The ongoing roll out of the Corvid Vaccination Programme is something that gives us all hope for this New Year. As GPs we are getting increasing numbers of questions about the vaccination programme, and this blog is intended to help answer some of them for you. I’ve done it as a ‘Frequently Asked Questions’ piece and hope it helps.
|Q. When will I be invited for my Covid Vaccination?|
| A. The Joint Committee for Vaccination and Immunisation has clearly outlined the order in which people should receive covid vaccination. That list is detailed here and vaccination sites have been given very clear instructions about not proceeding from cohort to cohort without getting approval to do so. You will therefore need to wait until your cohort is called. Many vaccination sites have already started, most on cohort 2, the over 80s. There is hope that the first 4 cohorts can be done by the middle of February, but this is a big ask. |
1 Residents in a care home for older adults and their carers
2 All those 80 years of age and over Frontline health and social care workers
3 All those 75 years of age and over
4 All those 70 years of age and over Clinically extremely vulnerable individuals
5 All those 65 years of age and over
6 All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7 All those 60 years of age and over
8 All those 55 years of age and over
9 All those 50 years of age and over
|Q. Why has my town not started vaccinating, while others nearby have?|
|A. Initially there was low availability of vaccine coming out to local sites. Each site needs to get itself ready in order to be able to administer the vaccine safely. This will take some sites longer than others. This readiness alongside availability of vaccine has led to sites going live in various ‘waves’. The final waves should be going live the week beginning 11th January. Sites in the earlier waves are not ‘better’ than those in the later waves, it’s just the way things have worked out. Because of the rapid roll-out, everyone will be up and running very soon, so don’t worry – you will get your vaccine!|
|Q. Where can I get my Covid Vaccination?|
| A. There are a number of sites now giving the vaccine. Hospital sites have now been asked to focus on vaccinating frontline health and care staff. Community sites being run by groups of GP Practices will continue to undertake the majority of the vaccinations for patients. You should therefore expect (at the moment) to receive an invitation from your GP practice for your vaccination. There are some community pharmacy sites coming on-line over the coming weeks, and I expect initially they will also be vaccinating the frontline health and care staff. |
A recent development has been the opening of mass vaccination sites across the country. Some people may receive a letter saying they can book to go for their vaccination at one of these sites. You can choose to do this or wait for your General Practice site to contact you.
|Q. Who should I call to arrange my covid vaccination?|
|A. Please don’t call anyone! Don’t call us, we’ll call you is the answer to this question. Please be patient and wait until you are invited. If you receive a letter inviting you to a mass vaccination site (as the question above), then please don’t ring your GP about it. Either follow the instructions in the letter and book to go to the mass vaccination site, or wait for your GP to contact you.|
|Q. What do I need to do when attending for my vaccination?|
| A. If there is anything you need to know, you will be advised of this when offered your appointment. Take careful note of any instructions given as they will vary from site to site. The vaccination site might not be your usual GP surgery, and might not even be a local NHS venue. Follow any instructions given. I would suggest trying to avoid arriving early as sites will wish to avoid bottlenecks and queueing – social distancing needs to be maintained – remember Hands, Face, Space at all times. If you are receiving the Pfizer vaccine you will need to wait for 15 minutes before leaving. If you receive the AstraZeneca-Oxford vaccine you are advised not to drive for 15 minutes after vaccination. Depending on the vaccination site there might be issues with car parking, so be prepared for this. As you will be attending for a vaccination in your upper arm, wearing short sleeves will help, although a warm coat over the top is advised as it’s a cold time of year – some sites may use outdoor areas and marquees for the 15 minute observation period. |
There has been much said about the need to take your NHS number. This is because the IT system used to record your vaccination asks for this. If you have your NHS number (on a repeat prescription/hospital letter/via patient on-line access) then you can take it along. If you don’t know your NHS number then please do not ring your GP just to get it! Your GP will already have it so probably won’t ask you for it when you attend, and you don’t actually need it anyway – the IT system can find you using your name, date of birth and postcode.
|Q. Is there anyone who should not receive the Covid vaccination?|
| Pfizer Vaccine |
Anyone known to have had previous immediate severe anaphylactic reaction to the vaccine or any of its components. Anyone with a history of immediate onset-anaphylaxis to multiple classes of drugs or an unexplained anaphylaxis.
| AstraZeneca-Oxford Vaccine|
Anyone known to have had previous immediate severe anaphylactic reaction to the vaccine or any of its components.
| For both vaccines|
– Anyone who either has an active Covid infection or has had one in the past 4 weeks should wait until recovery. Equally anyone who has any other acute illness should wait until they are feeling better.
– You need a space of a week between a covid vaccine and any other vaccine, so don’t have your covid jab within a week of your flu or shingles jab, and delay your flu or shingles jab for at least a week after your covid jab.
|Q. If I had a reaction to vaccine dose 1, should I have vaccine dose 2?|
|A. As above, if you had an immediate severe anaphylactic reaction to the first dose, you should not have the second dose. If you had an allergic skin reaction to the first dose, you can have the second dose, but this should be in a hospital setting. If you had other, non-allergy related effects such as a headache or sore arm, then you can have the second dose.|
|Q. Can I have the vaccine if I am pregnant or breastfeeding?|
|A. At the moment there is no safety data relating to the vaccine in pregnant women. The advice is that pregnant women can be vaccinated if they understand this and it is felt that they would be at significant risk from Covid-19. There is not thought to be any reason why a breastfeeding woman should not receive the vaccine.|
|Q. Are there any side effects from the vaccine?|
|A. For both vaccines the most common side effect is a sore arm. Other side effects can include headache, aches and pains and a ‘flu-like’ feeling. Some people have reported a raised temperature. These effects are not long-lasting and will usually have settled within 24-48 hours.|
|Q. Should I have the same vaccine for both first and second doses?|
|A. Yes, you should. There is no scientific evidence either way about whether having a different vaccine for second dose will be effective or not, so you should have the same one. Having said that, there may be exceptional situations whereby that is not possible. It is thought that a second dose of a different vaccine is better than no second dose at all.|
|Q. Once I’ve been vaccinated, can I stop distancing myself from others?|
|A. No. Once vaccinated, you should receive greatest protection at least 1 week after your SECOND dose. This does not mean you can then ignore all the current guidance. Hands, Face, Space still applies. We know that not everyone will respond to vaccination. We do not know if vaccination will prevent you from carrying and transmitting the virus. It is really important that you continue to follow the guidelines and don’t take your guard down.|
|Q. Will my GP Practice remain open during the Covid Vaccination Programme?|
|A. Yes! GP services are not stopping just because we are responding to the pandemic. The way you access your GP may feel different at the moment, and you cannot directly book an appointment without having a phone call first, but your GP surgery is still open. Even on the days they are vaccinating there will be provision to assess people who need it. Please ring your GP surgery if you need to, and don’t forget about NHS 111 which you can access via phone or on-line.|
|Q. Is the covid vaccine safe?|
|A. The vaccines currently being given in the UK have been developed by Pfizer/BioNTech and Oxford/AstraZeneca.|
They have met strict standards of safety, quality and effectiveness set out by the independent Medicines and Healthcare products Regulatory Agency (MHRA).
Any coronavirus vaccine that is approved must go through all the clinical trials and safety checks all other licensed medicines go through. The MHRA follows international standards of safety.
Other vaccines are being developed. They will only be available on the NHS once they have been thoroughly tested to make sure they are safe and effective.
So far, thousands of people have been given a COVID-19 vaccine and reports of serious side effects, such as allergic reactions, have been very rare. No long-term complications have been reported.
Read about the approved Pfizer/BioNTech vaccine for COVID-19 by MHRA on GOV.UK
Read about the approved Oxford/AstraZeneca vaccine for COVID-19 by MHRA on GOV.UK
Specific questions have been asked about the impact on fertility following the Pfizer/BioNTech vaccine. The information for healthcare professionals for this vaccine states that “Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity” https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontech-vaccine-for-covid-19?1
|Q. I have heard that the time between doses 1 and 2 has been increased from 3-4 weeks to 12 weeks. Why is that?|
|A. The original plan for the Pfizer/BioNTech vaccine was to give the second dose at least 3 weeks after the first. The Oxford/AstraZeneca vaccine recommended a 4-12 weeks gap. With the current surge in cases, hospitalisations and deaths it is felt that greater good will come from more people receiving a single dose as quickly as possible. There is still the absolute intent for everyone to receive 2 doses and we know this is required. In simple terms this seems to me to be a maths problem – giving more people some protection leads to the saving of more lives than giving less people (half the number) full protection.|
|Q. Is there anything else in the vaccine dose?|
|A. All drugs and vaccines contain additional components that help turn it into the medicine, tablet or injection. These substances are called excipients. I have listed the excipients for the two currently available vaccines here. If you know you have anaphylaxis to any of these, you should not receive that vaccine. There is nothing else in the vaccine other than the active ingredient and these excipients. There are no tracking chips.|
This vaccine contains polyethylene glycol/macrogol (PEG) as part of ALC-0159.
ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate),
ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide,
potassium dihydrogen phosphate,
disodium hydrogen phosphate dihydrate,
water for injections
L-Histidine hydrochloride monohydrate
Magnesium chloride hexahydrate
Disodium edetate dihydrate
Water for injections
I am aware that more questions will likely emerge as time moves on. I will therefore endeavour to keep this blog updated with additional questions and answers. If, therefore, you have a question, do post it on this blog or on Twitter (@DrJonGriffiths). I cannot promise to answer all questions directly, but will see what I can do.
Dr Jonathan is a GP in Cheshire.