The rescheduling of second doses of the Pfizer/BioNTech Covid-19 vaccine will bring faster protection to greater numbers of people most at risk from the virus - including more health care workers.
This will prevent more severe disease, hospitalisation and deaths, and reduce pressures on our health service.
The detailed rationale for this UK-wide decision was spelt out in documents published in late December 2020.
The decision is based on the expert advice of the independent Joint Committee on Vaccination and Immunisation (JCVI).
The Chief Medical Officers for NI, Scotland, Wales and England agree with the JCVI that prioritising the first doses of vaccine for as many people as possible will protect the greatest number of at risk people in the shortest possible time and will have the greatest impact on reducing mortality, severe disease and hospitalisations and in protecting the health service.
JCVI advice has been developed based on:
- a review of UK epidemiological data on the impact of the COVID-19 pandemic so far;
- data on demographic and clinical risk factors for mortality and hospitalisation from COVID-19;
- data on occupational exposure;
- a review on inequalities associated with COVID-19;
- Phase 1, 2 and 3 data on the Pfizer/BioNTech vaccine and the AstraZeneca vaccine, and Phase 1 and 2 data on other developmental COVID-19 vaccines;
- mathematical modelling on the potential impact of different vaccination programmes.
In their joint letter to health service colleagues in NI and across the UK, the four CMOs stated: “Halving the number vaccinated over the next 2-3 months because of giving two vaccines in quick succession rather than with a delay of 12 weeks does not provide optimal public health impact.”
A detailed roll-out of the Covid-19 vaccines in NI is scheduled. More details of this programme will be provided next week.
Progress of our vaccination programme will inevitably depend on the rate of manufacture and supply, as part of UK-wide arrangements.
Supplies are continuing to arrive, with more scheduled for later this month. As the Health Minister stated in the Assembly on 6/1/2021, there will inevitably be some frustrations during this programme.
He also stated: “We do not have enough supplies to vaccinate everyone right now. Supplies will inevitably come in batches. And that means we have to prioritise. In that we will be guided by the Joint Committee on Vaccination and Immunisation.
“Prioritisation will inevitably create tensions. I have been pressed by some Members to move different workforces and sectors up the list.
“Let me make clear again, I will continue to take my lead from the JCVI. In the coming weeks, the primary focus will remain on protecting those members of our community most at risk of serious illness and death from the virus. I don’t see how anyone could argue against that.”
The BMA in NI has registered its opposition to the UK-wide decision on the rescheduling of second doses of the Pfizer/BioNTech Covid-19. This opposition was conveyed to the Health Minister in a meeting on 5 January 2021.
To be clear, the BMA’s request at that meeting was for those who have already had their first dose of this vaccine to receive their second within three weeks.
The Minister and Department fully understand the concerns the rescheduling has caused to these colleagues.
Nevertheless, the rescheduling in line with JCVI guidance will mean that more health and social care colleagues and more vulnerable citizens will get the protection of the first dose more quickly and authorised by the MHRA.
Given the current progression of the pandemic – and the particular threat posed by the new variant detected in the UK and Republic of Ireland – this change in approach is required.
Care home residents and staff in NI will get their second doses within the original three-week period. This recognises the particular logistical and infection prevention challenges associated with care homes and the Pfizer/BioNTech vaccine. NI has led the way in the UK with care home vaccination.
NI’s health and social care system should be proud of its progress to date on Covid-19 vaccination. Everyone can be assured that the programme will be scaled up significantly and rapidly when more vaccines become available and everyone will receive their second dose to complete their course within 12 weeks.
There will inevitably be challenges and frustrations in the weeks and months ahead. We will all have to be patient as we await our turn in the schedule – a schedule that will be based on age and other clinical vulnerability factors, as guided by the JCVI advice.
As the Minister told MLAs, everyone in positions of influence has a responsibility to ensure public comments are fully informed and are asked to choose their words carefully on any frustrations that arise. Rash commentary or conclusions must not be allowed to damage public confidence in vaccination.
Health and social care services and staff in NI are facing an incredibly difficult January and February. Society is facing another incredibly difficult lockdown. Vaccination is our route map to better times. We all must now act to protect those most at risk, including healthcare workers, and to protect our health service.
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