I have a lot of respect for Joan Bakewell. A trailblazer, at 87 she is still making waves. But last week my heart sank when she appeared on Good Morning Britain saying she’s planning to take the Government to court over its decision to delay second doses of the Covid vaccine from three weeks to three months.
She thinks it is unsafe. Waiting might ‘invalidate’ the first shot. The new plan ‘should be backed up by data and it isn’t’, she added. Well, I have to say Joan, I love you, but on this you’re just so wrong.
We are in the mother of all crises, with vaccine in short supply. Simply put, giving a scheduled second shot to Joan and others means that someone else, whose need for protection is equally important, cannot be given their first. And right now, the urgent need is to give as many people as we can protection in the fastest possible time.
Think of some of those lower down the priority list: carers of disabled children, 70-year-olds with serious health conditions. Their need is great. And think too of the knock-on effect if one of them does get Covid. It’s likely they’ll get it bad. Perhaps end up in hospital.
Court threat: Angry Dame Joan Bakewell, pictured above, making her point on TV last week. My heart sank when she said she’s planning to take the Government to court over its decision to delay second doses of the vaccine from three weeks to three months, writes Vivienne Parry
It means yet another bed isn’t available for someone with cancer or heart disease, for a start. And, if they get a jab, we know that scenario can be avoided.
I think back to those times, during my childhood, when extra guests arrived at our house and my mother, alarmed that there might not be enough food to go round, would hiss at us: ‘FHB’ – family hold back. This is the same. We are all in this together and have to be pragmatic.
Last week, another national treasure, Esther Rantzen, said that she’d rather her second dose went to people who work in supermarkets. That’s the spirit!
And Joan, having had just one dose, is not unprotected. The decision to make the change was made by the Joint Committee on Vaccination and Immunisation, which advises the Government on vaccine programmes. I know a bit about the rigour involved in its process, as I sat on its board during the swine flu outbreak of 2009.
The evidence is that nine in every ten people who have a single shot of the Pfizer vaccine are protected from Covid-19 infection. Meanwhile, the Oxford AstraZeneca jab has been shown to be 73 per cent effective after one dose – that means seven in ten people who have the jab won’t get Covid.
But, more importantly, research shows all patients who have one dose are protected against severe disease – not a single person who had the Oxford vaccine, and then did get Covid, ended up in hospital.
Immunity from the first dose of the Oxford jab lasts at least 12 weeks, according to the studies, and there is no reason to think the Pfizer jab would differ.
Yes, that second dose is still important. But the priority is now to retain vaccine stocks and get a first dose to as many people as possible. This, experts agree, will save the most lives.
The AstraZeneca/Oxford Covid-19 vaccine is administered at Superdrug in Guildford, as in-store pharmacists and nurses administer the vaccine on behalf of the NHS (file photo)
Under the initial plan, patients who’d had a first shot had a second dose reserved. By releasing these, a million more people will now get a jab faster.
Joan is also worried about safety. It is assumed since the Pfizer vaccine has been licensed on the basis of a three-week interval between doses, exceeding it must be in some way dangerous.
But the choice of three weeks by Pfizer was driven by urgency. It was decided early on that two doses gave the best protection – this is the case with many vaccines. Three weeks was the minimum amount of time they could leave it, as it takes this long for the immune system to respond fully to the first jab.
The results they presented to regulators were based on this timeframe. They didn’t study a six-week or 12-week interval. They just needed to get it done. And so they are unable to go on record saying it is safe to extend the period between doses: they simply didn’t collect the evidence to back that up. But experience from many other vaccines tells us that a longer interval may actually mean better protection.
The body’s first encounter with a vaccine primes the immune system. The second encounter seals the deal – it makes sure there is the longest-lasting immunity possible.
Many jabs are three months apart – child immunisations, for instance. The HPV vaccine, which is 100 per cent effective, is given in two doses, six months apart.
It is assumed since the Pfizer vaccine has been licensed on the basis of a three-week interval between doses, exceeding it must be in some way dangerous. But the choice of three weeks by Pfizer was driven by urgency, writes Vivienne Parry (file photo)
Those in the top-four priority groups for the Covid jab are likely to get a second dose between March and May, just as the incidence of Covid will be starting to wane.
Also, it’s likely they’ll get a third shot, along with their flu vaccines, in the autumn. They really are going to be well protected.
Much fuss has been made by some doctors about consent. GPs say they feel duty-bound to honour this: patients consented to a course of treatment, and signed a form. That’s why you may have heard a fair few stories of people having their second doses, as planned.
Yet doctors can still use discretion. That frail 95-year-old, for example, who couldn’t be reached by phone and who’d be deeply distressed by the shock news she wasn’t getting that second dose she thought was vital. But consent forms are not contracts. No one is obligated. They don’t give patients a right to a particular vaccine.
Most people would understand why their jab was being postponed, if it was explained. And even if the conversation was awkward, well, that’s life.
More than a third of over-80s have now had the jab – and more than 3.2 million first doses have been given. Many areas are already doing the over-75s, although this is highly localised.
Everyone’s now talking about who should be next, who should be bumped up the list, and who shouldn’t be a priority. As I’ve written repeatedly in this newspaper, it’s vital all NHS workers are given a shot without delay. Doctors, nurses, porters, cleaners, receptionists – every single person who goes anywhere near a patient. It’s the only way we can begin to stamp out hospital-acquired Covid, which is a huge problem.
After that? Well, if we keep up the pace, the vulnerable will be covered by March. Some argue that, as is happening in Indonesia, we should vaccinate younger adults who have to go out to work. And as with flu, could vaccinating children be key? One thing is sure. The more people have either had a jab, or had Covid, the more things will improve. The virus will have constant blocks in its path.
We must focus on getting as many of those blocks in place as we can, as fast as we can. And that, Joan, means one dose for now, not two.