Q. Do I have a choice about what COVID vaccine I’ll receive?
A. The vaccine you will be offered will be dependent largely on the supplies available from the manufacturers and the logistics of the roll out of the COVID vaccine programme.
Q. Should I contact my immunology centre or GP about getting the COVID vaccination?
No, all services are over stretched. Wait to be contacted by the NHS, your NHS number is being used to track people wherever you are vaccinated. In some areas you will be contacted by a Hub not your own GP, but they will contact you. Your immunology centre will not have any vaccine and will not have a means to liaise with the vaccination hubs.
Q. Who will let me know when I can get the COVID vaccine?
A. The NHS is working through a priority list as set out by the Joint Committee on Vaccination and Immunisation (JCVI). You SHOULD NOT contact the NHS or your local GP surgery about the COVID vaccination.
The NHS will let you know when it is your turn to have the vaccine. This will be in the form of a letter/email from your GP or the NHS. It will include all the information you need to book appointments, including your NHS number.
** PLEASE NOTE : Do not respond to texts, emails or messages that are not from your GP/NHS or that ask for personal details including bank details – there are a number of scams using COVID vaccination to get peoples’ details. You will either be sent an appointment or there will be a web booking system, but you will not have to enter personal details **
Q. Can I be vaccinated if I have had a severe allergy?
A. The Pfizer vaccine is not recommended for people who have had anaphylaxis (severe allergic reaction) to drugs, vaccines or food. It is still recommended when there is a history of allergy without anaphylaxis, but this would be discussed with you.
Every person attending for vaccination will be asked.
If you cannot have the Pfizer vaccine, you will be added to a wait list for the Astra-Zeneca vaccine.
Q. Do I need to be registered with a GP to get the vaccine?
A. To get the vaccine, you will need to be registered with a GP surgery. If you aren’t you will have to get registered or wait until the vaccine is offered more widely at other locations.
Q. Can I have pay for a private COVID vaccination?
A. COVID vaccines will ONLY be available through the NHS.
Q. It is good news about the RNA based vaccine, developed by Pfizer and BioNTech indicates, but is this suitable for people with CGD and X-linked carriers?
A. There is no reason to believe that people with CGD and X-linked carriers wouldn’t have a normal vaccine response but this vaccine represents a new class of vaccine which relies on translation of injected mRNA into SARS CoV 2 spike protein and for the protein to then be presented to the immune system by antigen presenting cells. Ultimately it will be important to have evidence of vaccine immunogenicity in patients with NADPH oxidase defects.
Q. Are any of the vaccines being developed for COVID, live vaccines?
A. None of the COVID vaccines being developed are live. It is important to emphasise that CGD patients, and carriers, where advised medically, should receive all vaccines except those specifically contraindicated (e.g., live BCG, live Salmonella). Particularly regarding the different types of COVID vaccine (and flu vaccines), they are not contraindicated.
Q. How much do we know about the vaccines recently in the news?
A. Pfizer/BioNtech and Moderna have recently announced highly successful interim results from their COVID-19 vaccines trials, and results from other vaccine trials are expected soon.
Interim findings from Pfizer/BioNtech indicate their RNA vaccine is 90% effective in preventing COVID-19. Two doses are needed to give protection.
The vaccine has been tested on 43,500 people in six countries and no safety concerns have been raised. However, the data presented is not the final analysis as it is based on only the first 94 volunteers to develop COVID so the precise effectiveness of the vaccine may change when the full results are analysed. On the 23rd November the Medicines and Healthcare products Regulatory Agency (MHRA) approved the use of this vaccine for a mass vaccination programme.
The Moderna trial involved 30,000 people in the US and the analysis was based on the first 95 to develop COVID-19 symptoms. Two doses are needed to give protection. Only five of the COVID cases were in people given the vaccine and 90 were in those given the placebo treatment. The company says the vaccine is protecting 94.5% of people. The data also shows there were 11 cases of severe COVID in the trial, but none happened in people who were immunised.
The Oxford University/AstraZeneca vaccine uses a modified, inactivated cold virus to carry the genetic information of COVID into the body to get the immune system to mount a response. Early data from the clinical trials suggests it is safe and could protect up to 70% of people. There is good data that it will work in elderly people. The vaccine does not need to be shipped or stored in an ultra-cold environment, it is also considerably cheaper than the Pfizer/BioNtech and Moderna vaccines.
There are some unknowns about the vaccines, for example, we do not know if the vaccine stops you spreading the virus or just from developing symptoms; or if it works equally well in high-risk elderly people. We also do not know how long the immunity will last and this question will only be answered by long-term follow up studies.
Q. Have any of the vaccine trials involved people with CGD or other primary immunodeficiencies?
A. We do not know precisely the mix of people who have taken part in the clinical trials but people affected by immunodeficiency would not be eligible to take part in a vaccine trial in the way that they are conventionally set up.
Q. Is there any evidence about the effectiveness of the RNA vaccines for primary immunodeficiency patients?
A. In short, no, because these patients haven't been enrolled in the trials. Our experience to date of COVID-19 infection suggests that the antibody response is at least as important as T-cell responses for clearing this virus. The pre-clinical vaccine trial data suggests that antibody is essential for preventing primary infection. There will be more research data available about this over the coming months.
Q. How safe are the vaccines and who will monitor their safety?
A. All vaccines undergo extensive safety testing and must meet exacting standards to progress through the different stages of clinical trials. Their use must be approved and licensed before their use through expert review of all trial data through the Medicines and Healthcare products Regulatory Agency (MHRA). They check that the trial meets the necessary efficacy and safety levels. You can find out more about this process at http://vk.ovg.ox.ac.uk/vaccine-development
Q. When will we know if the vaccines are working for the general population?
A. The government is keeping tabs on infection by age and location. We should start to see a fall in cases and hospitalisation in those groups targeted by the vaccine first within 2 months of the vaccination roll-out.
Q. How will the safety of the vaccines be monitored after the vaccination programmes start?
A. The safety of the vaccines will be monitored on an ongoing basis, as with all licensed drugs. This is undertaken by the Medicines and Healthcare products Regulatory Agency (MHRA) through the Yellow Card Scheme. Reports of suspected side effects are sent to the MHRA by drug companies (who are obliged to pass on any reports of suspected side effects that are defined as serious), health professionals, and patients themselves.
The data are evaluated each week, and the reported side effects are compared against the expected side effects as detailed in the information sheet for the vaccine. If a previously unidentified reaction emerges, or the frequency of reactions is not in line with what is expected, then the MHRA will investigate carefully. What happens next depends on the kind of side effect identified, but options include insisting that details of the new side effect are given in the product information leaflet or giving out warnings identifying groups of patients who should not be given the vaccine. In rare circumstances, the vaccine may be withdrawn from use.
Q. Who decides on the priority list for a COVID vaccination programme?
A. The Joint Committee on Vaccination and Immunisation (JCVI) provides advice to the Government about this. They examine data on who suffers the worst outcomes from coronavirus and who is at highest risk of death. More information can be found at https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-25-september-2020
Q. Who will be prioritised for the COVID vaccination programme?
A. Age is, by far, the biggest risk factor for COVID so older age groups will be targeted first.
The current JCVI guidance says the order of priority would be as below:
This priority list is as follows:
- residents in a care home for older adults and their carers
- all those 80 years of age and over and frontline health and social care workers
- all those 75 years of age and over
- all those 70 years of age and over and clinically extremely vulnerable individuals
- all those 65 years of age and over
- all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- all those 60 years of age and over
- all those 55 years of age and over
- all those 50 years of age and over
It is estimated that taken together, these groups represent around 99% of preventable mortality from COVID-19.
Q. How long will it take for herd immunity to COVID-19 to develop within the UK population?
A. Herd immunity usually requires 60-70% of the population to have had the infection or be vaccinated, so in the UK that is approximately 40 million people.
Q. Will the vaccines stop the spread of COVID?
A. It is unlikely that a vaccination programme will be able to fully stop the spread of the COVID virus unless we see high level uptake of a highly effective vaccine. The disease may well become endemic in the global population like flu and have to be managed on a yearly basis through vaccination programmes. This means that everyone, and most importantly those clinically vulnerable should continue to take measures to protect themselves from catching the virus.
Q. How can I find out more about the development of COVID vaccines and vaccination programmes?
A. These websites may be helpful: