Covid-19 vaccination programme: Doctor Q&A
As we start a new year, there’s hope on the horizon in the fight against Covid-19. While the UK vaccination programme gets underway, we take a closer look at the first three licensed Covid-19 vaccines to be rolled out this year
What vaccines are currently available in the UK?
As it stands, there are three licensed vaccines:
- Pfizer/BioNTech – licensed on 2nd December 2020
- Oxford/AstraZeneca – licensed on 30th December 2020
- Moderna – licensed on 8th January 2021
How do vaccines work?
Vaccines trick your body into thinking it has a particular infection, so your immune system produces antibodies against it. Then, if you encounter the virus or bacterium again, your body is already equipped to defeat it.
How do these Covid-19 vaccines work?
Pfizer/BioNTech and Moderna
Both the Pfizer/BioNTech and Moderna vaccines use messenger RNA (mRNA) which is a genetic code, or ‘message’, that the human body reads to make proteins. The Covid-19 virus has proteins studded all over the outside of its shape, giving it a spiked appearance. The vaccine contains a message that enables the human body’s cells to build these spike Covid-19 proteins, which are then displayed for the immune system to recognise.
Immune system cells (B cells) recognise the proteins as dangerous, and start to produce antibodies that will directly fight against the virus. Other types of immune cells – called ‘Killer T-cells’ – also read and remember this code.
The mRNA vaccine message is destroyed within a few days of entering the human body. It’s important to remember that it’s a message only; the body cannot build the Covid-19 virus from the message (only the spike proteins), and our human DNA is not affected or changed in any way from the vaccine.
The Oxford/AstraZeneca approach uses the spike protein code for Covid-19 and places this inside another, inactive, virus. In this case, it’s a chimpanzee adenovirus – which causes an illness like the common cold in chimpanzees. This virus has been genetically modified so it’s impossible for it to grow or cause harm inside humans.
As with the other vaccines, human B and T immune cells recognise and remember the Covid-19 spike protein code, which primes the immune system for the future.
This is a known vaccine technique, and has already been used to make other vaccines in the past – one example is the Middle East Respiratory System (MERS) vaccine.
Although they work in slightly different ways, all three Covid-19 vaccines produce the same result. If your body was to be infected with Covid-19, your immune system would remember what it’s learnt from the vaccine. It would react very quickly to destroy the virus and any infected cells before an infection takes hold.
How effective are the vaccines?
All of the licensed Covid-19 vaccinations have been proven to be effective, though depending on the type of vaccine, they’re 70-90% effective at preventing the virus.
But it’s important to note that the vaccines were all 95-100% effective at preventing severe symptoms or hospitalisations with Covid-19 during the clinical trials.
It’s unlikely that any vaccine will provide 100% protection.
How safe are Covid-19 vaccines?
All three vaccines have undergone several stages of vaccine trial – phase 1, phase 2 and phase 3. Data from these trials show that tens of thousands of people have had the vaccines with no serious safety concerns noted.
After completing safety trials, the UK Medicines and Healthcare products Regulatory Agency (MHRA) also assessed the vaccines and clinical trial data. The MHRA is an independent, experienced body that’s responsible for making sure UK medicines and medical devices work as they’re supposed to, and that they’re safe following international safety standards. The Covid-19 vaccines have met all the criteria.
How were the vaccines produced so quickly?
Usually in vaccine research, a great deal of time is taken up with applications for the research proposal, funding grants and in recruiting volunteers. There also needs to be enough of the disease circulating in the general population for clinical trials to be able to study the vaccine’s effect.
With the Covid-19 vaccine, there were minimal delays. Funding was available immediately, there have been plenty of volunteers keen to test the vaccine. And as we know, there’s a pandemic raging – so the efficacy of the vaccine can be demonstrated easily.
All of this means the vaccine could be developed at great speed. And we have to give credit to the scientific community – never in the history of vaccine development has the entire community worked so hard towards a common goal.
How are the vaccines given?
The vaccine is given via injection to the muscle of your upper arm. Two doses of the same vaccine are needed, so you’ll get this done twice.
For the Pfizer/BioNTech and Oxford/AstraZeneca vaccines, the second dose of vaccine will be given between three and 12 weeks after the first.
By giving the second dose of the vaccine at 12 weeks, the NHS can maximise the number of people receiving their first dose of vaccine in as quick a time period as possible. Clinical trial data shows substantial protection within 2-3 weeks of the first vaccination from severe Covid-19 disease. The second vaccine dose is important to sustain and extend this protection.
As it stands for the Moderna vaccine, the second dose is likely to be given four weeks after the first (although this may change to mirror the Pfizer vaccine dosing schedule, once the Moderna vaccine begins UK distribution in spring).
Are there any side effects to the Covid-19 vaccines?
All three Covid-19 vaccines may cause mild side effects such as:
- A sore, achy arm where the injection was administered
- Mild redness and/or swelling around the site of the injection
Most side effects are mild, and last no longer than a few days. The vaccines are being closely monitored for any other side effects.
How long does protection from the vaccine last?
It’s currently not known how long the immune protection triggered by these vaccines can last. Some vaccines for other diseases provide lifelong protection, while others require ‘booster’ doses to help the immune system continue to remember.
Which vaccine will I receive?
Unless there’s a specific reason why you may not have a vaccine (i.e. a prior allergic reaction to one of the components of the vaccine), then the vaccine you receive will be down to a random allocation.
When will I get a Covid-19 vaccine?
Vaccines will be rolled out in order through specific groups.
The allocation groups are:
- Residents in a care home for older adults and their carers
- All those aged 80 years and over, and frontline health and social care workers
- All those aged 75 and over
- All those aged 70 and over and clinically extremely vulnerable individuals
- All those aged 65 and over
- All individuals aged 16 years to 64 years with underlying health conditions, which put them at risk of serious disease and mortality
- All those aged 60 and over
- All those aged 55 and over
- All those aged 50 and over
- Rest of the population (priority to be determined)
The government has planned to offer a first vaccination to all those in groups 1-4 by the 15th February 2021, and has set a target to vaccinate groups 1-9 by spring.
The NHS will contact patients directly when it’s their time to get the vaccine.
Where will I go to get my vaccine?
The vaccines are being delivered to hospitals, and to some GP surgeries and pharmacies, so they can be administered to patients. There are also numerous vaccination centres being set up. These are large sites staffed by doctors, nurses and other healthcare professionals, that will provide mass vaccinations to a large number of people.
You’ll be contacted directly when your group becomes eligible, and will be able to book your vaccine timeslot.
It’s advised not to contact your GP or hospital specialist with requests to be ‘bumped up’ the list. The vaccine allocation list is fixed, and doctors are not able to change a patient’s place in the queue.
Can I choose which vaccine I get?
At the moment, it’s unlikely people will be offered a choice. All the licensed Covid-19 vaccinations are effective at immunising people against the virus. So the priority must be vaccinating as many people as possible, as quickly as possible.
If people were allowed to pick and choose, the logistics of rolling out the vaccine programme effectively become far more complicated.
as with any other vaccination, a record will be kept of which vaccine has been administered, which batch of vaccine this came from and when and where it was given. This record will be available on the medical records kept by a GP, and a hard copy documentation card will be given to you after receiving the vaccine.
Can I get the vaccine if I’m pregnant, breastfeeding or trying to conceive?
The Joint Committee on Vaccine and Immunisation (JCVI) has assessed the evidence and the way in which the vaccines work, and has deemed them safe for breastfeeding women and those who are trying to conceive. There’s no need to avoid pregnancy for any length of time after the vaccination, and there’s no evidence of any effect of the vaccines on fertility.
Pregnant women are currently advised to avoid vaccination, unless the risks to the mother from contracting Covid-19 outweigh the potential risks to the developing baby from vaccination (i.e. a mother in the extremely clinically vulnerable group).
But, there are no known risks of vaccination to a pregnant woman or developing baby. The advice to avoid vaccination is only down to a lack of available evidence from clinical trials (as pregnant women were not part of the trial groups). It may be that the guidance for pregnant women changes in future.
Can I get the Covid-19 vaccine if I have allergies?
There were some initial concerns surrounding allergies, particularly with the Pfizer vaccine. The MHRA has advised that the vaccine is safe to be given to those with food or medication allergies.
But the vaccines should not be given to anyone who had a prior allergic reaction to the ingredients of a vaccine. Nor should the second dose be given to anyone who suffered a serious (anaphylactic) reaction to the first dose.
Do I have to get vaccinated?
No. There are currently no plans to make the Covid-19 vaccination compulsory.
But it’s really important to recognise that the more people that become immune to Covid-19, the quicker the transmission of the virus will fall. This is particularly important for protecting vulnerable, high-risk groups.
What can I do after I’ve had the vaccine?
You should not change your behaviour after having the vaccine; it’s important to continue to respect social distancing, wear a mask when required, wash your hands regularly and follow the current tier or lockdown rules.
Vulnerable people that have been asked to shield should still do so – even after having the vaccine.
In the future, people that have been immunised with the vaccine might be given more freedom to travel or socialise – so called, ‘vaccine passports’. But this will be a government decision if it comes. With time, and when enough people have been vaccinated, it is hoped that the restrictions on our lives may ease.
Can I spread Covid-19 to others after I’ve had the vaccine?
It’s a possibility. As the virus and the vaccine are both new, research is still underway to assess whether someone can spread the virus after being vaccinated.
The vaccine is designed to protect you as an individual from becoming unwell with Covid-19, but it could still be possible to carry the virus in your nose and throat and spread it to other, unvaccinated, people.
If you’ve been in contact with someone who has Covid-19, or you’re contacted by the Test and Trace service, you’ll still have to self-isolate.
Will Covid-19 variants affect the vaccination programme?
Some people are concerned that as the virus evolves and mutates, it might develop resistance to the vaccines. Current evidence based on the most recent mutation in the UK has not shown this to be the case.
Theoretically, if there are only small changes in the virus then the vaccine should still produce the desired immune response. But whether potential virus mutations cause problems with Covid-19 vaccines in the future, remains to be seen.
Just like everything throughout the pandemic, the science is continually evolving and there’s lots we still don’t know about this virus. The scientific community will continue to study it and monitor the effectiveness of the vaccines in protecting people against Covid-19.
This article was written by Dr Rhianna McClymont, Lead GP, Livi.
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