Intended for healthcare professionals


Covid-19: Order to reschedule and delay second vaccine dose is “totally unfair,” says BMA

BMJ 2020; 371 doi: (Published 31 December 2020) Cite this as: BMJ 2020;371:m4978

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  1. Elisabeth Mahase
  1. The BMJ

Healthcare workers in England have been told to reschedule appointments for the second dose of the Pfizer and BioNTech covid-19 vaccine after the government’s advisory committee decided that vaccinating as many people as possible with a first dose should be the priority.

The BMA has called the decision “unreasonable and totally unfair” and said it could cause “huge logistical problems” for general practices and vaccination centres.

The government has now said that people should receive their second dose of vaccine (whether the Oxford and AstraZeneca or the Pfizer BioNTech one) within 12 weeks of the first, rather than within a few weeks. But many GPs and clinical leaders have told the BMA that delaying already promised second doses “will have a terrible impact on the emotional wellbeing of their most vulnerable, at-risk patients.”

Healthcare professionals were informed of the change through a letter from NHS England on 30 December,1 following the Medicine and Healthcare Products Regulatory Agency’s approval of the Oxford and AstraZeneca vaccine.2

The letter said, “Prioritising the first doses of vaccine for as many people as possible on the priority list will protect the greatest number of at-risk people overall in the shortest possible time and will have the greatest impact on reducing mortality, severe disease and hospitalisations and in protecting the NHS and equivalent health services. Operationally this will mean that second doses of both vaccines will be administered towards the end of the recommended vaccine dosing schedule of 12 weeks.”

“[The four UK chief medical officers] recognise that this will mean we need to reschedule second doses for most of our current first dose recipients, but for the reasons set out today by JCVI [the Joint Committee on Vaccination and Immunisation] and the CMOs, doing so should substantially improve individual and population-level protection against covid-19 over the next three months.”

So far people aged over 80 and care home residents have been the first to receive the vaccine.

Richard Vautrey, chair of the BMA’s General Practitioners Committee, said, “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. For example, to make contact with even just 2000 elderly or vulnerable patients will take a team of five staff at a practice about a week, and that’s simply untenable.”

He added, “The government must see that it’s only right that existing bookings for the oldest and most vulnerable members of our society are honoured, and it must also as soon as possible publish a scientifically validated justification for its new approach. As doctors, we believe this can and should be done even as practices and the wider NHS step up the covid-19 vaccination programme to deliver initial doses of vaccination to other vulnerable people, including frontline healthcare professionals—many of whom still have not even received their first vaccination.”

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