Covid-19 second-stage vaccinations to be delayed across UK

More than 500,000 people who have been vaccinated against Covid-19 will have their second dose delayed for up to 12 weeks as the NHS rethinks the rollout that is aimed at halting the surging death toll in the UK.

In a change of policy, applying across the UK, the NHS will now prioritise administering to as many people on the priority list as possible the first dose of either the newly approved Oxford/AstraZeneca vaccine or the Pfizer/BioNTech jab, so as to maximise the number of people protected against the disease.

Recipients will still get the two doses required to confer full immunity, but now the second will be delayed, in most cases coming 11 to 12 weeks after the first.

Previously, those receiving the Pfizer jab had a second dose-date set three weeks later on from their first dose. That gap was originally expected to be four weeks for the Oxford vaccination.

Sir Simon Stevens, chief executive of NHS England, disclosed the move in a letter to health service leaders in England on Wednesday, a day on which 981 more Covid deaths were announced. The move has been prompted by the Medicines and Healthcare products Regulatory Authority changing its guidance on how the vaccines can be deployed.

Quick guide When and how will I be able to get a Covid vaccine in the UK?

Show

Hide

Now that the UK has authorised the first Covid vaccine, who will get it first?

The government’s Joint Committee on Vaccination and Immunisation (JCVI) says its priority is to prevent Covid-related deaths and protect health and social care staff and systems.

Elderly care home residents and their carers are first on the JCVI’s list because their risk of exposure to the virus is higher and because the risk of death closely correlates with older age. They are followed in priority by anyone else over 80 and frontline health and social care workers.

Even so, for pragmatic reasons NHS staff are likely to be the first group to receive the Pfizer/BioNTech jab. This is because the vaccine needs to be stored at ultra-cold temperatures, which can be achieved more easily by using hospital facilities

Are there enough doses to reach all the priority groups?

Together, care home residents, their carers and the over-80s make up nearly 6 million people, and frontline NHS staff a further 736,685. Matt Hancock, the health secretary, has said he expects 10m doses of the Pfizer/BioNTech vaccine to be available this year, so if this is the only vaccine authorised, everyone else would have to wait until further doses become available next year. 

Where will I go for the vaccine?

Covid-19 vaccines are expected to be delivered at three types of venue: NHS trust “vaccine hubs” at hospital sites; mass vaccination centres, which are in the process of being set up at places such as football stadiums, conference buildings and racecourses – these are expected to vaccinate up to 5,000 people a day; and at GP surgeries and pharmacies. GPs can also visit care home residents and housebound patients at home without them needing to travel.

How far apart will the two doses be administered, and will I protected after the first?

While there is some evidence to indicate high levels of short-term protection from a single dose of vaccine, a two-dose schedule is what has been approved by the MHRA.

The second dose will need to be delivered at least 21 days after the first, and both will be injected into the deltoid muscle – the thick triangular muscle we use to raise each arm.

For the Pfizer vaccine, its efficacy rate was calculated seven days after the second shot. It is likely that people will have some protection before this, but this is how long it will take for full protection to kick in. We will learn more about the extent of protection and how long it lasts as data from ongoing clinical trials comes in.

Can I pay to get the vaccine privately?

Unlikely. England’s deputy chief medical officer, Jonathan Van-Tam, has said he believes Covid-19 vaccines should be delivered according to clinical priority rather than allowing people to jump the queue if they can afford it.

Will I be able to choose which vaccine I have?

Also unlikely, at least in the short to medium term. Assuming more than one vaccine is approved, the priority will be distributing any available doses to the people who need it as quickly as possible.

Linda Geddes

Was this helpful?

Thank you for your feedback.

He also disclosed that the NHS hoped to have immunised all 25 million people in its nine priority groups by late spring, the first time any NHS leader or government minister has given a date for when those considered vulnerable will have had the chance to be vaccinated.

Dr Julia Patterson, the lead for EveryDoctor, a network of grassroots medics, said: “This sudden change of plan from the government will heap enormous pressure on the NHS staff delivering vaccines, and will also cause anxiety for vulnerable people who have had a first dose of vaccine and now face uncertainty about when they will receive their second dose.

“The government should be swiftly recruiting an additional mass workforce to roll out the vaccines, for example by enlisting the army, and not simply load further pressure on to NHS staff.”

The shift to delayed second doses means most of the many hundreds of thousands of people in England who have received their first jab, following use of the Pfizer product begun in the UK on 8 December, will now have to wait until as late as March for the second.

The chief medical officers of the four home nations have approved the policy switch amid a growing expectation that the daily death toll will soon exceed 1,000, given the explosion in infections and hospitalisations in recent weeks.

There is also acute concern that the NHS is being rapidly overwhelmed by the number of people now seriously ill in hospital, especially in the south of England. Buckinghamshire followed Essex on Wednesday by declaring a “major incident” in response to soaring Covid-19 cases.

Explaining the rationale for the change, the chief medical officers said in a statement, quoted by Stevens in his letter: “Prioritising the first doses of vaccine for as many people as possible on the priority list will protect the greatest number of at-risk people overall in the shortest possible time and will have the greatest impact on reducing mortality, severe disease and hospitalisations and in protecting the NHS and equivalent health services.

“Operationally this will means that second doses of both vaccines will be administered towards the end of the recommended vaccine dosing schedule of 12 weeks.”

In his letter Stevens makes clear that:

• Anyone who is due to have their second dose by next Monday can still do so.

• Appointment dates for those whose second dose is due after 4 January “should be rescheduled in most instances for between three [weeks’] (for the Pfizer/BioNTech vaccine) and four [weeks’] (for the AstraZeneca vaccine) and 12 weeks’ time, with most recipients to be booked in the last week of that 12-week period”.

• Those who are due to have their first jab from New Year’s Eve onwards should also not have their second dose until up to 12 weeks later. “Most recipients to be booked in the last week of that 12-week period.”

In a move that will be warmly welcomed by NHS staff, Stevens also confirmed that the imminent arrival of the Oxford vaccine – which will start being deployed on Monday – means staff immunisations can start right away.

Hospital and GP leaders, and frontline staff, have become increasingly vocal in recent weeks in airing their concern that leaving NHS personnel unvaccinated could expose both them and patients to danger at a time when the coronavirus is still rampant.