GPs can shorten the 12-week interval between doses of the Covid vaccine in ‘exceptional circumstances’, NHS England has said.
They can also take a ‘pragmatic approach’ to giving second doses sooner following a clinical assessment if ‘operationally convenient’, according to new guidance.
Under current guidance, second vaccine doses should be offered within 12 weeks of the first, with a 77-84 day interval.
But new FAQ guidance published on Friday has said that GPs can schedule second-dose appointments earlier than 77 days after the first jab ‘in exceptional circumstances’.
These include for patients with ‘planned immunosuppressive therapy’ who should be considered for vaccination ‘ideally at least two weeks before’ starting the therapy ‘when their immune system is better able to make a response’, it said.
It added: ‘Where possible, it would also be preferable for the two-dose-schedule to be completed prior to commencing immunosuppression.
‘This would entail offering the second dose at the recommended minimum for that vaccine (three or four weeks from the first dose) to provide maximum benefit that may not be received if the second dose was given during the period of immunosuppression.’
GPs should use any surplus vaccine from second-dose clinics to offer first doses to those who ‘have been vaccinated prior to starting immunosuppression and who need a shorter interval between doses’, the guidance said.
The dosing schedule can also be ‘compressed if that makes delivery of a second dose more certain’ for homeless people and rough sleepers, it added.
The FAQ document also addressed a question around whether second doses can be given sooner if ‘operationally convenient’.
NHS England said: ‘The clinical evidence for the Covid-19 AstraZeneca vaccine shows better efficacy following a 12-week gap, which is the basis of the JCVI recommendation.
‘However, local areas should agree a pragmatic approach to giving doses earlier than this following a clinical assessment and weighing up risks and benefits.’
The document also outlined that:
- PCNs will receive supply for second clinics to take place 11 weeks after first doses
- Vaccinations must be recorded in a ‘timely manner’ to inform supply allocations. This is especially important for the Pfizer vaccine ‘as its supply is finite’
- Vaccine deliveries will not be separated into first and second doses – this must be done on-site using the weekly allocation summaries provided
- There should be a ‘common-sense’ approach to second-dose location, for example, if patients have moved away from where they received their first jab
- People using the National Booking Service for vaccination at mass centres or community pharmacies are given the ‘closest available appointment locations’ for their second dose
- Consent must be sought before each vaccination, including in care homes, but a second consent form is not necessary
It comes as the health secretary last week confirmed that second-dose clinics will not be affected by a reduction in Covid vaccine supply next month.
Official guidance changed on 31 December to say all second vaccine doses should be given after 12 weeks instead of three weeks to maximise the number of people protected against Covid-19 in the shortest possible timeframe.