I fucking knew it. Second vaccine dose.

[NiceGerbil]

News is that people who have had first dose are only getting second 3 months later. Against the guidelines of the org who made the vaccine.

I said this rush to push it out would result in, how are they going to follow up and make sure they get the second?

And here we go. Second dose not organised. UK govt say this is AOK.

FFS. I'd rather they took the time to do it properly. But hey. Pissup in a brewery situation again.

I said a few days ago to DH. Are they properly tracking this to make sure the follow up jab isn't missed?

I was too optimistic. Govt have decided second jab isn't that important.

FFS.

These people are very stupid. If they arrive at the decision you outline at least they have 70-90% chsnce of being protected.

I think it's more like 52% after the initial dose.

I'm not raging or trying to whip up a storm.

I'm surprised my posts are coming across that way.

Vaccine take up for other things in the the UK has been falling away.
Yes of course lots of people aren't medically literatate. Which is why we have always had a simple message. Follow the instructions. There have been TV ads a couple years ago to say finish courses.
For the government to just cast the approved regimen aside- and then to follow up with second dose can be a different vaccine? It's highly irresponsible. News today says public health England strongly disagree.

None of this is helpful to a decent, orderly roll out. It makes people wonder what's what. Feel unsure. It's a matter of opinion, the scientists disagree.

It would have been best to roll it out in an organised way and as per the protocols. I mean FFS.

The effect on public confidence in the vaccine, understanding of what's required (1 is good enough!), and unintended consequences in the messaging are irresponsible.

@NiceGerbil

I'm not raging or trying to whip up a storm.

I'm surprised my posts are coming across that way.

Vaccine take up for other things in the the UK has been falling away.
Yes of course lots of people aren't medically literatate. Which is why we have always had a simple message. Follow the instructions. There have been TV ads a couple years ago to say finish courses.
For the government to just cast the approved regimen aside- and then to follow up with second dose can be a different vaccine? It's highly irresponsible. News today says public health England strongly disagree.

None of this is helpful to a decent, orderly roll out. It makes people wonder what's what. Feel unsure. It's a matter of opinion, the scientists disagree.

It would have been best to roll it out in an organised way and as per the protocols. I mean FFS.

The effect on public confidence in the vaccine, understanding of what's required (1 is good enough!), and unintended consequences in the messaging are irresponsible.

I agree that the government gambling on single doses, spaced at an interval inconsistent with the manufacturer’s recommendations (in the case of Pfizer) risks playing into anti-vaxxer hands.

We cannot afford to undermine confidence in future vaccination programs. There will be more pandemics. Anti-vaxxers still cite the narcolepsy episode from the swine flu vaccine. Nothing is risk free but sticking to manufacturer protocols, the intervals and doses trialled, is surely the safest path forward.

@NiceGerbil in case you haven’t noticed, we are in a major medical emergency where long-term comms is a tiny issue in comparison to the numbers who will die of cancer in the coming months if Covid numbers increase. Plus your posts are medically illiterate when it comes to the detail—the first aim of medicine is to help save people’s health, not to sound good when explained to joe public!

Your ridiculous posts are a clear case of working backwards—you have a point you’ve set out in the first post, when your rationale for that is disproved you’ve made up another (even less persuasive) one, rather than assess whether your end conclusion is sound.

You can't force someone to have a vaccine, and you can't force them to have the second jab. There has to be an elemwnt of responsibility. They turned up to the first, surely they will go to the second.

I find it disappointing and wish they were transparent about why e.g where the resources are going.

“I said a few days ago to DH. Are they properly tracking this to make sure the follow up jab isn't missed?”

Well, yes? The plan was originally to do it after 3 weeks, now they say 12, doesn’t mean they’re planning on burning the paperwork in the meantime? Have you never had a health appointment booked for 3 months in the future? Why is that so different to an appointment booked for 3 weeks from now? Nonsense argument.

“FFS. I'd rather they took the time to do it properly.”

Well the whole point is they can do it 90% for lots of vulnerable people or 95% for half that. This was they save maximum lives and give the health service a chance. Don’t get what’s so controversial about the principle at least. This isn’t normal times, delaying vaccinating 3 million vulnerable for just 2 months will mean a lot of extra deaths.

“It was a really stupid and totally predictable move as they were desperate to win some kind of race they have in their heads and the logistics weren't in place.”

Logistics have been a farce, but to be fair this is about supply not the ability to give them, and the UK have done uncharacteristically well in securing vaccines.

“I expect all the people already vaccinated will end up having 2 of a different jab at a later date.”

Is this based on anything, or just on your detailed medical knowledge?

“They have already said they will mix vaccines.”

This is a misrepresentation, but to be fair when you posted this was making the rounds and seemed genuine. It’s only in some very rare cases where there is issues around notes of which vaccine was originally used. Will not be practice.

“I think that what they haven't done is considered the ramifications. For the government to say, manufacturer instructions don't matter. One dose is really good. Mix and match. I worry that
A. It undermines the message that we all learn from young. Finish the course. Take it at this time of day. Bring your children exactly at these weeks and note in red book etc etc. Always follow the instructions. They've kind of undermined that completely and I don't think they've realised what the consequences might be”

We’re in the middle of a frigging pandemic and the health system is literally crashing as we speak. It looks like urgent cancer appointments will be cancelled. Medical comms are important but I don’t think we should be causing 100,000s of deaths because a non-expert is worried about what the comms will be like.

“B. Anti vaxxers are v active. Making people worry. The message is out that 1 dose is pretty good. Won't that mean that many people who are a bit scared will think well I'll have 1 and that is a balance between fear and safety?”

Anti vaxers need to be tackled by the gov. No doubt, they are dangerous. However, even if vaccine take up is affected ultimately by a few %, again it’s about the population as a whole and the need to help the health service. If a lot of people only get 1 dose it’s not a disaster anyway, still works better than many vaccines.

“The headline on the BBC about the 'race' to vaccinate and Israel are 'winning' shows up a childish mindset. Our government was keen to say. Bought most. Inoculating most. Winning!!!! Which is entirely the wrong attitude.”

Well it’s actually the right one, because in this case it’s massively helpful! And a good way to hold governments to account. They fucked up big time on tests and were crucified for this, it’s right that they are held to account in these numbers. They’re not abstract, they make a big difference to saving lives. And show how some countries like France are really struggling to get in top of vaccines.

“It's all style over substance which is not ok for a pandemic.”

I agree with your points here generally, nightingale hospitals in particular. However in this case it’s not plucked out of the air, there is science behind it and many experts have been calling for it.

“None of this is helpful to a decent, orderly roll out. It makes people wonder what's what. Feel unsure. It's a matter of opinion, the scientists disagree.”

That’s all true, but is a side effect of a global pandemic that is taking thousands of lives, and causing many more with hospital treatments getting cancelled. I would question why anyone would think orderly is more important than swift in this situation, when delays mean deaths.

The fact that the government has decided to go against the regimen that was tested and the basis on which it was approved is trivial?

It's going against the science to point this out?

Very strange posts tbh.

I suppose time will tell.

I wanted a controlled roll out, properly managed, with everyone knowing what's what. And now we have. All sorts of mixed messages.

This was always going to happen. I didn't predict the mixing thing so soon which is just... Well.

Yes we're desperate so use the tools we've been given wisely in ways that have been tested and passed.

Not this shitshow.

I remain astonished at people making excuses for the government’s failures here. They have shown for nearly a year to have an inadequate capacity to manage this pandemic. The vaccine rollout is of a piece.

I genuinely hope these changes still lead to a good outcome for her immunity but that doesn’t change my view that the government has been disorganised and irresponsible throughout. The reason the vaccine needs to be rushed and given out on a delay and mix of manufacturers is because of the emergency situation we are in due to the virus’ uncontrolled spread.

There will be countries who begin vaccinating after “world first approved” Britain and get their populations all the same brand with the advised gap between doses because they took the time to plan it properly.

@Borisisafecklesstoad

Surely those who are saying it's fine, you are missing the point. Phizer who made the initial vaccine have said there is no evidence to say it will be effect I've with one dose and the second MUST be given in a 4 week window! The Oxford vaccine fair enough, 70% efficacy at one dose Best in mind those health care professionals who have been vaccinated with phizer are now unwilling non consented guinea pigs swinging in the wind and at massive risk. It's reprehensible and what the f do we do when those health care professionals start dropping like flies, we already are massively undervalued and treated appallingly by those in charge of the NHS, it's flipping criminal. Cried real tears tonight at the thought of being in work and being so at risk, it feels like someone just ripped the carpet out from us again, it's honestly heartbreaking

I’m assuming you’re in this category. I get it’s hard and scary.

I’m a clinically vulnerable clinician who will be doing AGPs on Tuesday on covid +ve patients. I have not had the first dose. It’s scary for me, too. I would give anything to be in your shoes.

Stopping clinicians having the second dose straight away lets clinicians like me have the first.

Thanks @Motorinabfor everything you do. The point you make about the vaccine is crucial and is exactly why the trap between jabs has been changed!

*gap bloody autocorrect

I wonder if what they intend to do long term is just give one to as many as possible then do it on a yearly basis leaving the gap for a year and just having an annual vaccine. Eventually when rates go low low low they might only vaccinate in areas where there are outbreaks.

Anyone else worried about half vaccinating the elderly while the rates are high ? Like a poor choice of antibiotics might help create super bacteria? I dunno . Some are calling for a very strict lockdown to bring rates down before a mass vaccination programme starts

twitter.com/eckerleisabella?s=21

“Is it just me or does uncontrolled, high level community transmission with circulation of several new #SARSCoV2 #COVID19 variants while starting vaccination with modified schemes, leading to partial immunity in a large proportion, sounds like a bad idea? #evolution #thirdwave”

@ChelleMum85. This is not what they’re saying now. The advice is that the first and second doses should be the SAME vaccine and that mixing them should only be a last resort - a different second dose is better than none at all but the advice is that it should be avoided if possible and should only happen on rare occasions.

@moominmomma1234

Anyone else worried about half vaccinating the elderly while the rates are high ? Like a poor choice of antibiotics might help create super bacteria? I dunno . Some are calling for a very strict lockdown to bring rates down before a mass vaccination programme starts

twitter.com/eckerleisabella?s=21

“Is it just me or does uncontrolled, high level community transmission with circulation of several new #SARSCoV2 #COVID19 variants while starting vaccination with modified schemes, leading to partial immunity in a large proportion, sounds like a bad idea? #evolution #thirdwave”

I’m more concerned about some vulnerable not get any vaccine, whilst others get two doses. Therefore, I 100% support the change in policy.

twitter.com/eckerleisabella/status/1345024694643208195?s=21

I know l know, we have a very vulnerable family member who may benefit now from an early vaccine , but it feels like a gamble , taking the vaccine off licence and spreading out the doses. Admittedly I am a glass half empty kinda person ! What if it creates a more dangerous strain.

That was for @Sertchgi123

“The science has been of a very high standard for the vaccine trials, and it is highly frustrating that this is now being ignored. We do not know how the vaccine will perform with an increased gap between the injections, and we do not know how protective a single injection is going to be over the longer term. So why take the risk?”
Professor Martin Hibberd of the London School of Hygiene and Tropical Medicine

The fact that the government has decided to go against the regimen that was tested and the basis on which it was approved is trivial?

It's going against the science to point this out?

I can understand why you’re framing it like this, but it’s a compete misunderstanding of how clinical trials and medicines licensing works. Your lack of knowledge (understandable - this is not your field) also completely skews your risk assessment. Your trust in Pfizer’s press release over independent regulators is misplaced.

I, and several posters up-thread have considerably more specialist knowledge than you which gives us the insight to conclude that this risk-based decision taken jointly by several independent public bodies is the right step to take at this time.

Should we be in this position? No, of course not. But here we are.

Do I expect you to believe me? No. And your healthy cynicism is understandable. The government has lied, obfuscated, over-promised and made many dangerous handbrake u turns. It’s a shambles and they have failed in their public duty. Messaging has been woeful throughout.

But sometimes “they” get it right. Usually when they finally listen to the people who actually know what they are talking about.

And this decision falls into the category of “desperate times call for desperate measures”. I will gladly “share” my two doses with another HCP so we can both have some degree of protection.

[quote moominmomma1234]twitter.com/eckerleisabella/status/1345024694643208195?s=21[/quote]
There is a risk of vaccine escape, but it’s very unlikely to happen within that 8 week window. And in any case, the threshold for vaccine efficacy to permit authorisation was to be >50%, which we have with the single Pfizer dose (even taking a response average across the whole of the first 21 days, which is the worst case). So we’re no worse off than we would have been if the vaccine efficacy had been shown to be more “normal”.

Scientists say it hasn't been tested that way government say it'll be fine 🤪
50% 90% 70% bugger off and sort it out you pack of numpty knobs

@Haffiana

“The science has been of a very high standard for the vaccine trials, and it is highly frustrating that this is now being ignored. We do not know how the vaccine will perform with an increased gap between the injections, and we do not know how protective a single injection is going to be over the longer term. So why take the risk?” Professor Martin Hibberd of the London School of Hygiene and Tropical Medicine

Because it's not a risk taken in isolation.

It's a tradeoff between two competing risks.

On the one hand, you have the risk of not knowing what happens to immunity from 3-12 weeks with a single dose. There is some evidence, and there is reasonable supposition (which, as you say, is not evidence), and they outline which is which in their report.

On the other hand, you have the risk of leaving half of your target group unvaccinated.

You can't choose not to take a risk. You have to chose which risk to take.

The JCVI are gambling - based on the evidence and their knowledge of how other vaccines work - that the former risk is significantly smaller than the latter. Does it mean that risk isn't there? No. Just that it's the least bad option.

In normal circumstances this would be outrageous. As would closing schools, banning christmas, closing shops, mandating masks, and all the other things that have happened this year.

These are not normal circumstances. My ITU colleagues are talking openly about stretch capacity being overwhelmed, which means patients who would normally be saved dying ugly deaths. If we could wait for more vaccine supply to come available so everyone could have the two doses at the recommended interval then that would absolutely be best. We can't. The NHS is literally collapsing.

The JCVI are taking a bad decision, because the alternate decision is worse.

@Bluethrough

It's a 3 (Pfizer) or 4 week gap (Oxford, although they had better results with a longer gap) not 2 The contingent of scientist made the decision The first dose has an effect without the second ( >90% after 11 days then boosted to 95% with the second) we just don't know the longevity because it has not been tested. However, evidence from other vaccines and moderna suggest it lasts until the 12 week booster, in fact a longer gap can often be beneficial

Neither company called the 2nd dose a "booster" and if they got 90%, they'd not needed a 2nd at all, WTO effectiveness for a vaccine is 50%.
These are brand new vaccines, rushed through (rightly) on emergency approval because of the situation the world is in, the comparison someone in Govt made with a tetanus vacc having a booster 10years later is rubbish science.

I think sticking to what the manufacture is saying is the wise choice, if for no other reason then this shower is not capable of organising the follow up inside 12 weeks.

Personally, i think they are doing this for cost reasons.

They did get >90% efficacy with one dose, the second dose increases efficacy to 95% and is also thought to increase infection longevity (although as the single dose wasn't tested).

I think it's supply issues rather than cost.

I would probably have given all the second doses as planned to those who had already received the first- but I think the increase in spacing is reasonable. It's no harder to give an 8-12 week appointment than a 3 week one ( although I agree that people are more likely to forget.)

Immunity longevity not infection