Covid-19: Health and social care staff must be vaccinated now, says BMA
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n60 (Published 08 January 2021) Cite this as: BMJ 2021;372:n60Read our latest coverage of the coronavirus outbreak
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Dear Editor
I strongly believe the government needs to prioritise the second dose of the vaccine within the manufacturers recommendations. I signed up to be a vaccinator with the understanding I would have around 95% immunity after the 2 doses. I haven't been able to be frontline up to now as I'm in a high risk group. I do not now feel confident to be a vaccinator with just 1 dose and potentially lower immunity, but I would with the 2 doses. There must be other NHS staff out there in a similar predicament, who could be back on the frontline, reassured by having the full protection of the vaccine. Can the government be lobbied to change their position on this please? The NHS needs as many staff as possible back on the frontline.
Competing interests: No competing interests
Dear Editor
Given the urgency of the crisis and limitations on vaccine supplies, the advice of the JCVI to widen coverage by extending the gap between doses to 12 weeks was understandable, although based on minimal scientific and clinical data. Inevitably the government blundered in, demanding rebooking of appointments already made, creating huge practical problems for patients, carers and staff, undermining the consent process and further damaging public trust. Despite the outrage of many immunologists we should all support the policy, provided two conditions are met:
1. Vaccinators should receive a full course of immunisation. Without a full complement of neutralising antibodies, an unprotected vaccinator could potentially infect hundreds of vulnerable people before their positive status is detected. Partial protection could speed up selection of more virulent Coronavirus strains.
2. An urgent concerted attempt must be made to answer some of the multitude of research questions raised by the change in dosing schedule: does the time course of humoral and cell mediated immunity vary between patient groups?; does it differ between vaccines or with different doses?, and of course does one vaccine provide better protection against severe illness or transmissibility than another?
The last question could only be answered by randomisation. This is clearly impractical in the short term, but once the network is set up and the supply chain stabilised there is no reason why different regimens could not be compared between randomised “clusters”. At the moment it would be unreasonable to burden clinical staff with the extra organisational and paperwork involved, but retired potential volunteer vaccinators such as myself could take this on.
Competing interests: No competing interests
Dear Editor
Perhaps, using its professional megaphone the BMA has made “an urgent call” for all health and social care workers to be vaccinated by the end of January[1], and seemingly by 7th January, the government/NHS England has acted in double-quick time by acceding to BMA’s request[2]. Although this is effectively another U-turn by the government, it is most likely that frontline healthcare staff including doctors would see this as a positive move.
However, it is sickening to read that doctors had to rely on leftover vaccines [1] or I would say scraps, directly due to the highly questionable, most insensitive policy of Joint Committee of Vaccination and Immunisation (‘JCVI’) to relegate the priority status of frontline NHS staff in early December. In contrast, the US government considered “21 million frontline healthcare workers" will be first in line to receive the covid-vaccine [3]; in fact, on 22 December 2020, I asked, “would it not be a sensible time now for the UK government to urgently review their vaccination priorities even if it amounts to yet another U-turn?”[4], so I am personally happy about this latest change of stance by the government or its JCVI.
The next task for the BMA as a trade union should be to ensure all doctors receive their second vaccine dose in line with the manufacturers’ recommendation without risking possible efficacy issues which could potentially lead to in the extreme, catastrophic outcomes if there's a substantial delay in receiving the second dose. The WHO has already warned that there “is no scientific evidence for a delay of more than six weeks in administering the second dose of the Pfizer/BioNTech vaccine against Covid”[5].
References
[1] BMJ 2021;372:n60
[2]https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2021/....
[3] BMJ 2020;371:m4924
[4] https://www.bmj.com/content/371/bmj.m4924/rr
[5] https://www.theguardian.com/world/2021/jan/05/no-data-to-support-uk-dela...
Competing interests: See text; NHS doctor
Re: Covid-19: Health and social care staff must be vaccinated now, says BMA
Dear Editor I am a primary care worker who visits patients in their own homes. I am also the career for my mother who is isolating due to heart surgery. I haven’t yet been invited for a COVID vaccine, while people younger and further down the line from me have been vaccinated.
Competing interests: No competing interests