Are 2nd doses of Pfizer vaccine being cancelled?

[UntamedWisteria]

Has anyone got any authoritative information on this? A link to a reliable source?

I think Matt Hancock mentioned this, and have seen stuff on Twitter about it. But nothing rock solid.

My parents (in their 80s) were due to get their 2nd dose next week. They will be devastated if it's cancelled. I know they have said they will start by only giving the Oxford vaccines as a single dose, but it's not clear what happens to those who've already had their first Pfizer dose.

Thanks.

In the case of the Pfizer vaccine, the MHRA, CHM and JCVI jointly assessed that the new dosing regime is safe and sufficiently effective.

Based on what trials? What evidence? What data?

Do you have a source for the information stating that it has been jointly assessed?

@herecomesthsun

can you not use the word scaremonger when someone is making reasonable points?

this is a discussion board

Apologies, you're right. I did think twice before posting that- will try a third next time

So will you refuse a single dose vaccine unless you can have the other at 21 days?

Yes, I will refuse a single dose vaccine. What's the point? If I just reduce my interactions by 50% I'm as well protected surely?

My 81 year old dad hasn't even had the first dose yet so I think your parents are lucky to have had the first one. They will have some protection. I'd rather people didn't get the second dose for a bit if it means my parents (mum of 75 with underlying health issue) get their first dose faster!

But it's not a single dose, it's a dose followed by another dose with a 4-12 week interval between doses.

The 52% figure is an average of 0-21 days. Actually the protection kicks in around day 11, so it goes from 0 to around 90% at that time. Meaning that 12 days after vaccination you have excellent protection. The booster increases the protection ( up to 95%) and is likely to make it longer lasting.

Not if a single contact of yours has COVID. Then you're not protected at all. The virus doesn't count how many people you've seen that day and what the rate is in your area. If you insist on 21 days, you'll likely be waiting a long time to see your relatives.

@ObliviouslyIgnorant

In the case of the Pfizer vaccine, the MHRA, CHM and JCVI jointly assessed that the new dosing regime is safe and sufficiently effective.

Based on what trials? What evidence? What data?

Do you have a source for the information stating that it has been jointly assessed?

This is how medicines licensing works.

For evidence, there was a press conference led by June Raine, head of the MHRA, on Wednesday morning. You’ll find it on BBC news on IPlayer.

Anyway, I'm out. I should read usernames more closely next time. Hopefully some of the links and information on this thread will help inform others. Stay safe and well all.

My Gran still has her appointment in 3 weeks scheduled for her 2nd dose after having the first one on 29th...that said, it could just be that they haven’t had chance to ring her and postpone it yet.

@Schoolchoicesucks

It appears that some health authorities are continuing with previously booked 2nd doses, whilst others are rescheduling.

The evidence suggests there is some level of protection from 1st dose and the authorities have decided better to get this level of protection to more people, than a higher level of protection to fewer.

On a population level, this is sensible and will reduce pressure on the health service to enable them to treat the sickest and maintain some level of other operation.

On an individual level, those who have had 1st dose and will now be delayed in receiving 2nd, they will be in a riskier position. However, only for another couple of months and during this time, restrictions will still apply. Plus if they have already received 1 dose, they are more likely than most to have other health needs and so more likely than most to need the NHS not to be overwhelmed in order to offer them some level of treatment. So they will also benefit from others receiving some level of protection too.

The vaccine approval for Pfizer was amended to allow the delayed 2nd dose so there is no need to wail about FDA approval.

Pfizer have stated that the vaccine hasn't been tested in this way, they are correct, it hasn't. The BMJ concerns were around logistical rescheduling rather than disagreeing with the science.

Perhaps it is a bit of a gamble, but it's not an illogical one and isn't based on unsound science.

There is an issue in that people who are vulnerable may be much more liable to get very ill or die.

So if a person A with 10% risk dying (we can't know risk exactly but that ballpark) has both doses their risk might reduce to .1% .

If someone B with 0.1% risk dying has both doses of the vaccine their risk might then effectively be zero.

Suppose person A has only one dose - there are figures suggesting the Pfizer vaccine would then be 52% effective. So is their risk then 5% of dying? and can we even be sure of the 5% reduction without more studies?

If this is so that person B can be vaccinated, person B's reduction in risk is relatively small.

So giving separate doses might diminish efficacy with little gain. Hypothetically.

It is really complicated as in addition

• some very vulnerable people may refuse or be unable to take the vaccine (so the one dose policy might benefit them)
• we don't have research on the one dose schedules(we will be the research, which might not be a bad thing if the evidence we have is in the right direction)
• the different levels of risk between different groups might fall steeply from 1 to 4 and then plateau more, for example, so there needs to be a calculation of when there is more gain giving second doses than spreading the first dose further

There is also an issue re exposure to risk. So CEV healthcare staff/teachers probably should have 2 doses fairly close together if they want to work/ teach face to face, I think (#I have an interest in this I admit)

It’s actually down to clinical judgement. If the GP lead in a vacc centre decides to go ahead with those already booked they will go ahead as long as they get a delivery.

It will be mixed.

If you have had your first dose already don't you think it's fair for someone else to have their first dose instead of you having your second?

Why should some people be fully immunised at the expense of others who will be left completely at risk?

With the speed that Covid is now spreading getting as many people as possible partially immunised is more important than getting a few people fully immunised. It's not a perfect situation obviously.

Second doses are going ahead as planned in my part of the West Country next week. Both Dorset and Yeovil appear to have decided the govt advice is too late to change all the prebooked appts and rebook with new pts, so are going ahead. And I have to say, as a HCP, I agree with their decision. The license was granted on the basis of 2 doses and the evidence for the success of this meant MHRA granted the license. Liability for this vaccine is already a thorny issue, requiring me to take out an extra personal liability insurance if I volunteer to administer doses, and I dread to think what the premium would be if I was volunteering to administer an off label novel vaccine. The govt is on their own with this one, the evidence is too limited for me to judge whether this approach is the right one, as the trial never looked at the extended gap and all the trial data is being extrapolated without any evidence.

@DryHeave

Let’s not forget a key aspect of the vaccine isn’t to prevent the disease, it’s to prevent the disease resulting in serious illness/hospitalisation.

Even with 1 dose of the Oxford vaccine no one had to be hospitalised with Covid. That is the goal at the moment. Not disease eradication.

So I haven't read the scientific literature yet.

However, did these studies include CEV people and people over 80/ 70/ 65/ 60?

Because these are the people more at risk of hospitalisation.

So if we want to minimise hospitalisation by using the vaccine these are the groups on which to focus attention.

@muddledmidget

Second doses are going ahead as planned in my part of the West Country next week. Both Dorset and Yeovil appear to have decided the govt advice is too late to change all the prebooked appts and rebook with new pts, so are going ahead. And I have to say, as a HCP, I agree with their decision. The license was granted on the basis of 2 doses and the evidence for the success of this meant MHRA granted the license. Liability for this vaccine is already a thorny issue, requiring me to take out an extra personal liability insurance if I volunteer to administer doses, and I dread to think what the premium would be if I was volunteering to administer an off label novel vaccine. The govt is on their own with this one, the evidence is too limited for me to judge whether this approach is the right one, as the trial never looked at the extended gap and all the trial data is being extrapolated without any evidence.

Good points.

@Izzy30

If you have had your first dose already don't you think it's fair for someone else to have their first dose instead of you having your second?

Why should some people be fully immunised at the expense of others who will be left completely at risk?

With the speed that Covid is now spreading getting as many people as possible partially immunised is more important than getting a few people fully immunised. It's not a perfect situation obviously.

The people already immunised will be the ones most at risk, like my MIL who is 90 and CEV in addition.

There is an argument for her to have full immunisation if her risk of death on catching covid is very high and the other person who would get the freed up dose would have a significantly lower risk.

This would very much be about comparing risks on the evidence we have.

So it could go either way.

It's quite important whether we are looking at 52% or 90% coverage with 1 Pfizer dose and it is key whether this would apply to outcomes of hospitalisation or death.

My trust sent an email yesterday afternoon to say that second doses would be postponed for 3 months. I got my first dose at 6pm yesterday and was still given an appointment for the end of January, but told it would be cancelled. 🤔🙄

herecomesthsun I agree with every single one of your posts. I wish someone would listen and answer our questions. Instead I'm told that I know fuck all. Well nobody seems to know fuck all.

Lots of people have answered questions, explained with links why it's not 52% protection and that it's not healthy people that will be getting the first doses more quickly, it's other 80+ people, health and social care workers and the ECV.

@ObliviouslyIgnorant

So will you refuse a single dose vaccine unless you can have the other at 21 days?

Yes, I will refuse a single dose vaccine. What's the point? If I just reduce my interactions by 50% I'm as well protected surely?

No. You’re conflating reducing your likelihood of exposure to an infectious person with reducing the likelihood of you becoming ill with Covid if you are exposed. They aren’t the same thing at all.

Well they've the same efficacy?

@herecomes I don't think that the 2nd doses are being delayed until after the wider population have 1st doses though, are they? Just for 12 weeks (so 9 weeks from original dosing schedule) to allow more of the higher risk groups (which may now include face to face teaching staff) to have some protection from 1st dose.

I don't think there would be much support for rolling out 1st vaccines to low risk groups before 2nd doses have been given to the ecv and cv groups. And neither should there be.

@Obliviously Why wouldn't you do both? (Reducing your contacts AND having the vaccine 1st dose) To reduce your chances to (say) 25%?

If you are not concerned about the side effects of the vaccine and you accept that it confers some protection upon you, why on earth would you refuse it?

DH (care home worker) had his first jab on Tuesday at a hospital hub, with 2nd appointment 4 weeks later (not 3, note). He’s had a text today to say that appointment is cancelled, and he will be sent another for 11-12 weeks after the first.