MNHQ here: COVID vaccine Q&A with NHS experts - ask your question here

[RowanMumsnet]

Hello

We're very pleased to say we've managed to secure some time with experts from a range of disciplines to answer all your questions about the COVID vaccine.

Thread now closed for new questions.

This is a non-live Q&A: we’ll be collecting your questions until midday on Thursday March 11, and the answers will be posted up on this thread on Wednesday March 17. [EDIT: Due to new guidance which came out on Wednesday, the questions will be posted later in the week.]

So if you have any questions at all about the vaccine, now's your chance to ask 'em. When are you likely to get the jab? Do you have questions about how pregnancy and breastfeeding affect your eligibility? How were the jabs developed? How has the government and vaccine experts planned out the stages in which the population is vaccinated? What's the best way to encourage reluctant people take up the offer? Are there any common side effects?...

The experts answering your questions will be:

Dr Nikki Kanani, a GP in south-east London and Medical Director of Primary Care for NHS England and NHS Improvement. Nikki has held a range of positions within healthcare and with her sister she co-founded STEMMsisters, a social enterprise supporting young people to study science, technology, engineering, maths and medicine.

Professor Jacqueline Dunkley-Bent, the first Chief Midwifery Officer in England. She has worked as a midwife and a nurse and held senior positions in clinical practice, education, leadership and management.

Professor Lucy Chappell, a consultant obstetrician and spokesperson for the Royal College of Obstetricians and Gynaecologists. She chairs the RCOG vaccine steering group, which is working to co-ordinate messaging for clinicians and women around COVID-19 vaccines, pregnancy and fertility. Lucy is also a National Institute of Health Research (NIHR) Professor in Obstetrics at King’s College London and runs a research programme investigating prediction and prevention of adverse pregnancy outcomes, particularly in women with pre-existing co-morbidities such as chronic hypertension and chronic kidney disease.

Dr Gayatri Amirthalingam currently works as a Consultant Medical Epidemiologist in the Immunisation and Countermeasures Division, Public Health England. Her main areas of responsibility include the national surveillance of vaccine preventable diseases (VPDs) and providing expert clinical advice on vaccine related issues.*

So please do add all your questions here by Thursday March 11 midday and we look forward to posting up the answers next week.

As always, please remember our guidelines - please keep it civil, and if one topic is dominating a thread, we might request that people don't continue to post what's effectively the same question or point. Rest assured we will ALWAYS let the guest know that it's an area of concern to multiple users and will encourage them to engage with those questions.

And with that it’s over to you for your questions.

Thanks
MNHQ

*edited to reflect that Dr Mary Ramsay was not able to partake and was replaced by Dr Gayatri Amirthalingam.

I work as a frontline health care worker and received my first Pfizer vaccine 6/1/21 when I was not aware I was pregnant. I am due to have my 2nd vaccine 24/03/21 but my trust advised that they are not in a position to vaccinate as they administer under PGD guidance that does not cover pregnancy . I discussed this with my GP and they too administer under a PGD directive and they have had advised to hold off until post pregnancy. I am just worried as to what I should do as I feel that I am still vulnerable with only 1 Pfizer vaccine. I would be grateful for any advice at all. I am 36 and don’t have any underlying health conditions but just with being a frontline worker. Thank you

I have chronic ITP which is observed but not treated. I have flu jabs and have never had any reaction. On 5th Feb I had my first dose Covid vaccination, AZ. 24 hours later I began to feel exhausted and ache in thigh and upper arm muscles. This has continued over the next 4+ weeks. I had a negative Covid test after 10 days. My GP ordered blood tests which, apart from platelet count, showed my body chemistry to be ‘reassuringly spot on’. My symptoms are those listed as short lived after the vaccination. I have rested. I have tried light exercise. I remain exhausted and aching. My appetite and sleep are fine. Is this linked to the AZ vaccine?

I would like to have some idea of how soon a vaccine suitable for medically vulnerable children may be available and whether there will be a priority system when a paediatric vaccine programme is rolled out?

I'm aware the trials in children are underway, but after a year of shielding 10 year old ds, I (and other parents of medically vulnerable children) are very keen for news about a suitable vaccine, and a return to some sort of normality for our children.

Thankyou

Do you have any information on what studies are currently being conducted on breastfeeding women and the vaccine, and when results might be released?

And what's your view on vaccine passports, given that groups such as pregnant women aren't currently advised to have the vaccine except in particular circumstances?

Thank you.

Hi,

Which is more effective-Pfizer or astra veneca? Thanks

When I have had my 2nd vaccine in April how safe will it be for me to go out and about?

I'm CEV and haven't been into a shop for over a year!

“What sort of research is currently being undertaken to measure responses beyond 3 weeks in those individuals who had the Pfizer response, as I understand most of the countries who have used it to date still used the 3 week interval?“

This. I’m really worried as a recent article in the Lancet is expressing concern against this strategy.

Also, I was given my (Group 6,CV) Pfizer vaccine at a centre booked by my gp. How will they plan to match up the 2 doses? We didn’t get second appointments yet, and were told the gps would arrange it, but the centre I went to said they never knew until the day of what vaccine they would be administering (I wasn’t asking, the registration person was just very chatty)

If a person has chronic migraine, and has attacks on fifteen days per month, and if that person also is medicated for diverticulosis, would they be exempt from the vaccine for the purpose of travel within Europe and internationally?
If that same person had fears of the the vaccines possible affects, could they show their exemption letter or cert’ in order to board aircraft and fly.

Are there any published figures for the amount of deaths worldwide, from having the vaccine.

Why are a number of medical staff, including consultants, refusing the vaccine.

Thank you

Thanks MNHQ.

My question relates to the small study reported today: the one from King's College London and Francis Crick Institute research team, showing that the Pfizer vaccine was significantly less effective for cancer patients than for the general population after one dose.

Broadly, I'd like to understand more about the practical implications, as I'm in the affected group.

I actually had the AZ vaccine, but am still very concerned.

I am 32 years old and 11 weeks pregnant. I have no health issues at all, have never had gestational diabetes and am not overweight. I am not a carer for anyone.

Yesterday I received a text from the NHS calling me up for my vaccination. I was under the impression that I should not be vaccinated until my baby is born, but the NHS know I am pregnant (my pregnancy is registered, has been for 6 weeks and I'm under the care of midwives) and sent the text regardless.

My GP aren't accepting phone calls so I don't know whether I should ignore the invite (and wait until my baby is born), or go ahead on the basis they know I'm pregnant and still called me up.

Thanks for your help.

I understand some clinical trials are underway to test the vaccine(s) on children. What is the current expected date when the results for these trials will be known?

Brilliant.

How does the vaccine impact those people both male and female trying to conceive or pregnant.

I want to vaccine as soon as I'm allowed it but I woukd be concerned if there is any impact on future fertility or conception

Thanks

We're going to cut off the questions here so that the NHS team have time to prepare their answers - thanks so much for all your questions.

Hello everyone - in order to include new guidance from the Joint Committee on Vaccination and Immunisation released yesterday, the questions will be posted either today or tomorrow.

Thanks for your patience.

MNHQ

Thanks for your patience everyone - the guidance will be posted early next week. Apologies for the delay.

MNHQ

Hello - quick update to say that though the answers are ready they still haven't received the final sign off to make sure they're in line with the absolute latest guidance. Sorry! We'll update you first thing next week - we're almost there! Thanks again for your patience.

Hello everyone - thanks so much for your patience. The answers will be posted up this afternoon.

MNHQ

@RhubarbCustardy

Hi,

Which is more effective-Pfizer or astra veneca? Thanks

Hi @RhubarbCustardy

Over 30 million people in the UK have now received their first COVID-19 vaccine dose, with either the Pfizer or Astra Zeneca vaccine. Both of these vaccines have passed rigorous tests on safety and efficacy.

The latest data shows that both vaccines are highly effective in preventing severe COVID-19 disease.

We are monitoring the impact and effectiveness of the vaccine programme.

In February PHE found that one dose of the Pfizer vaccine reduces infection risk in healthcare workers by >70%, two doses by 85%. An in a separate study by Public Health Scotland, they found that one dose of the AstraZeneca vaccine reduces risk of hospitalisation by 94% (all ages, 4 weeks after dose).

An effective vaccine, regardless of the brand, will save lives and reduce hospitalisations. Everyone should be assured that whichever vaccine they receive will be highly effective and protect them from COVID-19.

@gildalilly

I am interested to know whether there's any way of knowing if the vaccine has worked on an individual. Also would people be better of getting one AZ and the second vaccine a Pfizer, for example, to give more chance of being covered? Is it possible that one vaccine would work and the other not? Hope this makes sense.

Hi @gildalilly

There is currently no evidence on the interchangeability of the COVID-19 vaccines, although studies to investigate the safety and immune responses in individuals receiving mixed doses are underway.

PHE advises that every effort should be made to work out which vaccine the individual received as their first dose and to complete with the same vaccine.

For some individuals there may be circumstances where it is not possible determine which vaccine was received as their first dose or the same vaccine is not locally available. In the extremely rare situation where someone is likely to be at immediate high risk or is unlikely to attend another vaccine appointment it is reasonable to offer one dose of the locally available vaccine to complete their schedule.

• Dr Gayatri Amirthalingam

@Downthefarm

It has been reported that the Pfizer vaccine is effective against the South African variant but that the AstraZeneca is only effective against severe disease. I had the AstraZeneca., and am also CEV. Should I worry?

Hello @Downthefarm

Both the AstraZeneca and Pfizer/BioNTech vaccines have been shown to be highly effective against the COVID-19 variant first identified in Kent and the studies undertaken by PHE are based on the protection against the Kent variant.

Trials were conducted in South Africa with both the Pfizer/BioNTech and AstraZeneca vaccines but these were done in different populations with different outcomes measured and therefore cannot be compared directly.

The CEV group is a very broad category and responses to vaccine may vary within this group. However, it is important to complete the schedule with both doses of vaccine to maximise long term protection.

Variants of concern remain rare in the UK, however, PHE continues to monitor mutations in the virus and are continuing to work with pharmaceutical companies to develop modified vaccines that will respond to variants, should they be needed in the future.

“However we believe that our current vaccines will still offer protection and we are working with pharmaceutical companies to develop new vaccines that will respond to new strains. To reduce transmission it remains important that everybody follows the current guidance and rules and limits their interaction with other people.”

• Dr Gayatri Amirthalingam

@Spied

How many people 3+ weeks after having their first vaccine dose have ended up hospitalized with Covid?

Hi @Spied

The latest data shows that both vaccines are highly effective in preventing severe COVID-19 disease.

Severe disease in those who have received a first dose of COVID-19 vaccine is being closely monitored and data on this will be published as part of an evaluation of the vaccination programme in due course.

• Dr Gayatri Amirthalingam

@Phym

I had an antibody test 5 weeks after my vaccine (AZ). The test was conducted as part of a research study and tested for both covid induced antibodies and vaccine induced antibodies. My test came back negative for all antibodies. Does that mean the vaccine doesn't work on me and I have no immunity or is there a chance some T cell immunity is there that doesn't show up in an antibody test? Is it possible I will still make antibodies after more than 5 weeks? Is it likely the second dose will have no effect? I have RA and other conditions and was classed as CEV.

Hi @Phym

An antibody response can be a useful proxy of immune response, though importantly there is no currently accepted level of antibody that is known to correlate with protection. Reliability of antibody tests vary and therefore a negative test does not necessarily correlate with a lack of immunity.

There is also increasing evidence of the important role that cellular immune responses may play in the protection from COVID-19, like many other viral infections.

It is possible that you could still develop antibodies beyond 5 weeks following the first dose of your vaccine and it is very important that you do complete the schedule when you are invited for the second dose of vaccine.

• Dr Gayatri Amirthalingam

@PickleFish

I had measles vaccine, but still got measles as a child. I had rubella vaccine and still got rubella years later. I've had other vaccines that I'm much less likely to have come into contact with the disease, so it's impossible to tell how well they've worked. It is making me wonder how well I might respond to the Covid vaccine (which I've had). I've read that differences between people in terms of vaccine response can sometimes be down to the specific vaccine/disease, and other times be a more general difference in immune response of the individual, genetically based. Has there been any research done on what differentiates those who made good antibody responses to the Covid vaccine and those who didn't? Or was all the information about efficiency obtained just from figures of those who actually ended up testing positive (symptomatically or not), and nothing further followed up?

Is it known whether those who ended up testing positive after the vaccine (in trials and/or in real life) didn't produce as strong an antibody response, or whether the antibodies/other immune responses didn't work as well in those individuals - i.e., where in the chain of events did the failure occur?

I understand that different types of antibody tests can distinguish between antibodies produced by having had Covid, and antibodies produced by having the vaccine. What research is ongoing to determine strength of antibody response to vaccines? Are such tests available to general public in any way, or are they likely to be in the future, so that someone can be aware of their antibody status in the way that this can be tested for rubella, chicken pox etc?

What sort of research is currently being undertaken to measure responses beyond 3 weeks in those individuals who had the Pfizer response, as I understand most of the countries who have used it to date still used the 3 week interval? (More countries have extended the interval now, but the UK is ahead of all these, so presumably the research needs to be undertaken here - what is happening, and when might there be some preliminary results?)

Hello @PickleFish

Currently there is no agreed antibody level that correlates with protection and therefore the definitive evidence is the effectiveness of the vaccines against things such as a reduction in hospital admissions and prevention of deaths.

PHE has demonstrated high level of protection against hospital admissions in those aged 70 years and above following the first dose of either COVID vaccine used in the national programme. These data are fed back regularly to JCVI,which advises the government on vaccine use and prioritisation, regularly reviews data and evidence on vaccine efficacy and effectiveness.

In addition to these studies, PHE is monitoring antibody responses following up individuals for up to two years after they have received either the Pfizer/BioNTech or Astra Zeneca vaccine as part of the national programme, more on this study can be found here.

• Dr Gayatri Amirthalingam

@BlackeyedSusan

Is anyone collecting information on differing effects of vaccination on people with various medical conditions/ co-morbidities? (We have quite a handful between us) Given some conditions are fairly rare, how many people with a condition, would need to be vaccinated before you could see any particular effect other than just randomly occuring generally?

Hello @BlackeyedSusan

Vaccine effectiveness in different clinical groups is being monitored by Public Health England. We know that people whose immune systems are compromised may not respond as well to the vaccine, which is why it’s vital that these groups continue to shield in line with the guidance.

Evidence shows that the vaccine is working in older people and among healthcare workers and this will help prevent the virus spreading among clinically vulnerable groups.

• Dr Gayatri Amirthalingam

@HazeyJaneII

I would like to have some idea of how soon a vaccine suitable for medically vulnerable children may be available and whether there will be a priority system when a paediatric vaccine programme is rolled out?

I'm aware the trials in children are underway, but after a year of shielding 10 year old ds, I (and other parents of medically vulnerable children) are very keen for news about a suitable vaccine, and a return to some sort of normality for our children.

Thankyou

Hello @HazeyJaneII and @Jerble

It is important to remember that following infection, most children will have either an asymptomatic infection or mild disease with the risk of severe disease being rare.

Currently, for those children who are CEV and 16-18 the JCVI advice is that they can be offered the vaccine. In groups of children under the age of 16, vaccination should be a carefully discussed individual decision between parents/guardians and their GP or specialist in charge of that child’s care.

The Committee advises that only children at very high risk of catching the virus and serious illness, such as older children with severe neuro-disabilities in residential care, should be offered vaccination.

We currently have limited data to support vaccinating children in large numbers, trials in children are currently underway and once these data are available, they will be reviewed by the MHRA and JCVI to inform future decisions on extending the vaccine programme to children.

• Dr Gayatri Amirthalingam