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Second vaccine appointment cancelled

156 replies

vanished · 31/12/2020 12:08

I work in healthcare. I was due to have my second Pfizer vaccine next week, but I've just been informed that it's been cancelled.
Now, I understand the bigger picture, it means more supplies. Therefore more people can get their first dose, but...
does this compromise the "winning formula" of the Pfizer? Ie two doses 21-28 days apart? Potentially rendering all the first dose Pfizer recipients useless if they don't receive it for a longer period...
plus, I have volunteered to be a vaccinator. One of the provisos of the role is that you need to have received both doses. This will either mean I cannot help out now until March, or they change the rules. Personally as high risk, I would be a little more hesitant volunteering...
Of course the great public health demand is more important, I'm just a bit concerned that this new approach to Pfizer is concerning...

OP posts:
Frazzled2207 · 31/12/2020 19:15

I honestly think this could be a disaster in the making. Government are saying that first jab of Pfizer gives 90% protection and the second jab 95%. Pfizer say they never said such thing and they genuinely don’t know what efficacy a 12 week gap makes.

oneglassandpuzzled · 31/12/2020 19:16

[quote viques]@oneglassandpuzzled

I congratulate you on volunteering as a marshal, I am sure you will do an efficient and effective job (unlike the inefficient people who left vulnerable pensioners waiting outside in the cold for several hours in Harlow the other day) . I appreciate that your role is essential and will free up HCP for clinical duties.

My , only half lighthearted, worry is that the govt/Hancock will be so desperate that he will let almost anyone wield a syringe to cope with the backlog. This is after all the man who encouraged his next door neighbour -with no previous manufacturing experience - to produce phials for vaccine distribution , and moreover approved and paid for them for NHS use before they had been licensed as safe.[/quote]
I realised you probably weren’t thinking of non-syringe wielders and I’m sorry for being tetchy after an afternoon on the application form 😫

JacobReesMogadishu · 31/12/2020 19:17

I think people who have had the first vaccine already have got a valid argument that they only consented on the understanding they’d get the second one. Certainly not ethical to change it for those. But I see why moving forward they need to change the schedule.

JacobReesMogadishu · 31/12/2020 19:18

@Frazzled2207

I honestly think this could be a disaster in the making. Government are saying that first jab of Pfizer gives 90% protection and the second jab 95%. Pfizer say they never said such thing and they genuinely don’t know what efficacy a 12 week gap makes.
Oh that’s bad....I believed them that it was only a small difference. So possibly for all we know there is no protection at all from only one dose?
Motorina · 31/12/2020 19:19

[quote AldiAisleofCrap]**@Motorina* Which is better on a population level? Your father and another vulnerable patient having good protection, or your father having excellent protection whilst that other person has none?* the other person won’t be CEV though.[/quote]
Eh? Yes, they will. Lots of CEV people still to have their first vaccine.

I don't think there are any easy or good answers on this one. I'm mostly glad I'm not the one having to make the decision.

Em777 · 31/12/2020 19:27

Snippet from an article on this in the Telegraph:

Lizzie Toberty, a GP spokeswoman for DAUK, warned the intervention “undermined the vaccine programme as a whole.”

She told the Telegraph: “The idea that the Government can come in and change the schedule without an evidence base is extremely concerning.

“It is population protection versus individual protection. Their logic seems to be that if we confer some protection on as many people as possible, perhaps that is better than fully protecting certain cohorts. But the over 80s need the fullest protection. This is an untested strategy. It’s a huge gamble.”

Dr Toberty warned that patients who had not consented to receiving the Pfizer vaccine 12 weeks apart might now legitimately request the Oxford vaccine, rendering the last eight weeks “wasted.”

Dr Katrina Farrell, a haematologist, revealed on Twitter that she had received a letter cancelling her appointment for her second jab.

“This means that the vaccine is not being delivered as licensed,” she said. “I did not consent to receive an off-label drug with no evidence of benefit with a single dose.

“This means that tens of thousands of Scottish & UK health & social care workers have rolled their sleeve up for a vaccine unlicensed at this dose schedule. For which they did not consent. This is a scandal.”

Aside from a lack of evidence about immunity, Dr Toberty said the logistical challenge of contacting thousands of elderly patients to change their appointments would be time consuming, impractical and cause anxiety for many.

Dr Richard Vautrey, chair of the British Medical Association’s (BMA) GP committee, said it was “grossly and patently unfair to tens of thousands of our most at-risk patients” to try and reschedule their appointments.

www.telegraph.co.uk/news/2020/12/31/gps-rebel-govt-change-pfizer-vaccine-strategy-12-weeks-calling/

HibernatingTill2030 · 31/12/2020 19:33

Honestly I think the only decent thing to do is honour all 2nd doses for anybody who has had the vaccine up to this point.
As pointed out, people agreed to have the 2 doses 21 days apart. Anything else is untested and completely unfair.

Eyewhisker · 31/12/2020 19:33

I think this is totally sensible. It is said all the time that the second jab delivers long-lasting protection. As they only have data for a few months, they have no knowledge of this.

The Pfizer vaccine is more effective after one dose than Oxford after two. We know that natural immunity lasts at least 3 months. We know that it really didn’t matter much when the booster jab was given for Oxford. It would be strange that suddenly the Pfizer jab stopped working after 10 weeks when it gives higher levels of antibodies than Oxford, and where Oxford is fine for a 12 week interval.

I presume the outraged on this thread would rather their elderly parents went unprotected for 6 months as all the capacity is used to give second doses to the first cohorts.

lockdownromance · 31/12/2020 19:54

It sounds like the people who are against this are either ones who got the first jab or their relatives in same position. For a person who won't get the jab anytime soon it sounds better to give some protection to a larger cohort.

Mistigri · 31/12/2020 19:58

I completely understand that it may be better from a public health point of view to give one dose (but only "may ", because we have zero clinical data to support this).

But we need to be clear that this is an experimental treatment and from an ethical point of view, you need informed consent from patients. The early vaccination patients couldn't consent to being experimental subjects because they weren't asked.

Mistigri · 31/12/2020 20:11

Oh that’s bad....I believed them that it was only a small difference. So possibly for all we know there is no protection at all from only one dose?

All we know is that for the approximately one week between immunity kicking in from the first dose, and the second dose being delivered, patients are well protected.

We can't say anything more than this with any confidence because no other dose schedule has been tested.

It's possible to hypothesise about immunity from a single dose, based on what we know about natural immunity (from covid infection) and data from other vaccines which were tested using different schedules. But there is no clinical evidence that a single dose is effective because this has not specifically been tested.

Personally speaking I am very receptive to the idea that there may be public health benefits at the population level to giving one dose - clearly when dealing with pandemics governments need to be flexible and open to trade offs. However, we need to be absolutely clear that this is off label (ie it is an unauthorised treatment) and that patient consent needs to be carefully sought because it is experimental. And there is no way that patients who have already been vaccinated can retrospectively consent to a public health experiment they were not told about.

HibernatingTill2030 · 31/12/2020 20:25

@Mistigri

I completely understand that it may be better from a public health point of view to give one dose (but only "may ", because we have zero clinical data to support this).

But we need to be clear that this is an experimental treatment and from an ethical point of view, you need informed consent from patients. The early vaccination patients couldn't consent to being experimental subjects because they weren't asked.

Yes, this. I would be pissed off I had taken this vaccination on the basis of clinical trials- and now the recommended regime based from those trials has been changed halfway through to a regime with zero trials to back it up.
Toddlerteaplease · 31/12/2020 20:30

It's been changed to having them 3 months apart. I had my first dose this evening. But despite the email being sent out 2 hours previously, they are still
Making appointments for 3 weeks that they know will be cancelled. Bonkers!

YouCanWorkItOut · 31/12/2020 20:36

Heard on Radio 4 this morning there was a Q and A about the vaccines and Prof Openshaw said Pfizer conferred full immunity 2 weeks after first dose. Second dose was for top up/long term?

BBCONEANDTWO · 31/12/2020 20:40

[quote Clavinova]Pfizer themselves are against this increase in time between vaccinations as it isn’t as well tested.

Not everyone at Pfizer;

USA TODAY spoke with Dr. Scott Gottlieb, former commissioner of the Food and Drug Administration. Gottlieb, 48, serves on the board of Pfizer ...

Q: For the Pfizer and Moderna vaccines, each person is supposed to get two doses, three or four weeks apart. Between the two companies, 40 million doses are expected to be available in the U.S. this month. Is it better to give 20 million people two doses, one in December and one in January, or get all 40 million out there and then catch up to the second dose as supply increases?

A: I feel very strongly that we should get as many shots in arms as possible, right away. The reality is that one dose is partially protective. I just fundamentally disagree with (saving half the supply for January) ...

eu.usatoday.com/story/opinion/2020/12/07/covid-vaccine-get-many-shots-arms-possible-right-away-opinion/6483439002/[/quote]
This sums it up for me yes let's try and get as many protected as much as possible.

Mistigri · 31/12/2020 20:43

Prof Openshaw said Pfizer conferred full immunity 2 weeks after first dose. Second dose was for top up/long term?

No one knows the implications of a single dose because this wasn't tested.

If this were a clinical trial, and the researchers changed the dosing schedule halfway through without obtaining patient consent, they would get an rocket up their arses from the ethics board, and rightly so.

Mistigri · 31/12/2020 20:46

This whole thing is terrible for public confidence. Honestly this sort of cowboy approach by government makes me wonder about political pressure on the MHRA re the Oxford vaccine (which other regulators aren't close to approving).

Like I said, I get the potential health benefits of a single dose. But it has to be done ethically. You don't just randomly perform huge public health experiments on vulnerable people without even telling them what you are doing and seeking their consent.

ancientgran · 31/12/2020 20:51

People saying they will refuse the Pfizer vaccine - you won't get a choice which one you get. No it's going to be like going to Subway for a sandwich, they will unveil all the options and you will pick the one you like the look of. Well that is the fantasy.

Vinorosso74 · 31/12/2020 20:56

I think it's wrong cancelling the already booked appointments for so many reasons let alone the fact that a reasonable number may have dementia and generally get confirmed.

ancientgran · 31/12/2020 20:59

My next dose is booked in for the 11th. So far, it's still going ahead. If I get an email cancelling it, I shall be emailing the people providing it, asking what scientific evidence they have seen to suggest a delayed 2nd dose is effective, and other points raised here re consent etc. Why? Your local GP or vaccine hub aren't making the decision, all you will be doing is wasting their time.

Haffiana · 31/12/2020 21:03

@ancientgran

My next dose is booked in for the 11th. So far, it's still going ahead. If I get an email cancelling it, I shall be emailing the people providing it, asking what scientific evidence they have seen to suggest a delayed 2nd dose is effective, and other points raised here re consent etc. Why? Your local GP or vaccine hub aren't making the decision, all you will be doing is wasting their time.
Yes, it is them making the decision. They have the right to carry on with the original 2 shot programme if they choose.
AldiAisleofCrap · 31/12/2020 21:08

@Eyewhisker The Pfizer vaccine is more effective after one dose than Oxford after two last time I checked 52% was less than 70%!

Dogatetheleftovers · 31/12/2020 21:42

Pfizer Biontec have issued a statement in which they categorically state

<a class="break-all" href="https://www.ft.com/content/d97c72c5-ed23-4c2b-bf1c-9cc10b21f007" rel="nofollow" target="_blank">www.ft.com/content/d97c72c5-ed23-4c2b-bf1c-9cc10b21f007</a>

Although partial protection through the vaccine appears to begin as early as 12 days after the first jab, Pfizer stressed that two doses were required to provide the maximum protection against the disease, with an efficacy figure of 95 per cent. Crucially, it said: “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

I understand the idea to spread the vaccine programme as far as possible but only if protection is achievable otherwise it’s just a waste of precious resources surely.

HibernatingTill2030 · 31/12/2020 22:04

The government are playing a very dangerous gamble if there is no testing data to show that protection lasts after 21 days.

Molly333 · 31/12/2020 23:19

Can i ask you about applying to be a vacvinator. Can you confirm that you have been told you need to have had noth doses before you can do it? The reason is that I would like to do this but would prefer the vacine first as my family are extremely anxious about covid

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