Health authorities are cracking down on vaccination centres breaking rank with official guidance and offering early second doses to young people, amid “confusion” over the best time to receive their follow-up jab.
The Joint Committee on Vaccination and Immunisation has advised that second doses should be given no earlier than eight weeks after a first jab, citing evidence which shows that the longer interval provides higher levels of protection than the usual three-week gap.
But many GP-run sites and large-scale vaccination centres have defied these orders, which are enforced by NHS England, in order to fully vaccinate people ahead of 19 July and ensure their stock does not go to waste.
Last weekend, the Science Museum in London was slapped down by NHS officials after offering out second Pfizer jabs to anyone who had received their first dose more than 21 days ago. On Friday, Wembley Stadium announced it was providing a similar service but was later told to stop.
The day before, NHS England issued a communication reminding all primary care networks (PCN) of the JCVI’s dosing guidance. Changes have also been made to the Public Health England Green Book, outlining the need to keep to the eight to 12-week gap.
“This consistent interval should be used for all two dose vaccines to avoid confusion and simplify booking,” NHS chiefs said in Thursday’s update.
The trend of vaccination sites defying regulation is thought to be particularly acute in London, which has a median age of 36 and is therefore proportionally younger population than the rest of the UK.
This means millions of Londoners aged under 40 will have only become eligible for a first dose seven weeks ago, on 13 May. In line with the JCVI’s guidance, many won’t be offered a second jab until 8 July at the earliest, reaching full immunity two weeks after that. Those in their 20s and below face an even longer wait that takes them well beyond 19 July, when most Covid restrictions are set to be lifted.
Because of this, GP-run vaccine sites in the capital have taken matters into their own hands and started offering their stock to local residents still waiting for a second dose.
“I can see why they’re doing it,” said one source involved in co-ordinating the capital’s PCNs. “These centres have the staff and the stock for it, but haven’t got people coming forward for second jabs.
“And with 19 July coming up quickly, they’re conscious that there are people out there who could easily be fully vaccinated against Delta but aren’t allowed under current advice. It’s understandable that they’re breaking the rules.”
One dose of the Pfizer vaccine provides 36 per cent protection against symptomatic Covid-19 from the Delta variant. This increases to 79 per cent two weeks after a second jab.
The source questioned whether London’s vaccination sites would “toe the line” after the recent communication put out by NHS. “The official literature is clear that they shouldn’t be doing this,” he said. “But if they’ve got people coming for a walk-in, they’re going to offer a second dose and not ask any questions”.
He also claimed that NHS England has been sending “arsey” emails to centres caught offering early second doses, and threatening not to fully pay GP sites which have been fully vaccinating people before eight to 12 weeks – a breach of the original contracts drawn up before the rollout. “There’s been plenty of sabre-rattling. They run regular reports into vaccine centres and flag up outliers who have been breaking rank.”
Ruth Rankine, the director of primary care at the NHS Confederation, said she was aware of centres that have been vaccinating people before the minimum eight-week limit.
“But we also understand the reasons [why],” she added. “Some sites may have excess supply that would otherwise go to waste, while others may be coming to the end of their programme and have taken a pragmatic approach to use up vaccines rather than waste them.”
Although the JCVI has advised that people should receive their second dose a minimum of eight weeks after their first, the original clinical trials conducted into the UK’s approved vaccines showed that it was safe and effective to fully immunise people over a three to four-week period.
Early JCVI guidance recommended a 12-week gap, which was introduced at the beginning of the rollout when supplies were short and the emphasis was on administering as many first jabs as possible to get vaccine coverage up quickly. Research also later confirmed that a longer interval between the first and second dose triggers a marginally superior immune response.
Now, though, the situation has changed. Confronted with the highly transmissible Delta variant, the imminent lifting of most Covid restrictions and a healthy looking stockpile of supplies, there is a desire among some GP-led sites to bring forward second doses.
The British Medical Association, the doctors’ trade union, said: “The vaccines are both licensed for shorter intervals (21 days for Pfizer) and other countries are delivering them with shorter intervals.
“However, it is down to JCVI to advise based on the epidemiological situation in the UK and the level of supply. We believe it is right that no vaccines are wasted.”
Labour’s Alex Norris, a shadow minister for health and social care, said: “The vaccine is our biggest defence against the Delta variant. What we need now is clear guidance from the NHS and ministers about second jabs, not confusion and mixed messages.”
An NHS spokesperson said: “NHS operational guidance is clear that second doses should be offered from eight weeks to ensure maximum protection, and this is in line with JCVI and government advice for people aged 40 and over. The NHS is also proactively contacting those who are eligible to bring forward their jab.”