Britain cancels second Covid dose for thousands amid plan to give more people first jab

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Britain’s chief medical officers have warned that there could be shortages of coronavirus vaccines lasting for months into the new year as they last night spoke out in defense of plans to delay people’s second doses of the jabs.

Officials have decided to extend the gap between people’s first and second vaccine doses from three weeks to 12, so they can use more doses to give more people a first jab.

But GPs have blasted the policy as ‘grossly unfair’ as they must now cancel appointments for patients hoping to get their second dose.

And frustrated scientists have warned there’s not enough evidence to prove that the vaccines will work as well this way.

But Professor Chris Whitty, England’s chief medical officer, said in a letter with his counterparts in Scotland, Wales and Northern Ireland that single dose could offer 70 per cent protection, and having this in a larger number of people would be more effective than 95 per cent protection in half as many. 

Margaret Keenan, the first person in the world to receive a Covid-19 vaccine, received her second jab earlier this week.

But thousands of others across Britain will see their second appointment delayed so the NHS can focus on delivering jabs to more people.

A total of 944,539 people across the UK had received the first dose of a Covid-19 vaccine by December 27, according to the Department of Health.

The Hospital Consultants and Specialists Association (HCSA) warned the ‘ill thought-out’ plan to delay the second dose would leave many vulnerable staff in limbo, while one doctor said she would continue to give second doses to elderly patients who had been promised them. 

Those backing the new plan, however, say every second dose given out is one less first jab for someone who has a high risk of dying of Covid-19.

In a statement published by the UK’s chief medical officers last night they said the decision had been made on a ‘balance of risks and benefits’.

The medical officers are Professor Whitty (England), Dr Frank Atherton (Wales), Dr Gregor Smith (Scotland) and Dr Michael McBride (Northern Ireland).

They said: ‘We have to ensure that we maximise the number of eligible people who receive the vaccine. 

‘Currently the main barrier to this is vaccine availability, a global issue, and this will remain the case for several months and, importantly, through the critical winter period. 

‘The availability of the AZ vaccine [Oxford/AstraZeneca] reduces, but does not remove, this major problem. Vaccine shortage is a reality that cannot be wished away.’

Explaining the thinking behind the dosing change the medical officers said they were ‘confident’ that one dose of either the Pfizer or Oxford and AstraZeneca vaccine would give most people ‘substantial protection’ against Covid-19.

They added: ‘In terms of protecting priority groups, a model where we can vaccinate twice the number of people in the next 2-3 months is obviously much more preferable in public health terms than one where we vaccinate half the number but with only slightly greater protection.’  

The letter was published yesterday following a fierce backlash against the Government’s plans to postpone people’s second doses of the Pfizer vaccine.

That jab, the first one to be approved by the UK and put into use from December 8, was trialled as a two-dose vaccine and found to be 95 per cent effective at preventing Covid-19 in clinical trials where the doses were given three weeks apart.

Scientists have not yet published data on how well the vaccine would work if the doses were spread out more, with a longer period between each jab.

Pfizer itself hit back at the British Government’s plan to change the way the vaccine is used and said this week: ‘Although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent.

‘There are no data to demonstrate that protection after the first dose is sustained after 21 days.’  

Doctors are angry at the decision, which means they have to cancel appointments already made for hundreds of thousands of patients who have already had a first dose.  

Paul Donaldson, general secretary of the Hospital Consultants and Specialists Association (HCSA), said the decision was ‘bizarre’ and ‘ill thought-out’.

He said: ‘While a planned and orderly deployment of the Oxford vaccination including longer timelines makes epidemiological sense, the decision to throw a spanner in the works of the existing Pfizer rollout appears simply bizarre unless there is an unknown hitch in supply.

‘We are hearing that vulnerable hospital doctors at high risk from Covid have been told not to turn up for their second dose and therefore will not receive full protection.

‘They are now left in limbo by a hastily formulated policy which seems extremely ill thought-out.’

One GP working in Oxford, Dr Helen Salisbury, told BBC Radio 4’s Today programme that she plans to continue giving second doses to people who were already promised them. 

She said: ‘We were… told we could use our clinical discretion, and that’s what we are doing.

‘There are several reasons. One is the science – we really don’t have any data, as far as I’ve been able to ascertain, maybe there’s data they haven’t released – but we don’t have data about immunity after the first dose beyond 21 days when people got their booster in their trial, so we don’t know what happens.

‘But the second and, I think, more important, is about our patients and our very vulnerable patients, the elderly, who we want to protect most and the relationship we have with them. Their trust in us, their trust in science and the vaccine. 

‘When you’ve started a patient on a course of treatment and you’ve said “This is what the plan is, here’s one jab, please come back in three weeks, it’s really important you have the second jab to be fully protected” and then, to turn round five minutes later and say, “Don’t worry about that, it’s okay, you can have it in 12 weeks not three weeks” – I don’t think that’s good enough, actually.’ 

Other healthcare experts have said the move to delay second doses will cause huge problems for thousands of partially vaccinated elderly and vulnerable people.

Richard Vautrey, chairman of the British Medical Association’s GP committee, said: ‘It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments.

‘The decision to ask GPs, at such short notice, to rebook patients for three months hence will also cause huge logistical problems for almost all vaccination sites and practices.’

Arguing the case for the Government, Professor David Salisbury, a former vaccination director at the Department of Health and now expert at the Chatham House think-tank, said the policy was simply about saving lives.

He said vaccinating as many people as possible is now the top priority, even if it means the vaccines are slightly less effective than they would be in an ideal scenario. 

He told Radio 4: ‘The reason for doing this is to save lives…

‘In a perfect world there would have been huge stockpiles of vaccines, there would be no problems about rolling the vaccines out as fast as you need them, but we are facing rising cases, rising hospital admissions and rising deaths.

‘We have to do something and administrative inconvenience is really not a good reason to fail to save lives.’

He added: ‘Every time we give a second dose right now, we are holding that back from someone who is likely, if they get coronavirus, to die. And much more likely to die than somebody who has already had a single dose. 

‘I just think it’s so clear that this is what we should be doing.’

‘For example, to make contact with even just 2,000 elderly or vulnerable patients will take a team of five staff at a practice about a week, and that’s simply untenable.’  

The deployment of the newly approved Oxford/AstraZeneca vaccine will begin on Monday, almost a month after the roll out of the Pfizer/BioNTech vaccine, but second doses of either will now take place within 12 weeks rather than 21 days as initially planned.

In response to criticism from GP leaders about the change of plan, the joint statement said while it was ‘difficult’ to reschedule second jabs, it was better to offer more people the ‘substantial protection’ given by the first dose within two to three weeks, as the UK waits for more vaccine stocks to become available.

Meanwhile, GPs are being offered £10 for every care home resident they vaccinate in a drive by NHS England to reach the majority of those deemed top priority by the end of January.