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Coronavirus: How will the UK bring forward second vaccine doses to eight weeks?

Prime Minister Boris Johnson today announced that the NHS’s Covid vaccine rollout will be rejigged to try and protect people from the Indian variant which he fears will trigger a third wave before lockdown ends in June.

All over-50s will now get their second jab within eight weeks of the first, rather than 12, and vaccines minister Nadhim Zahawi said the rollout would ‘flex’ to get second doses to the 10million vulnerable people who aren’t yet fully vaccinated.

And as the rollout surges ahead with the PM warning ‘the race between our vaccination programme and the virus may be about to become a great deal tighter’, the AstraZeneca jab could be back on the cards for young people if infections start to surge and the risks of being unvaccinated outweigh the risks of developing a rare blood clot.

Scientists have already suggested that once someone’s Covid exposure risk moves to ‘medium’ or ‘high’ – an infection rate of around 0.5 per cent of the population per week – the benefits of the jab outweigh the risks for all over-20s. SAGE has warned the Indian variant could cause a huge wave if it’s significantly more transmissible than the Kent variant that is currently dominant. 

The plan to change up the programme comes amid warnings the Indian variant B1617.2, which appears to be causing outbreaks in Covid hotspots in the North West, could lead to a ‘substantial resurgence of hospitalisations’.

The rollout is not expected to be targeted at those hotspots but at getting high-risk people across the country fully protected if they aren’t already.

An average of 3.5million vaccine doses are currently being given out each week, suggesting it would take three weeks’ worth of supplies to get through the 10m, plus extra for those people in their 40s still getting first jabs.

Although most supplies are already going towards booster jabs for people who got their first doses in February and March, around one in three are given to first-timers, meaning up to 1million people per week – mostly in their 30s and 40s – could miss out on their first doses if the rollout is completely shifted. 

Now, everybody who gets their first dose by June 5 will be owed their second jab before the end of July, which could delay the NHS’s plans to get a first jab to everyone by that date. The previous cut-off had been May 8.

Here’s how the Government could do it:

Experts at the Winton Centre for Risk and Evidence Communication at Cambridge University calculated that once the infection rate in a country becomes high the benefits of giving the AstraZeneca vaccine to adults in any age group far outweigh the risk of a possible blood clot

Experts at the Winton Centre for Risk and Evidence Communication at Cambridge University calculated that once the infection rate in a country becomes high the benefits of giving the AstraZeneca vaccine to adults in any age group far outweigh the risk of a possible blood clot

WHAT IS GOING TO CHANGE AND WHY? 

Boris Johnson said the gap between first and second doses will be shortened from 12 to eight weeks for people at high risk from Covid – those over 50 or with health problems.

Ministers have refused to budge from the age-based rollout to immunise younger people in hard-hit areas, but will bring forward millions of people’s second doses by up to a month to make sure they get fully protected as soon as possible.

A large third wave would cause widespread hospital admission and death because of vaccine failure rates. These are inevitable because no jabs are perfect, but they are lower if people have had two doses and significantly lower two to three weeks after the second dose.

Mr Johnson said in a Downing Street press conference today: ‘It’s more important than ever therefore that people get the additional protection of a second dose.

‘So, following advice from the Joint Committee on Vaccination and Immunisation, we will accelerate remaining second doses to the over 50s and those clinically vulnerable right across the country so they are just eight weeks after the first dose, and if you are in this group the NHS will be in touch with you.’

Vaccine minister Nadhim Zahawi explained this morning: ‘The clinicians will look at all of this to see how we can flex the vaccination programme to make it as effective as possible to deal with this surge in this variant, the B.1.617.2. They will make those decisions and we will be ready to implement, whether it’s vaccinating younger cohorts.’ 

Vaccines are being given out working down the age groups because older adults are more at risk of developing severe disease, being hospitalised and dying when they catch the virus. 

Young people, however, are less likely to die but the most likely to spread the virus and vaccinating them could help to limit local outbreaks. Ministers have not yet said they will switch their approach to the rollout to address this.  

Boris Johnson today said the gap between first and second doses will be shortened from 12 to eight weeks as he warned: '

Boris Johnson today said the gap between first and second doses will be shortened from 12 to eight weeks as he warned: ‘

WHO ARE THE 10MILLION PEOPLE BEING FAST-TRACKED?  

Ministers signed off on plans to speed up second doses for all adults over-50 last night amid rising cases of the Indian variant, and urged everyone in their 40s to get a first dose if they haven’t already.

NHS England figures suggest three quarters of adults in this group have already had their second dose but the remaining one in four – including vulnerable people – are still waiting for second shots.

SAGE WARNS OF ‘REALISTIC POSSIBILITY’ INDIA VARIANT IS 50% MORE INFECTIOUS 

There is a ‘realistic possibility’ the Indian Covid variant is far more transmissible than the Kent strain and could lead to up to a thousand deaths a day by summer, the Government’s scientists warned tonight.

The SPI-M subgroup said it was confident the mutant B.1.617.2 strain was more infectious than the currently dominant variant, and that it could spread up to 50 per cent more easily.

It warned that pressing on with easing all lockdown restrictions on June 21, as is currently the plan for England, could lead to more than 10,000 more people being hospitalised with the disease daily by Autumn because ‘there are still too few adults vaccinated’ to stop its progress. 

The bleak models were presented to No10 this week after cases of the strain more than doubled in seven days and four people were found to have died from the variant. The fact it’s spreading rapidly when the country is still in lockdown and among a highly-vaccinated population has sent alarm bells ringing.

England’s chief medical officer Professor Chris Whitty told a Downing Street press conference tonight the variant is expected to become the most dominant in the UK. 

The Government’s scientists have said they are confident the strain is not more deadly and that vaccines will work well against it. But they warn the death toll could climb significantly by the fact it is able to infect more people than previous strains and there are still 30million unvaccinated Britons.

Surge testing is being deployed in 15 hotspots, mostly in the North West of England, and second vaccine doses are being sped up for over-50s in an effort to contain the strain and pre-empt a deadly third wave.

SPI-M scientists advising SAGE this month estimated what a more transmissible strain could do to the country after lockdown is lifted in June and claimed it could trigger up to 20,000 hospital admissions per day in a worst-case scenario. January’s peak, which nearly crippled the NHS, was around 3,800 a day in England.

A Warwick University modelling team cautioned that if it was 40 per cent more transmissible the next surge could be worse than the second wave, with up to 6,000 daily admissions, and a 50 per cent increase could lead to 10,000 per day. 

Less grisly numbers from the London School of Hygiene & Tropical Medicine suggested a 50 per cent rise could lead to 4,000 per day. But the LSHTM also found that a 50 per cent more virulent variant could lead to 1,000 deaths a day by Autumn, which is about the same as the peak last spring. Deaths peaked at 1,900 this January. 

Professor Whitty told the Downing Street news conference tonight: ‘We expect over time this variant will overtake and come to dominate in the UK in the way that B117 took over and other variants have taken over prior to that.’ 

Despite the warnings, Boris Johnson today said the loosening of rules on Monday, allowing indoor socialising and holidays, is still set to go ahead as planned. But he admitted June 21 could be delayed if SAGE is confident the variant will spiral.

SPI-M ruled out surge vaccinations in hotspots because it found it would complicate the vaccine rollout too much and only be slightly more beneficial and is instead going for a national measure. It will shorten the time between second doses from 12 to eight weeks in the over-50s in an effort to get people protected quicker. 

Dr Simon Clarke, a microbial biologist from Reading University, said ministers were right to speed up doses for this group if they feel the Indian variant poses a risk.

He added that bringing forward second doses for millions would mean more people had stronger immunity against the virus earlier, which could stop further hospitalisations and deaths.

‘Overall, it might mean that a few more people get protected which is fair enough,’ Dr Clarke said.  

Getting jabs to older groups sooner could stop any uptick in hospitalisations and deaths due to the Indian variant.

Early studies show it is still susceptible to vaccine-triggered immunity. A Public Health England variants expert said today evidence showed the strain’s effect on jabs was ‘not particularly concerning’.

WHERE WILL THE SUPPLIES COME FROM? 

The NHS uses vaccine as quickly as it gets delivered and is not moving at maximum capacity, suggesting the rollout is held back by vaccine supply. The one-day record for jabs given is around 850,000 and it is currently managing around 650,000 per day.

This means it will have to redirect Pfizer and AstraZeneca supplies being used for first doses to the second dose rollout.

Last week 1.05million first vaccine doses were given out, so most of those will likely be used instead in the second dose effort. This is except Moderna supplies which have not been in circulation for long enough for anyone to get a second jab. The Government won’t reveal how many of each of the jabs it is using. 

These, combined with the approximately 2.5million already being used for second jabs, could see the Government get through the remaining 10million people in the next three to four weeks, before the planned end of lockdown on June 21, although Mr Johnson admitted: ‘The race between our vaccination programme and the virus may be about to become a great deal tighter.’ 

Dr Clarke said it was likely most over-50s had received the AstraZeneca jab because it is no longer being given to under-40s, but many have also received Pfizer’s jab because it was the most available for a number of months. 

The NHS is understood to have a rolling stock, meaning there is no stockpile it could use to suddenly scale up the programme.

WHO MIGHT MISS OUT BECAUSE OF THE NEW STRATEGY? 

Turbo-charging second doses for over-50s will likely mean younger Britons will have to wait longer for their jabs because of finite supplies.

The rollout this week opened to 38- and 39-year-olds, of whom there are around a million, and has been working its way through those in their 40s in the most recent weeks.

Around 73 per cent of people in their 40s have got a vaccine so far, meaning the remaining 27 per cent might have to wait longer to get their jab if appointments are limited in the coming weeks. 

People in their 30s will likely face a longer wait for the rollout to offer their first appointments but it’s not yet clear whether the Government is likely to miss plans to get a first dose to everyone by the end of July.

Dr Clarke said it was unlikely that people who had already booked jab appointments for next week would have their visits cancelled, but the NHS might close the booking system to first-timers or severely limit numbers in the forthcoming weeks.

‘They won’t be a cancelling of first doses,’ Dr Clarke said, ‘But I do think they have probably got enough stuff and are deep enough into the over-50s for this not to be needed.’ 

Redirecting jabs from first appointments to speed up second inoculations will undoubtedly delay jabs for younger adults particularly those aged in their 30s.

A Warwick University model of a more infectious variant after lockdown is completely lifted on June 21 suggests that any more than a 30 per cent increase in transmissibility compared to the Kent variant could lead to an August peak of daily hospital admissions that is higher than either the first or second wave. In a worst-case scenario with a variant 50 per cent more transmissible, hospital admissions could surge to 10,000 per day or even double that  (Thick lines indicate the central estimate while the thin lines are possible upper limits known as confidence intervals)

Hospitalisations would be significantly lower if only next Monday's step three was taken and the full relaxation postponed, with the 50 per cent increase leading to a peak of 6,000 daily admissions - up to a possible 14,000 - and 40 per cent to fewer than 3,500, with an upper limit of around 8,000 per day

Hospitalisations would be significantly lower if only next Monday’s step three was taken and the full relaxation postponed, with the 50 per cent increase leading to a peak of 6,000 daily admissions – up to a possible 14,000 – and 40 per cent to fewer than 3,500, with an upper limit of around 8,000 per day

Similar but less grim modelling by the London School of Hygiene & Tropical Medicine suggested that a 50 per cent increase in transmissibility could trigger a peak of 4,000 admissions per day in July or August, possibly extending to 6,000 per day

Similar but less grim modelling by the London School of Hygiene & Tropical Medicine suggested that a 50 per cent increase in transmissibility could trigger a peak of 4,000 admissions per day in July or August, possibly extending to 6,000 per day

WILL THE ASTRAZENECA VACCINE BE USED FOR UNDER-40s TO STOP THE VARIANT? 

When the second dose surge for vulnerable groups is completed – now set to be mostly done before the end of June – the UK will want to hurtle through the younger age groups to try and limit the spread of the virus.

Medics have been advised not to use the AstraZeneca vaccine on people under the age of 40 is a suitable alternative because of a tiny risk of developing blood clots after the jab.

But this advice was formed based on the county having a small outbreak and low case numbers – the current infection rate is 23 cases of coronavirus per 100,000 people – and it could change in the face of a third wave.

Experts at the Winton Centre for Risk and Evidence Communication at the University of Cambridge calculated that, for people in their 20s and 30s, the risk-benefit ratio was in favour of offering a different vaccine while the infection rate remained below 42 per 100,000 – as it currently is.

Once the infection rate rises to around 140 cases per 100,000 people, the balance tips in favour of giving the AstraZeneca jab to people in their 30s rather than leaving them unvaccinated.

And if the rate reaches 419 per 100,000 or higher – which the UK’s did during the second wave – adults of all ages should get the jab, they suggested.

SAGE advisers have warned the Indian variant, if it is significantly more transmissible than the Kent strain, could trigger a huge wave of infections that could tip the scales and caused the Government to give whatever jabs they can to people of all ages.

Experts at the Winton Centre for Risk and Evidence Communication at the University of Cambridge calculated that, for people in their 20s and 30s, the risk-benefit ratio was in favour of offering a different vaccine while the infection rate remained below 42 per 100,000 - as it currently is

Experts at the Winton Centre for Risk and Evidence Communication at the University of Cambridge calculated that, for people in their 20s and 30s, the risk-benefit ratio was in favour of offering a different vaccine while the infection rate remained below 42 per 100,000 – as it currently is

Once the infection rate rises to around 140 cases per 100,000 people, the balance tips in favour of giving the AstraZeneca jab to people in their 30s rather than leaving them unvaccinated

Once the infection rate rises to around 140 cases per 100,000 people, the balance tips in favour of giving the AstraZeneca jab to people in their 30s rather than leaving them unvaccinated

If the infection rate reaches 419 per 100,000 or higher - which the UK's did during the second wave - adults of all ages should get the jab, the researchers suggest

If the infection rate reaches 419 per 100,000 or higher – which the UK’s did during the second wave – adults of all ages should get the jab, the researchers suggest

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