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Supply concerns as green book update sets minimum COVID-19 jab interval at eight weeks

By 02/07/2021No Comments

A BMA update published this week said that in recent weeks ‘some areas have reported a significant reduction in the volume of Pfizer vaccine available and supplies are not meeting demand from those still to be vaccinated’.

The updated added that ‘some people are waiting weeks for their first-dose appointment at a time when we need as many as possible to be protected as quickly as possible’.

New health and social care secretary Sajid Javid this week repeated the government’s stance that the UK faces a ‘race between the virus and the vaccine’.

COVID-19 cases

A total of 27,989 new cases of COVID-19 were reported on 1 July – the highest figure seen since late January – as the Delta variant continues to spread across the UK. More than 110,000 new cases have been reported UK-wide over the past week.

However, the total number of vaccines administered in the week to 30 June was 2,344,747 – the second-lowest figure recorded over an equivalent seven-day period since mid-January.

Meanwhile, after a 10-day period from the middle of June in which first-dose vaccinations outnumbered second doses for the first time since April, in the past three days for which data is available second doses have made up the majority of jabs, according to GPonline analysis.

Second doses are currently being administered primarily in age groups which have received the Oxford/AstraZeneca vaccine.

Delta variant

The BMA update added: ‘While the government insists that the UK is on track to offer a first dose to all adults by its 19 July deadline, we need to know what supplies are available nationally. This is especially urgent given the need to stem the spread of the Delta variant.’

Warnings over supply come as dosing and scheduling advice in the green book on COVID-19 vaccination was updated.

Following reports of vaccination sites offering second doses of vaccine three or four weeks after the first jab, updated advice says that ‘for both adenovirus vector and mRNA vaccines, there is evidence of better immune response and/or protection where longer intervals between doses are used’.

The guidance says the JCVI is recommending an interval of 8 to 12 weeks between doses of all COVID-19 vaccines in use in the UK, adding: ‘Operationally, this consistent interval should be used for all two-dose vaccines to avoid confusion and simplify booking, and will help to ensure a good balance between achieving rapid and long-lasting protection.’

Dosing interval

The green book says that the ‘main exception’ that could allow second doses to be brought forward to less than eight weeks after the first dose is for patients about to start immunosuppressive treatment. In these cases, two doses of Pfizer/BioNTech vaccine can be administered a minimum of 21 days apart, while doses of Astra/Zeneca and Moderna vaccines can be administered a minimum of four weeks apart.

A spokesperson for Pfizer said its deliveries of vaccine to the UK were continuing as planned. The spokesperson said: ‘We are working relentlessly to support the rollout of COVID-19 vaccination campaigns worldwide.

‘In the UK, quarter one deliveries (January-March) were completed in line with our contractual agreement and we remain on course to continue to deliver a steady supply of vaccines to the UK, in accordance with the monthly schedule, agreed in advance with the vaccines taskforce. 

‘Decisions on dosing regimens and how best to roll out the vaccination programme to priority groups sit with the health authorities in each country.’



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