Top doctors have demanded the gap between the first and second doses of Pfizer‘s Covid-19 vaccine to be halved to six weeks amid concerns a long wait between the jabs is less effective.
The British Medical Association (BMA) has recommended to cut the waiting time, warning in a letter that the strategy is ‘difficult to justify’ and the UK is ‘internationally isolated’.
Dr Richard Vautrey, Chair of the BMA’s GP Committee, told Sky News this morning that they are ‘in dialogue’ with Prof Whitty over the 12-week gap, saying ‘we need to understand the data’.
Both the vaccines approved so far – one made by Pfizer and the other by Oxford University – rely on two doses to be most effective, with them ideally spaced three weeks apart.
But in a scramble to stop the devastating second wave of Covid-19, Britain has abandoned this rule and decided it will extend the gap to 12 weeks so it can give more people a single dose as soon as possible.
It emerged on Thursday that NHS hospitals could even be banned from giving out the jabs if they don’t stick to the strategy of delaying second doses by 12 weeks or longer.
The benefit will be that millions more people end up being vaccinated in the coming weeks. But it’s possible the vaccines won’t work as well in the long run.
The World Health Organization (WHO) has previously said governments should be giving people their second dose within 21 to 28 days of having the first, to make sure the vaccine works long-term.
BioNTech and partner Pfizer have also warned that they have no evidence their jointly developed vaccine will continue to protect against Covid-19 if the booster shot is given later than the 21-day gap tested in trials.
Meanwhile, in the UK’s Oxford/AstraZeneca vaccine trial, 59 per cent of those who received two doses had a nine to 12 week gap between the first and second jab, compared to 18.6 per cent in Brazil’s study.
The combined results found that the vaccine was more effective in the group that had over six weeks between the two doses than in the group that had less than six weeks between doses, according to The Lancet.
It comes amid calls from nursing leaders for higher-grade face masks to be given to staff to protect them against highly transmissible strains of Covid-19.
Public Health England medical director Dr Yvonne Doyle has also said it is not ‘absolutely clear’ if a mutation of the virus first found in Kent is more dangerous, despite fears that a UK Covid variant is more deadly than the original strain.
Senior doctors have called for the gap between the first and second doses of Pfizer’s Covid-19 vaccine to be halved to six weeks (pictured: Stephen Hartley is given his Pfizer/BioNTech jab by Primary Care Practitioner Nikki Brown at Haxby and Wiggington Surgery in York)
Professor Whitty pictured speaking during a coronavirus news conference at 10 Downing Street in London yesterday, during which Boris Johnson announced that the new variant of Covid, which was first discovered in the south of England, appears to be linked with an increase in the mortality rate
Dr Richard Vautrey (pictured above), Chair of the BMA’s GP Committee, told Sky News this morning that they are ‘in dialogue’ with Prof Whitty over the 12-week gap, saying ‘we need to understand the data’
In a private letter to Professor Chris Whitty, the BMA indicated that second doses may not be guaranteed following a 12-week gap due to the ‘unpredictability of supplies’, reports the BBC.
Although agreeing that the jab should be ‘rolled as quickly as possible’, the association called for an urgent review of the policy that is ‘proving evermore difficult to justify’.
A BMA spokesperson told MailOnline: ‘The BMA remains fully committed to supporting the Chief Medical Officer and the government in rolling out the vaccine as quickly as possible to protect the public and health care workers most at risk.
‘This letter to the Chief Medical Officer represents part of an ongoing dialogue about the best approach to the rollout of the vaccine and shares with him the growing concern from the medical profession regarding the delay of the second dose of the Pfizer-BioNTech vaccine as the UK’s strategy has become increasingly isolated from many other countries.
‘BMA members are also concerned that, given the unpredictability of supplies, there may not be any guarantees that second doses of the Pfizer vaccine will be available in 12 weeks’ time.
‘The World Health Organization has published its analysis of delaying the second dose and recommended that both doses of Pfizer-BioNTech should be given within 21-28 days, or as soon as possible thereafter.
NHS staff and key workers queue in the Louisa Jordan Hospital before receiving the coronavirus vaccine today in Glasgow, Scotland. Five thousand health and key worker staff are set to be vaccinated at NHS Louisa Jordan Hospital today as part of a mass vaccination drive by NHS Greater Glasgow and Clyde
An NHS member of staff speaks to a patient as she prepares to deliver the coronavirus vaccine at the Louisa Jordan Hospital in Glasgow, Scotland this morning
Immunisation Nurse Debbir Briody administers the Pfizer/BioNTech Covid-19 vaccine to Staff Nurse Amanda Thompson at the NHS Louise Jordan temporary hospital at the SEC Campus in Glasgow, Scotland
‘WHO has said that in exceptional circumstances this might be extended to within 42 days and there appears to be evidence for this in the Pfizer-BioNTech trial. However, the UK’s delay to 12 weeks goes well beyond even this timeline.
‘The BMA supports giving a second dose up to 42 days after the first dose, in line with international best practice as this would still allow for a doubling of the numbers of people protected by vaccination within a given time period compared to the original a 3-week dose interval.
‘The Association is urging the CMO to urgently review the UK’s current position of second doses after 12 weeks.’
The BMA’s Dr Vautrey also said: ‘It’s important that we have a proper scientific enquiry, we review the evidence and we are open to implementing that evidence as best as we can.’
Dr Chaand Nagpaul, BMA council chairman, said that he understood the ‘rationale’ behind the decision to delay the second dose of the coronavirus vaccine to 12 weeks, but said the UK should follow ‘best practice’.
Speaking on BBC Breakfast, Dr Nagpaul highlighted WHO analysis that recommended second doses of the Pfizer vaccine only be delayed ‘in exceptional circumstances’.
He said: ‘What we’re saying is that the UK should adopt this best practice based on international professional opinion.
‘Most nations in the world are facing challenges similar to the UK in having limited vaccine supply and also wanting to protect their population maximally.
‘No other nation has adopted the UK’s approach. We think the flexibility that the WHO offers of extending to 42 days is being stretched far too much to go from six weeks right through to 12 weeks.’
He continued: ‘Obviously the protection will not vanish after six weeks but what we do not know is what level of protection will be offered… we should not be extrapolating data where we don’t have it.
‘I do understand the trade-off and the rationale but if that was the right thing to do then we would see other nations following suit.’
Dr Nagpaul pointed out that giving people second doses of the Pfizer vaccine sooner would ‘free up’ appointments for more patients in future.
He added: ‘The concern we have… if the vaccine’s efficacy is reduced… then of course the risk is that we will see those who are exposed maximally to the virus may get infected.
‘The other worry is that members of the population, those who are at highest risk, may not be protected.’
People pictured queueing at a vaccination centre in Hemel Hempstead on January 7, after a third coronavirus vaccine from US biotech firm Moderna was approved for use in the UK
Doctors administer the Pfizer-BioNTech vaccine at a vaccination centre in Salisbury Cathedral on January 20. Matt Hancock said over 5million doses have been given out to 4.6million people
Although agreeing that the Covid jab should be ‘rolled as quickly as possible’, the BMA called for an urgent review of the policy that is ‘proving evermore difficult to justify’
However, PHE’s Dr Doyle defended the decision to delay the second dose of the coronavirus vaccine to 12 weeks, saying the move had been taken on ‘public health and scientific advice’.
Dr Doyle told Radio 4’s Today Programme: ‘The more people that are protected against this virus, the less opportunity it has to get the upper hand. Protecting more people is the right thing to do.
‘People will get their second dose. As supplies become available more people will be vaccinated. It is a reasonable scientific balance on the basis of both supply and also protecting the most people.’
A Department of Health and Social Care spokesperson told MailOnline: ‘Our number one priority is to give protection against coronavirus to as many vulnerable people as possible, as quickly as possible.
‘Through the UK vaccines delivery plan we are getting vaccines rapidly rolled out to older and clinically vulnerable people, as well as our frontline health and social care staff, and 5.3 million people have already received their first dose.
‘The decision by the MHRA to change vaccine dosage intervals followed a thorough review of the data and was in line with the recommendations of the UK’s four Chief Medical Officers.
‘Both vaccines provide a high degree of protection after the first dose, and the Government has closely followed the guidance of the Joint Committee on Vaccination and Immunisation (JCVI) which was clear that we should give as many people as possible some level of immunity initially.’
Professor Peter Horby, chairman of Government advice group Nervtag, said it was ‘encouraging’ that the UK coronavirus variant did not appear to be more resistant to current treatments, but people should continue to follow the rules after receiving the jab.
He told BBC Breakfast: ‘A vaccine is not a passport to do what you like, especially after one dose… it takes a while for protection to set in.
‘So don’t think you’ve got a free pass, we’ve still all got to adhere to the restrictions whether we’re vaccinated or not.
‘The encouraging news is that the UK variant is not affecting how the treatments work and it’s not affecting how the vaccines work so we believe the vaccines and the treatment are just as good against this virus as they’ve always been.’
Earlier this week, a leaked internal memo sent to staff at an NHS trust in Southampton warned second doses must not be given out too soon.
The decision to extend the delay was made to try and stretch the limited supply of jabs to cover more vulnerable Britons and get the UK out of lockdown as soon as possible, rather than offering stronger protection for fewer people.
But it has drawn sharp criticism from both scientists and doctors, with medics writing to Health Secretary Matt Hancock and vaccines minister Nadhim Zahawi to urge them to rethink the policy.
The Doctors’ Association UK said no studies had been done to prove a single dose of a vaccine, or two spaced very far apart, would reliably prevent cases of Covid.
Pfizer and BioNTech earlier said in a joint statement: ‘The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design.
‘There is no data to demonstrate that protection after the first dose is sustained after 21 days.’
It follows Mr Hancock boasting on Thursday that more than 5million doses have been given out to 4.6million people across the UK – around one in every 14 people.
Around 2million vaccines were dished out last week — and one in ten inoculated Brits have received their second dose.
Staff at the University Hospital Southampton NHS Trust, The Independent reports, received an email that said: ‘This has become of the highest political import.
‘David French, our CEO, has been sent a letter which is absolutely crystal clear and leaves nothing to the imagination – we are not to offer any second vaccines before 12 weeks under any circumstances, at risk of losing our licence.
‘This is not at the present time negotiable in any way. A region near us has given 34 second doses and are being investigated centrally.’
A spokesperson for University Hospital Southampton Foundation Trust said at the time: ‘No vaccine has been wasted as we have progressed through our first dose programme, offering a second dose 12 weeks after the first, which is in line with national guidance.’
Elizabeth Van-Tam, the mother of deputy chief medical officer for England Jonathan Van-Tam, prepares to receive her vaccine for Covid-19 in Whittlesey, Cambridgeshire, on January 21
NHS England denied the claim hospitals would lose their vaccination licences for not following the rules, but declined to comment.
The European Medicines Agency has said that the maximum interval of 42 days between the first and the second dose of the Pfizer-BioNtech vaccine should be respected to obtain full protection.
Evidence of the vaccine efficacy is based on a study where administration of doses was done 19 to 42 days apart, the agency said, noting that full protection comes only seven days after the booster.
It added: ‘Any change to this would require a variation to the marketing authorisation as well as more clinical data to support such a change, otherwise it would be considered as ‘off label use’.’
However the Joint Committee on Vaccination and Immunisation (JCVI), which sets the ground-rules for the vaccine programme, has said the country should get first doses of the jabs to as many people as possible.
Although a single dose of the two-dose vaccine regimes will not offer as much protection, it may still prevent many people from getting Covid-19.
The JCVI claims that one dose of Pfizer’s vaccine could prevent as many as 89 per cent of illnesses.
But new data emerging in Israel suggest this initial dose’s protection could be as low as 33 per cent, meaning two thirds of people given the single vaccine dose could still catch Covid if they were exposed to the virus.
This has not yet been verified in a publicly available scientific study, but raises concerns about Britain’s strategy.
When the UK made the decision to split the doses with a wider gap than Pfizer had intended, both the company and the World Health Organization refused to endorse the policy because they said there was no proof the jab would still work.
Nurses claim they are being treated like ‘lambs to the slaughter’ as they call for higher-grade face masks to protect against new coronavirus strains
Nursing leaders have called for higher-grade face masks to be given to staff to protect them against highly transmissible strains of Covid-19.
The Royal College of Nursing (RCN) and the British Medical Association (BMA) warned that members had raised fears they were being given inadequate personal protective equipment (PPE) in a letter to the Health and Safety Executive (HSE).
One nurse described feeling as though staff were being treated like ‘lambs to the slaughter’ due to the inadequacy of surgical masks.
The College is now calling for a review of infection control guidance and calling for all NHS staff to be given the higher grade of PPE as a precaution pending the outcome.
Nurse leaders are calling for an urgent review into the face masks that are given to staff. Pictured: Staff nurses working at St George’s Hospital in Tooting, south-west London
The RCN said it was aware that some NHS trusts are using higher grade face masks in all parts of their hospitals, while others use standard face masks, thereby creating a ‘postcode lottery’ for nursing staff.
RCN chief executive and general secretary Dame Donna Kinnair said nurses were concerned that the standard face mask may not be effective in protecting against new strains of the virus and possible airborne spread in healthcare settings.
Dame Donna said: ‘The Government’s silence on this issue is creating a postcode lottery for nursing staff whereby some working on wards have access to the higher-grade face masks and others do not.
‘It must stop dragging its feet on this issue. Nursing staff need to have full confidence that they are protected.
‘Staff picking up this virus at work are angered at any suggestion they have stopped following the rules – this is down to the new variant and the dangerous shortage of adequate protection.’
Jane, which is not her real name, is a nurse from Yorkshire and member of grassroots campaign group Nurses United.
She said she contracted Covid in April 2020 after helping a coronavirus patient inside an ambulance, while both she and the patient were wearing a surgical mask.
She has suffered from debilitating Long Covid symptoms since, even taking the last four weeks off work due to chronic fatigue – nine months after her initial infection.
‘I feel kind of like half the human that I was,’ Jane added.
Jane said failing to protect all staff with suitable PPE made staff feel like ‘commodities’.
‘In critical care areas they’re in full PPE but in the actual wards we’re still in surgical masks… the issue is that the surgical face masks aren’t effective enough,’ she said.
RCN chief executive and general secretary Dame Donna Kinnair said nurses were concerned about the standard face mask
On top of the trauma, the PTSD and everything else that staff are feeling… people feel let down, scared and vulnerable – like we’re just commodities or lambs to the slaughter.
‘People start doubting who they’re working for and what they’re doing.’
In a letter to Jo Churchill, minister for prevention, public health and primary care, Dame Donna said staff were ‘aware that fluid repellent surgical face masks and face coverings, as currently advised in most general healthcare settings and patients’ homes, are not protective against smaller infective aerosols’.
In a further letter to Sarah Albon, chief executive of the HSE, and signed by Chaand Nagpaul, chair of the BMA council, Dame Donna called on the HSE to take a ‘precautionary approach’.
She said: ‘In the absence of clarity on the reasons behind the new variants’ increased infectivity, we are calling for the HSE to take a precautionary approach and to use your role as a regulator to ensure employers and those developing national guidance meet and understand their responsibilities.’
She added: ‘Adequate supplies of PPE that meet the required specifications are vital to support nursing staff to do their jobs safely.
‘Without support to use suitable PPE, nursing staff are putting their own lives, and the lives of their colleagues, families and patients, at risk.’
In the letter, the RCN cites NHS data showing a 22 per cent rise in the average number of health care staff off due to Covid-19 in the first week of this month compared with the last week in December.
From December 31 to January 6 an average of 41,641 employees were off each day, up from 34,210 for the period December 24 to 30.
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