixing of COVID-19 vaccines ‘extremely unlikely’, NHS England tells MPs

By 12/01/2021No Comments

Last week GPs raised concerns that patients could be given a different COVID-19 vaccines for their first and second dose after the Joint Committee on Vaccination and Immunisation (JCVI) updated its guidance, advising GPs to administer second doses within 12 weeks, rather than three or four.

NHS officials have this week written to GPs to set out further advice on delaying the second dose of vaccine – advising that all second-dose appointment must be rescheduled to 12 weeks after the first dose.

GPs have warned that extending the dosing schedule made the NHS ‘more likely to face the scenario of mixing vaccines due to supply issues and the number of vaccines ordered’.

But NHS England’s vaccine deployment chief commercial officer Emily Lawson told MPs at a House of Commons public accounts committee meeting on 11 January that she did not expect mixing to occur – and stressed it should be done only as a ‘last resort’.

Mixing vaccines ‘unlikely’

MPs were also told that it was ‘too early’ to know whether an annual COVID-19 vaccination campaign would be needed, although it was revealed the UK has sufficient doses of vaccine in the pipeline to repeat the process next year if required.

Responding to questions around the potential mixing of vaccines following changes to guidance, Ms Lawson said: ‘It’s important to emphasise that [the mixing of vaccines] is written as a last resort, we don’t expect this to happen.

‘The only situation in which that would happen is somebody didn’t have their first dose in the UK because we do have this ability to look back at GP records to see what vaccine you have received, which would not only tell you what vaccine it was, but what batch number as well. So, it’s an extremely unlikely occurrence.’

She added that a clinical trial was being set up to analyse whether the mixing of vaccines would be efficacious, but argued the data needed to be examined. ‘We don’t have a programme set up for that now because that isn’t how the programme is set up. The programme is set up to give you the same vaccine at 12 weeks as you had in the first week.’

Medico-legal risk

DHSC permanent secretary Sir Chris Wormald clarified that the mixing of vaccines was not government policy and there was ‘no data to support the approach’. He added there were ‘some very, very exceptional circumstances’ that people might have two different shots.

Current advice in the Green Book is that people should ideally 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.

Campaign group DAUK has warned moving to the 12-week gap between vaccinations could make it more likely that the same vaccine would not be available. It warned of potential ‘severe’ medico-legal consequences for clinicians if there was a ‘COVID-related adverse outcome’ because of a delayed second dose.

Permanent secretary at the Department for Business, Energy and Industrial Strategy Sarah Munby also told MPs that it was too early to know if an annual COVID-19 vaccine campaign would be needed.

Annual COVID-19 vaccination

‘Of course we are absolutely thinking about the fact that annual vaccinations may be required,’ she said. ‘It is too early to say whether they will be or not. We’ve got plenty of doses to be getting on with, not just for this year but likely next year as well.’

She pointed out that the government has orders in place that could deliver around 367m doses of vaccine. ‘Let’s assume all of those reached approval – we would have more than enough to revaccinate everybody next year if we wanted to. So we have time in hand here. We are not making an annual vaccination plan now because we don’t know that one is necessary, and we don’t need to yet.’

Statistics published by NHS England show that as of 10 January, the NHS in England had delivered 2,333,764 doses of COVID-19 vaccine. The government has pledged to offer all adults a vaccination by autumn 2020.

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