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Science is not on the side of the delayed second doses

Science is not on the side of the delayed second doses

Many a colleague and healthcare worker who have contacted me regarding the delay of second dose of the Pfizer/BioNTech Covid vaccine feel totally let down by an unscientific and immoral decision. There is also a concern that many frontline vaccinators, who came forward on the basis that they would be protected by a second dose, now feel that they can’t continue in this role.

The mixed messaging and short notice from the Government has led to considerable concern, confusion and upset for healthcare workers and elderly, vulnerable patients. A doctor is rightly campaigning to challenge the decision of in court.

Israel’s Covid tsar, who, having studied preliminary data from 200,000 vaccinated people, has warned that a single dose of the Pfizer vaccine may be providing less protection than originally hoped. The study suggests the effectiveness of vaccine after a single dose is as low as 33%, rather than the 89% that had initially been suggested.

By contrast, those who had received their second dose of the Pfizer vaccine had a six to 12-fold increase in antibodies.

Thanks to the commitment of healthcare workers, more than 4.2m people have received their first dose of the vaccine in effort to meet the Government’s target to vaccinate the first four priority groups by mid-February – equating to 13.9m people. It would need a rate of over 400,000 a day to reach that target. You need a confident, healthy workforce to achieve such a target.

Staff illness rates are significantly higher than usual, and confidence within the profession is certainly now very badly shaken by disregard to manufacturer’s and World Health Organisation’s recommendations to give the second dose within 21 to 28 days.

The ambitious vaccine rollout could suffer a severe knockdown if the chief medical officer refuses to see the reason and scientific evidence to reverse his decision of delaying the vaccine to 12 weeks.

The Government must learn lessons from its past failures on many counts, like the fiasco of ‘test, trace and isolate’ initiatives. Please stop gambling with the health of at-risk individuals including healthcare workers, and allow the second doses of the Pfizer vaccine to be given between 21 and 28 days after the first.

After many Government misjudgements in the pandemic, primary care staff have come to the rescue, putting their heart and soul into vaccinating. Please protect them to protect the nation and allow their second doses immediately.

Science is not on the side of the delayed second dose of the Pfizer/BioNTech vaccine. The Joint Committee on Vaccination and Immunisation and Public Health England should revisit and reverse their decisions based on emerging scientific evidence.

Dr Kailash Chand OBE is a retired GP in Tameside



Please note, only GPs are permitted to add comments to articles

Sam Tapsell 23 January, 2021 12:29 pm

Pfizer might be very concerned that a single dose is good enough and countries like Australia or NZ will simply not bother with a 2 dose plan.
We cannot get a huge amount of information from Israel since they have proceeded with 21 days second dose: Antibody levels are not the same as immunity.
If we monitor our vaccinated staff and patient’s closely for cases, especially those who become seriously unwell, then we could stop protecting new people and switch to 2nd doses if data supports it.
There is such a massive benefit to protection for twice as many people I’m glad we’re taking a bold decision which could save many lives.

Vijay Rajput 23 January, 2021 1:25 pm

There is a compelling argument to vaccinate the high risk frontline healthcare personnel, police and any other essential workers who have frequent interaction with the public ( risk of transmission including asymptomatic pts) to be vaccinated in line with Pfizer trial recommendation s ( ie 3- 4 weeks after 1st dose). However, I do feel the other lower risk group cohorts could have the second dose delayed ( ie after 12 weeks). This would then allow vaccination of more people and help with the potential manufacturing delay and delivery chain of vaccination too ie suggest “sub stratify the 2nd dose strategy based on risk assessment”

Dr Vijay Rajput . GP

David jenkins 23 January, 2021 1:59 pm

i am 70, have copd and bronchiectasis. i am a locum gp with 40 years experience. i have a job in the local field hospital and i am waiting to start. at the moment, the hospital is full, and it is short of staff. i had the first pfizer jab on 21/12/20, and the second was scheduled on 18/1/21, but was cancelled. this means i am not as well protected as i need to be to start work in a patient facing role. i have had to tell the field hospital “sorry, but the government has prevented me from coming to help you out”. i am now sitting at home, while the other staff are running round like fools – all for the sake of one injection. the welsh assembly government has threatened our local health authority with legal action (though i’m not sure exactly what) if they give any second jabs before they have told them to !

in london, they are discarding some left over jabs instead of giving second doses. how on earth can this be sensible ?

my 1939 wolseley is coming along nicely thankyou – when i have had my second jab, i shall put the patients first and the car second, but until then, sorry, no can do !

please let me know when you would like me to go back to work – i’ll be isolating in the workshop till then !

Patrufini Duffy 25 January, 2021 3:14 pm

The next time your colleague doctor or best friend needs hep B immunisation, just make-up an extended, non-regulated, non-evidenced regime. And send them out there. To Africa, or into surgery. Then laud yourself for fronting the Hep B immunisation programme and making a difference. You wouldn’t do it, never in your right mind.

Mark Fentanyl 26 January, 2021 10:52 am

sometimes we get busy in the winter months, good to know that we can now delay all flu clinics to the summer, and all baby immunisations to age 3, 4 ,5 whatever whenever

Kevlar Cardie 26 January, 2021 12:27 pm

Body armour comes with a front and back plate, otherwise it’s not fully fit for purpose.

“Just sayin’ “, as the lower orders would phrase it.

Albert Pereira 27 January, 2021 12:06 pm

I don’t think it’s yet accurate to say that science is not on the side of the lake second doses, as there is insufficient data comparing the effects of The second vaccination given at different time periods.

The current issues faced by the government and NHS are practical ones. Rolling out supplies a vaccine to all areas of the country has been patchy, limited by supplies and supply lines.

There have also been significant manpower issues in delivering the first batches of vaccine over the past month. Locally my GP colleagues and I have also been needed to supply enough vaccinators to jab the Pfizer vaccine in the limited time window once it’s received in our hub. Four weeks into the program and working flat out, we are now vaccinating our level four patients with their first vaccination.

We would not have reached this position if we were working to give the over 80s the second vaccinations at this point.

I support the decisions made by the government and the NHS at this point in time, given the limited supplies of vaccine and impact on practical workload and deployment of existing staff who will need to keep helping with this programme at this rate of work for many months.

Dave Haddock 27 January, 2021 5:48 pm

Chand has a consistent record, reliably wrong on everything.

John Glasspool 1 February, 2021 2:58 pm

I’m with Dave Haddock. What would a “mere GP” know about it anyway?