Doctors say they will defy Government orders to give a second dose of the Pfizer coronavirus vaccine to elderly patients who were promised one when they got their first jabs.
A row has broken out over ministers’ decision to ration vaccine supplies to get single doses to as many people as they can in a scramble to stem the tide of Covid deaths.
Officials, warning that supply shortages could last until spring, have said patients who already had one dose of the vaccine should have their second one – which they were told they’d get three weeks later – postponed for up to 12 weeks.
But doctors have revolted and said they won’t deny vulnerable patients the vaccines they promised them amid concerns the jabs won’t work as well with just one dose.
GPs blasted the policy as ‘grossly unfair’ and frustrated scientists warned that clinical trials of the vaccine only tested how well it worked with a three-week gap, so there is no evidence the new regime would work long-term.
Professor Chris Whitty, England’s chief medical officer, said in a letter with his counterparts in Scotland, Wales and Northern Ireland that single dose could offer 70 per cent protection, and having this in a larger number of people would be more effective than 95 per cent protection in half as many.
Margaret Keenan, the first person in the world to receive a Covid-19 vaccine, received her second jab earlier this week.
But thousands of others across Britain will see their second appointment delayed so the NHS can focus on delivering jabs to more people.
A total of 944,539 people across the UK had received the first dose of a Covid-19 vaccine by December 27, according to the Department of Health.
The Hospital Consultants and Specialists Association (HCSA) warned the ‘ill thought-out’ plan to delay the second dose would leave many vulnerable staff in limbo, while one doctor said she would continue to give second doses to elderly patients who had been promised them.
Those backing the new plan, however, say every second dose given out is one less first jab for someone who has a high risk of dying of Covid-19.
Margaret Keenan returned to hospital this week to receive her second round of the Covid-19 vaccine, but thousands of other patients are set to see their appointments delayed under a new scheme aimed at getting more people to receive their first dose
Doctors across the country say they will carry on with the original three-week vaccination plan for patients who were promised it when they got their first jab.
GPs working for Black Country and West Birmingham NHS boards, as well as a doctor in Oxford, said they would honour the commitments they had made to patients.
PFIZER HITS BACK AT UK PLAN TO GIVE PEOPLE ONE DOSE NOT TWO
Pfizer warned yesterday there is ‘no data’ to show a single dose of its coronavirus vaccine provides long-term protection after the UK scrapped its original jab rollout plan.
The UK medical regulator is now recommending Covid jabs are given in two doses three months apart, rather than four weeks apart, to allow millions more people to be immunised over a shorter time period.
The strategy will apply to both Pfizer/BioNTech’s vaccine and the newly approved jab by Oxford/AstraZeneca, despite limited data around the effectiveness of the initial doses.
It is a direct response to spiking Covid cases and hospitalisations across the UK that are being driven by a new, highly infectious strain that emerged in the South East of England in September.
Virtually the whole of England is facing brutal lockdown until the spring, with Covid vaccines the only hope of ending the devastation.
Health bosses now want to give as many people as possible an initial dose, rather than holding back the second doses, so more of the population can enjoy at least some protection.
AstraZeneca praised the move and revealed it had tested the three-month strategy on a small sub-group of trialists in its studies.
But Pfizer said there was ‘no data’ in its studies to show its vaccine protects against Covid when taken 12 weeks apart.
In a thinly-veiled swipe at the UK, the US firm warned that any ‘alternative’ dosing regimens should be closely monitored by health authorities.
‘Data from the phase three study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent,’ Pfizer said in a statement.
‘There are no data to demonstrate that protection after the first dose is sustained after 21 days.’
One medic in Walsall told The Telegraph: ‘Our patients consented to a vaccine schedule of two doses and doing anything other than that would be doing them a disservice.’
And Dr Helen Salisbury, from a surgery in Oxford, told BBC Radio 4’s Today programme that it was about not ‘reneging on our promise’.
She said: ‘We were… told we could use our clinical discretion, and that’s what we are doing.
‘There are several reasons. One is the science – we really don’t have any data, as far as I’ve been able to ascertain, maybe there’s data they haven’t released – but we don’t have data about immunity after the first dose beyond 21 days when people got their booster in their trial, so we don’t know what happens.
‘But the second and, I think, more important, is about our patients and our very vulnerable patients, the elderly, who we want to protect most and the relationship we have with them. Their trust in us, their trust in science and the vaccine.
‘When you’ve started a patient on a course of treatment and you’ve said “This is what the plan is, here’s one jab, please come back in three weeks, it’s really important you have the second jab to be fully protected” and then, to turn round five minutes later and say, “Don’t worry about that, it’s okay, you can have it in 12 weeks not three weeks” – I don’t think that’s good enough, actually.’
In a statement published by the UK’s chief medical officers last night they said the decision had been made on a ‘balance of risks and benefits’.
The medical officers are Professor Whitty (England), Dr Frank Atherton (Wales), Dr Gregor Smith (Scotland) and Dr Michael McBride (Northern Ireland).
They said: ‘We have to ensure that we maximise the number of eligible people who receive the vaccine.
‘Currently the main barrier to this is vaccine availability, a global issue, and this will remain the case for several months and, importantly, through the critical winter period.
‘The availability of the AZ vaccine [Oxford/AstraZeneca] reduces, but does not remove, this major problem. Vaccine shortage is a reality that cannot be wished away.’
Explaining the thinking behind the dosing change the medical officers said they were ‘confident’ that one dose of either the Pfizer or Oxford and AstraZeneca vaccine would give most people ‘substantial protection’ against Covid-19.
They added: ‘In terms of protecting priority groups, a model where we can vaccinate twice the number of people in the next 2-3 months is obviously much more preferable in public health terms than one where we vaccinate half the number but with only slightly greater protection.’
The letter was published yesterday following a fierce backlash against the Government’s plans to postpone people’s second doses of the Pfizer vaccine.
That jab, the first one to be approved by the UK and put into use from December 8, was trialled as a two-dose vaccine and found to be 95 per cent effective at preventing Covid-19 in clinical trials where the doses were given three weeks apart.
Scientists have not yet published data on how well the vaccine would work if the doses were spread out more, with a longer period between each jab.
Pfizer itself hit back at the British Government’s plan to change the way the vaccine is used and said this week: ‘Although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent.
‘There are no data to demonstrate that protection after the first dose is sustained after 21 days.’
Doctors are angry at the decision, which means they have to cancel appointments already made for hundreds of thousands of patients who have already had a first dose.
Paul Donaldson, general secretary of the Hospital Consultants and Specialists Association (HCSA), said the decision was ‘bizarre’ and ‘ill thought-out’.
He said: ‘While a planned and orderly deployment of the Oxford vaccination including longer timelines makes epidemiological sense, the decision to throw a spanner in the works of the existing Pfizer rollout appears simply bizarre unless there is an unknown hitch in supply.
‘We are hearing that vulnerable hospital doctors at high risk from Covid have been told not to turn up for their second dose and therefore will not receive full protection.
‘They are now left in limbo by a hastily formulated policy which seems extremely ill thought-out.
‘For example, to make contact with even just 2,000 elderly or vulnerable patients will take a team of five staff at a practice about a week, and that’s simply untenable.’
England’s Chief Medical Officer, Professor Chris Whitty said vaccine shortage ‘is a reality that cannot be wished away,’ in a joint letter with his counterparts in Scotland, Northern Ireland and Wales
Other healthcare experts have said the move to delay second doses will cause huge problems for thousands of partially vaccinated elderly and vulnerable people.
Richard Vautrey, chairman of the British Medical Association’s GP committee, said: ‘It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments.
‘The decision to ask GPs, at such short notice, to rebook patients for three months hence will also cause huge logistical problems for almost all vaccination sites and practices.’
IS THE UK’S GREAT VACCINATION DRIVE DOOMED ALREADY?
Retired doctors desperate to roll their sleeves up and help Britain administer 2million Covid vaccines each week to end the continuous cycle of lockdowns by the spring have today hit out at the NHS ‘red tape’ that requires them to prove they aren’t terrorists before they’re allowed to chip in.
Ex-medics wanting to be deployed straight onto the frontlines to dish out the jabs have complained of the bizarre requirement to submit up to 21 documents in their application, including evidence that they have had any Prevent Radicalisation training.
Dr Melanie Jones, a former anaesthetist in South Wales, urged the NHS to ‘bend some rules’ so they can use their ‘Dad’s Army’ of up to 40,000 retired doctors and nurses who volunteered to help in the spring. Another retired medic claimed they ‘wouldn’t bother’ applying after hearing about Dr Jones’ ordeal on social media.
Despite their pleas, GPs tasked with delivering the vaccine say they urgently need more workers to help the UK drastically ramp-up the speed of the mammoth operation, which is considered the only hope Britain ever has of returning to normal life before the spring.
But the NHS has yet to call upon the Army to help turbo-charge the roll-out, with Defence Secretary Ben Wallace today insisting the military ‘stands ready’ to deliver as many as 100,000 doses a day, should it ever be called upon by the health service. Even Tesco has offered to hand over its network of refrigerated lorries and warehouses to turbo-charge the roll-out.
Matt Hancock has repeatedly promised the draconian restrictions that have been enforced on a rolling basis since March can be lifted when millions of the most vulnerable members of society have been given the jab — but No10 has never committed to an actual figure, leaving the nation completely clueless about when it will be possible for them to return to living a normal life.
And Downing Street’s plan vaccinate 2million people against Covid every week could already be doomed before the biggest inoculation drive in British history has even properly started, despite pleas from Labour for ministers to ‘move heaven and earth’ and rapidly speed up the roll-out.
In another blow to plans of drastically ramping up the vaccination drive, NHS England figures today revealed the speed at which jabs were given out slowed over the Christmas break — dropping from a rate of around 292,000 jabs a week to 243,000 in the seven-day spell ending December 27.
And a MailOnline analysis has revealed the UK may not be able to vaccinate all 30million Brits listed on the priority list until December 2022, if the NHS is only able to continue at the current pace. And it would take twice as long to ensure they are given the necessary second dose.
Even if health chiefs manage to ramp up injections to a million a week, it could still take until August next year for No10 to complete ‘Phase One’ by giving one dose of the jab to the most at-risk members of society.
Health Secretary Matt Hancock yesterday promised Britain would deliver the jabs as soon as it gets them, with the boss of AstraZeneca – whose coronavirus vaccine was given the green light yesterday – insisted they could deliver 2million doses a week by mid-January.
But supply issues could scupper the grand plans. No10’s vaccine taskforce originally promised 30million doses of the Oxford/AstraZeneca jab by the end of the year before scaling back their claim to 4million – but have since warned of ‘manufacturing challenges’. Mr Hancock yesterday revealed Britain will only have 500,000 doses ready to go from Monday.
Arguing the case for the Government, Professor David Salisbury, a former vaccination director at the Department of Health and now expert at the Chatham House think-tank, said the policy was simply about saving lives.
He said vaccinating as many people as possible is now the top priority, even if it means the vaccines are slightly less effective than they would be in an ideal scenario.
He told Radio 4: ‘The reason for doing this is to save lives…
‘In a perfect world there would have been huge stockpiles of vaccines, there would be no problems about rolling the vaccines out as fast as you need them, but we are facing rising cases, rising hospital admissions and rising deaths.
‘We have to do something and administrative inconvenience is really not a good reason to fail to save lives.’
He added: ‘Every time we give a second dose right now, we are holding that back from someone who is likely, if they get coronavirus, to die. And much more likely to die than somebody who has already had a single dose.
‘I just think it’s so clear that this is what we should be doing.’
The approval of the vaccine made by Oxford University and AstraZeneca should speed up the roll-out once it starts being administered from Monday, January 4.
That jab can, unlike Pfizer’s, be kept in a normal fridge instead of a specialist freezer and will be much easier to transport and store, meaning it can be distributed to vaccination centres in bigger batches and used for a longer period of time between deliveries.
There are around 31.7million people on the official waiting list for a jab, which includes everyone over the age of 50, people who are younger but seriously ill, and millions of NHS and social care workers.
Currently the UK is giving out 300,000 doses per week, a figure which is expected to speed up when clinics start using the game-changing Oxford University and AstraZeneca jab which was approved yesterday.
MPs and experts are calling for the vaccines to be given out at lightning speed in a desperate bid to stop the spread of the new coronavirus variant, which new evidence suggests may be so infectious that lockdowns can barely contain it.
Labour’s Shadow Health Secretary, Jonathan Ashworth, yesterday urged ministers to ‘move heaven and earth to roll out vaccination starting with two million jabs a week’.
Even at this ambitious speed – almost six times the rate vaccinations are currently being given out – it would take until April to get one dose to everyone on the priority list.
But there is hope some restrictions could be lifted before the list is completed, with Matt Hancock saying No10 can lift restrictions ‘when enough people who are vulnerable to Covid-19 have been vaccinated then’. However, he has never committed to an actual figure.
One scientist, however, told MailOnline it was impossible to put a logical number on when this would happen, and it would depend on how much risk the Government is willing to take. If lockdowns are lifted too soon, there could be a surge in severe cases, hospital admissions and deaths in groups who are at moderate risk but not priority for a vaccine, such as the middle-aged.
The NHS says people over 70 and those with the most serious long-term health conditions are at ‘high risk’ from Covid-19. These, combined with health and care workers, make up a group of 14.3million people, who could be given a single dose each within seven weeks at the ambitious rate of 2m per week, so by mid-February.
But lifting lockdown rules by then would involve putting younger groups, such as those in their 60s, 50s and 40s, at risk from a then-uncontrollable virus, and it would mean the people already vaccinated wouldn’t have the full protection of two doses, which both vaccines require.
Herd immunity, in which so many people are vaccinated that the virus can’t spread any more, will be impossible with the current strategy, scientists warned, with US infectious diseases director Anthony Fauci saying he doesn’t expect the country to ‘approach normality’ until the end of 2021, even with 80 per cent of the population getting vaccinated.
It is more likely that the UK’s restrictions will be phased out over a longer period to stop the virus spiralling among younger people, who still have a small risk of hospitalisation, death or long-term complications.
Scientists said they expect the current cycles of lockdown to carry on into the late spring or even the summer even if the vaccination programme goes to plan, meaning England faces many more months of misery.