The UK’s Covid-19 vaccination programme continues apace. With new vaccines, virus variants and eligible age groups now in the picture, take a look at what pharmacy teams need to know
Football stadiums, mosques, libraries and, of course, community pharmacies are among the local landmarks transformed into Covid-19 vaccination centres – even the odd bus has swapped passengers for patients to ensure as many people as possible can access their all-important vaccinations.
More than 68 million doses of Covid-19 vaccine have been given to adults across the UK, at the time of writing, with Department of Health and Social Care (DHSC) data showing 39.8 million people (75.5 per cent of UK adults) having had a first dose, and 26.4 million (50.2 per cent) their second. Across the home nations, this equates to over 57.5 million doses in England, 1.8 million in Northern Ireland, 3.4 million in Wales and 5.6 million in Scotland.
People aged 25-29 in England were invited to book their first vaccination from 8 June, with young people in the other home nations already eligible: those aged 30 and over in Scotland and over-18s in Wales and Northern Ireland. More age groups are becoming eligible each week.
Health secretary Matt Hancock has said the UK is on track for all UK adults to be offered a first dose by the end of July. This is good news as Government figures show there have been more than 4.5 million confirmed cases of Covid-19 in the UK, and more than 127,800 people have died within 28-days of a positive Covid-19 test during the pandemic.
So, with vaccinations ramping up, what are the latest developments?
Blood clot concerns
The discovery of a small number of cases of people suffering blood clots after having the AstraZeneca jab caused concern in recent months, but the European Medicines Agency (EMA) and the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) concluded that the risks of Covid-19 outweigh those of blood clots, especially for older people.
Nonetheless, the Joint Committee on Vaccination and Immunisation (JCVI)issued new advice on the use of the AstraZeneca vaccine for people under 40 years of age: those without underlying health conditions should receive an alternative where available. For those who have already had a first dose of AstraZeneca without experiencing the rare side effect of blood clots, they should receive a second dose of the same, as planned.
Previously, pregnant women were only advised to get the Covid-19 vaccination if they were in one of the high-risk groups, however the latest JCVI advice is that all pregnant women should get the vaccine when their age group is called. Pregnant women are being offered either the Pfizer or the Moderna vaccines, if available, because of the aforementioned blood clot concerns.
Pharmacy staff can encourage these women to discuss the benefits and risks of vaccination with their maternity care team if they are concerned. The JCVI advises that women should not stop breastfeeding in order to be vaccinated against Covid-19, those trying to become pregnant do not need to avoid pregnancy after vaccination, and there is no evidence that the vaccines affect fertility.
Encouraging younger people
In a bid to address potential vaccine hesitancy or ambivalence amongst younger people, YouTube has launched a campaign in partnership with the NHS encouraging them to get vaccinated when eligible.
The 'Let's Not Go Back' campaign will be promoted across YouTube’s platforms, social media and out-of-home advertising. YouTube’s UK managing director Ben McOwen Wilson claims 98 per cent of 16- to 34-year-olds could be reached with messages about “what the vaccine is, what the risks of the vaccine are, and the best way for them to move forward through that vaccination process”.
Evidence of effectiveness
The University of Oxford’s Nuffield Department of Medicine has found that people who have received a single dose of the Pfizer or AstraZeneca vaccines were 65 per cent less likely to get a new Covid-19 infection. Researchers found people were 90 per cent less likely to be infected after their second Pfizer jab, but as its rollout began later, there were not yet enough people who had received a second AstraZeneca jab to make a similar comparison.
The study also found the vaccines worked just as well in the over-75s and those with underlying health conditions as in the rest of the vaccinated population.
As viruses constantly mutate, new variants are a normal occurrence. In recent months scientists have discovered a number of these in the UK, which are now being referred to by Greek letters. The Delta variant (B.1.617.2), first identified in India, is causing most concern in the UK at the time of writing. Since being identified in the UK on 18 March, estimated numbers of infections have doubled every seven to 10 days.
Following concerns about the spread of the Delta variant, the Government has closed the gap between first and second vaccinations for the over-50s from 12 to eight weeks. This is good news, as the latest Public Health England data suggests two doses of either the Pfizer or AstraZeneca vaccines are “highly effective” against symptomatic disease from the Delta variant and are “likely to be even more effective at preventing hospital admission and deaths”. As yet, there is no equivalent data about the Moderna vaccine.
The Government has pledged to roll out a Covid-19 booster vaccine for the most vulnerable in the autumn, in order to protect them in time for winter, in much the same way as the UK’s flu vaccination programme.
It is not yet known how and where these boosters will take place, or what community pharmacy’s role will be. However, David Ashton from Abington Pharmacy in Northampton says: “It would be great if the manufacturers of flu vaccines are able to incorporate Covid boosters in with the annual flu jabs.”
As more vaccines are approved for use, pharmacy teams remain perfectly placed to answer customers’ concerns and tackle the spread of damaging misinformation.
Move over for Moderna
The latest vaccine to be rolled out in the UK is the two-dose Moderna vaccine, which became available in April of this year following its MHRA authorisation in January 2021. The UK has ordered 17 million doses.
This RNA vaccine introduces genetic material into the body, which contains the instructions to make the coronavirus’s spike protein. This will elicit an immune response. It can be stored for 30 days at normal fridge temperatures but can be stored for six months at -20˚C.
Moderna provides another alternative to the AstraZeneca vaccine for those aged 18-29 who are eligible for a jab, as per advice from the Joint Committee on Vaccination and Immunisation (JCVI).
The MHRA approved the one-dose Covid-19 vaccination developed by Janssen – the pharmaceutical arm of Johnson & Johnson – for use in the UK on 28 May 2021 for people aged 18 and over. This is the fourth Covid-19 vaccine to be authorised by the regulator and the first approved for protection against Covid-19 with a single dose. The UK has agreed a deal for 30 million doses for supply later in the year. “You must not forget you are an HCP, an ambassador and a public health champion,” says Dr Mahendra Patel, RPS Board member and Pharmacy Research Champion NIHR (Yorks and Humber). “Negative noise travels much quicker and has a bigger weighting than positive noise, and pharmacy has a duty to address that.”