Join Hafta-Ichi to Research the article “Bolton GPs offer second Covid jabs four weeks after first to use surplus | Vaccines and immunisation”
GPs in one of the UK’s Covid hotspots are offering all adults their second dose of Covid vaccination four weeks after their first, in a rush to administer vaccines within their shelf life.
Some GPs in Bolton have been sent so many doses of the Pfizer vaccine that they are offering second jabs a month earlier than government rules allow, concerned that otherwise they may be wasted.
It is just the latest sign that local areas are increasingly flexing – if not ignoring – national guidance in order to vaccinate everyone they can without throwing any doses away.
Across England, some local health services are offering jabs to people aged 18 or even 16 and over, while others – such as Blackburn, the current Covid hotspot – have begged for more first doses.
Blackburn, which has an infection rate of 439 cases per 100,000 people, 13 times the UK average, asked for thousands more doses in order to continue surge vaccination for all adults for another fortnight, but was knocked back this week.
Dominic Harrison, Blackburn’s director of public health, appealed against what he called an “unfair, unjust and avoidable” decision, saying it would lead to avoidable deaths and local NHS services being swamped within four weeks.
Kate Hollern, the Labour MP for Blackburn, said: “If there are additional vaccines that Bolton is struggling to make use of, Blackburn will willingly take them off their hands. We’ll work with them to make sure jabs get into arms where they’re needed most. It’s incredibly damaging that the government decided that Blackburn, which has got the highest case rate in the country, isn’t a priority.”
Nationally, only people aged 30 or over are eligible for vaccination, unless they are in a vulnerable group. The Joint Committee on Vaccination and Immunisation (JCVI) guidance stipulates that clinics can invite patients “outside the cohort only in very limited circumstances to avoid wastage”.
Yet the Guardian has received numerous examples of institutions and local authorities across the country that are ignoring the JCVI rules.
University College London has told its students of all ages they can receive vaccinations from noon on Saturday at a surgery near its Bloomsbury campus.
“The vaccination will be offered to all UCL students regardless of age on a first-come, first-served basis and no prior booking is required. We recommend you arrive early, as only a limited number of vaccinations are available on the day,” UCL said in a message to its 44,000 students.
Several boroughs in Greater Manchester are deviating from the JCVI guidance. In Stockport, the clinical commissioning group (CCG) offered a walk-in clinic for anyone aged 28 or over on Friday, while a Guardian reader in Salford said his 20-year-old daughter had been invited for a jab by Salford CGG on Wednesday. In parts of Manchester with large ethnic minority communities, 16-year-olds have been vaccinated in recent weeks.
In Bolton – which last month had the highest rates of the Delta variant of Covid, linked to travel from India, and is now second only to Blackburn – clinicians are using their discretion to speed up delivery of second doses.
“They’re drowning in vaccines and are really feeling the pressure not to waste any,” said one source in the local healthcare system. “They’ve been given so many doses that we are struggling to give them away. We are saturated.”
In a move to tackle the Delta variant, the JCVI guidance was changed on 14 May to say the second dose interval could be shortened from 12 to eight weeks for all over-50s plus younger people in vulnerable groups.
But the Guardian has seen texts sent by two Bolton surgeries inviting patients to get their second vaccination at a pop-up clinic at Eden boys’ school if their first dose was at least 28 days ago.
Some of the recipients queried the invitation on the Facebook page of Bolton’s CCG. They received a response from Dr Helen Wall, who is running Bolton’s vaccine programme.
“It’s licensed from four weeks, guidance nationally says eight but it’s clinical discretion,” she wrote. “There is felt to be potentially a small benefit in some people at leaving to eight weeks, but given we are 14 times the England average in our rates and the vaccine at first dose is only thought to be about 38% effective against [the Delta] variant compared to 89%-plus after two doses, you could argue getting two doses is ultimately beneficial. The clinical directors are making a clinical risk-based decision based on rates in the area.”
She agreed that the national messaging was confusing, given that the official Bolton CCG line is still that second dose eligibility is after a minimum interval of eight weeks, not four. “I agree it’s caused some confusion, apologies,” she said. “The challenge is we can’t change national guidance or advice but each clinician has scope to weigh up the pros and cons” for their patient population.
While the Oxford/AstraZeneca vaccine can be stored in a fridge for up to six months, all Pfizer doses must be used within 31 days after being removed from the deep freeze. When it was first licensed in the UK late last year, regulators said the Pfizer vaccine had to be used within five days, leading many vaccine centres to bend the rules at the end of the day to avoid wastage.
An NHS North West spokesperson said: “The NHS in Blackburn received extra doses of vaccines for surge vaccination services which helped jab over 19,000 people in just a few weeks and from a vaccine bus to walk in jab centres, the local area continues to jab all of those who are eligible and has enough supply to do so.
“Two new pharmacy-led sites will open next week, offering both walk in and pre-bookable appointments, and as vaccination offers the best protection for people and their families, anybody who is eligible for the vaccine but has not yet been vaccinated, should book themselves in for the lifesaving jab today.”
An NHS spokesperson said: “All vaccination services are expected to continue to vaccinate in line with guidance set out by the JCVI.”
Source: The Guardian
Keyword: Bolton GPs offer second Covid jabs four weeks after first to use surplus | Vaccines and immunisation