Some family doctors in Britain said on Thursday that they would defy government instructions to postpone patient appointments for a second dose of the coronavirus vaccine, a sign of concern in the medical community about Britain’s new plan. Britain to postpone the second injection as a way to give more people partial protection from a single dose.
British doctors, who were instructed to start rescheduling next week’s second dose appointments, said they did not want to ask older, vulnerable patients to wait another two months for their booster doses of the Pfizer- BioNTech. They said that these patients had full protection of two doses, had already provided caregivers to help them get to doctors’ offices and could not afford to rely on a new and untested vaccination strategy.
In addition, doctors said, it was logistically impossible to contact thousands of older patients in a matter of days and then fill those vacancies with first-time receivers.
The British Medical Association, a doctors’ union, said on Thursday that it would support doctors who decide to keep the second dose appointments that have been scheduled for January.
“It is grossly and patently unfair for tens of thousands of our highest-risk patients to now try to reschedule their appointments,” said Dr. Richard Vautrey, chairman of the union’s family doctors committee, in a statement. “The government must see that it is fair for existing reservations for the oldest and most vulnerable members of our society to be honored, and it should also publish, as soon as possible, a scientifically validated justification for its new approach.”
A spokeswoman for Britain’s National Health Service said in a statement that the service was giving family doctors “extra financial and logistical support” to “help ensure that thousands more get the vaccine quickly”.
Vaccines for covid19>
Answers to your vaccine questions
With the distribution of a coronavirus vaccine starting in the United States, here are the answers to some questions you may be asking yourself:
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- If I live in the USA, when can I get the vaccine? Although the exact order of vaccine recipients may vary by state, most will likely put doctors and residents of long-term care facilities first. If you want to understand how this decision is being made, this article will help you.
- When can I return to normal life after being vaccinated? Life will only return to normal when society as a whole obtains sufficient protection against the coronavirus. Once countries authorize a vaccine, they will only be able to vaccinate a few percent of their citizens, at most, within the first two months. The unvaccinated majority will still remain vulnerable to infection. An increasing number of coronavirus vaccines are showing robust protection against disease. But it is also possible for people to spread the virus without even knowing they are infected, because they have only mild symptoms or none at all. Scientists still do not know whether vaccines also block coronavirus transmission. So for now, even vaccinated people will need to wear masks, avoid crowds indoors and so on. Once enough people are vaccinated, it will be very difficult for the coronavirus to find vulnerable people to infect. Depending on the speed with which we as a society achieve this goal, life may begin to approach something normal in the fall of 2021.
- If I have already been vaccinated, do I still need to wear a mask? Yes, but not forever. Here’s why. Coronavirus vaccines are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be sufficient protection to prevent the vaccinated person from becoming ill. But what is unclear is whether the virus can flourish in the nose – and be sneezed or expired to infect others – even if antibodies elsewhere in the body have been mobilized to prevent the vaccinee from getting sick. The vaccine’s clinical trials were designed to determine whether vaccinated people are protected from disease – not to find out whether they can still spread the coronavirus. Based on studies of flu vaccines and even patients infected with Covid-19, the researchers have reason to hope that vaccinated people will not spread the virus, but more research is needed. In the meantime, everyone – even vaccinated people – will need to think of themselves as possible silent spreaders and continue to wear a mask. Read more here.
- It will hurt? What are the side effects? The Pfizer and BioNTech vaccine is given as an injection into the arm, like other typical vaccines. The injection in your arm will be no different than any other vaccine, but the rate of short-term side effects appears to be higher than that of a flu vaccine. Tens of thousands of people have already received the vaccines and none have reported serious health problems. Side effects, which may resemble Covid-19 symptoms, last for about a day and are more likely to appear after the second dose. Initial vaccine test reports suggest that some people may need to take a day off from work because they feel bad after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25 to 33 percent of patients, sometimes more, including headaches, chills and muscle pain. While these experiences are not pleasant, they are a good sign that your own immune system is building a potent response to the vaccine that will provide lasting immunity.
- Will mRNA vaccines change my genes? No. The Moderna and Pfizer vaccines use a genetic molecule to prepare the immune system. This molecule, known as mRNA, is eventually destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slide inward. The cell uses mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any given time, each of our cells can contain hundreds of thousands of mRNA molecules, which they produce to make their own proteins. As soon as these proteins are produced, our cells fragment the mRNA with special enzymes. The mRNA molecules that our cells make can survive just a matter of minutes. The mRNA in vaccines is designed to resist the cell’s enzymes a little more, so that cells can produce extra proteins from the virus and stimulate a stronger immune response. But mRNA can only last a few days at most, before being destroyed.
“The NHS must follow” the new guidance, the statement said, “in order to increase the number of vulnerable people protected from Covid in the next three months, potentially saving thousands of lives.”
The postponement of the second dose of the vaccine could double the number of people receiving an injection soon and eventually decrease the number of victims of the virus in Britain, where hospitals are facing a deluge of cases of a new variant of the coronavirus more contagious. While anyone may be better off receiving the second dose immediately, say some scientists, society as a whole benefits if more people receive partial protection from a single dose for now.
Other scientists, however, believe that Britain has outgrown the available evidence, potentially leaving the elderly and healthcare professionals without the full protection of two doses of vaccine amid terrible winter spikes. Britain made the decision without the public meetings or voluminous instructions that preceded American regulatory decisions. No trial has explicitly tested the long-term effectiveness of a single injection.
And the limited evidence that exists about the protection afforded by a single dose clashes with scientists’ fears that antibody responses will decline over time and may fall below a protective limit.
Some family doctors in Britain said they were concerned about the lack of evidence showing that patients would be protected for several weeks against Covid-19 after a single injection of the Pfizer-BioNTech vaccine.
“I was instructed to break my promise to my elderly patients,” Dr. Helen Salisbury, a family doctor at Oxford, said on Twitter Thursday morning, “And using a vaccine outside of its proven and approved schedule, probably putting them at risk”.