• Thursday, April 25, 2024

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How the UK is conducting its immunisation drive

By: Manju Chandran

Dr FARZANA HUSSAIN ANSWERS IMPORTANT QUESTIONS ABOUT THE COVID-19 VACCINE AND HOW IT CAN HELP US GET LIFE BACK ON TRACK

FRONTLINE healthcare staff and the elderly were among the first group of people to receive the Covid-19 vaccine as the UK began its immunisation drive on December 8.

The vaccine approved for use in the UK was developed by Pfizer-BioNTech. It has met strict standards of safety, quality and effectiveness set out by the independent Medicines and Healthcare products Regulatory Agency (MHRA).

After getting both doses of the vaccine most people will be protected against coronavirus. It takes a few weeks after getting the second dose for it to work.

The vaccine is safe and effective and offers the best protection against coronavirus.

Dr Farzana Hussain

Dr Farzana Hussain is a GP at Project Surgery in Newham, London. She answers key questions about the coronavirus vaccine.

1. How does the coronavirus vaccine work?
The Covid vaccine has a little bit of the shell of the virus inside. It’s not the whole virus, but a tiny little protein from the shell of the virus, which when injected into our body will enable it to make up that defence that we call immunity. That’s how we build the immunity to the real virus.

2. How many doses or booster shots are needed? What is the time gap between two booster shots?
At the moment, it’s two doses and they are taken three weeks, i.e. 21 days, apart.

3. Are there any side effects which would require people to stay off work? 
Studies show that, like other vaccines, there may be a little bit of muscle pain or you might get fever-like symptoms as with the flu vaccine. We are not seeing anything else. Some people, and that’s with the flu vaccine as well, will get a fever; like you would with a cold. And if you are not feeling well, you may want to stay off work. Generally speaking, we would not want people to stay off work because of the vaccine.

4. Can the person who has been vaccinated go about their normal lives soon after being vaccinated?
After people have been vaccinated, as long as they don’t have a fever or pain they can go about their lives as normal. The vaccine does not make recipients infectious. They can do everything they want to.

5. What happens if there is an adverse reaction to the vaccine?
Depending on what it is, if there’s a little bit of pain where the needle has gone in, you may want to take a couple of paracetamol and rest. But if the fever is very high and if you are concerned about anything, consult your GP.

6. Should people who have underlying health problems be concerned about taking the vaccine?
The Asian community – which has greater underlying issues such as diabetes, breathing problems or chronic obstructive pulmonary disease (COPD) – is far more at risk of contracting Covid. So, they should come forward and take the vaccine when they receive a notification from the NHS.

7. Do comorbidities in a recipient hinder the efficiency of a vaccine?
I know Covid is new, but there’s been nothing in vaccines in the past to show that comorbidities have made a difference.

8. Would you recommend a family gets its vaccine at the same time or do older people get it first and the youngest remain last in the queue?
The oldest will get it first and the youngest, last. That is really because of the vaccine distribution factor. We want to save our most vulnerable first. So, health and social care workers are prioritised first, then the over 80s, then over 70s and so on.

9. If people can’t get out of the house, can they be vaccinated at home?
Absolutely.

10. Are there any dos and don’ts once a person has been vaccinated?
No, there are no dos and don’ts, but do continue with all the other measures such as social distancing, wearing masks and washing hands. Let’s not forget that those are still very important.

11. How long is the vaccine effective against the coronavirus?
Since coronavirus hasn’t been around for very long, we just don’t know the answer to that yet. 12The quick turnaround of making the vaccine has been very encouraging.

12. How do you assure people that the vaccine is safe?
It has been a remarkable breakthrough in the scientific community. Often, the delay occurs because of licensing issues and not because of safety testing. So, I am personally very confident that safety testing has been as good as any other vaccine. The public can be assured that safety has not been compromised in turning this around so quickly.

13. Does the vaccine have ingredients that might be incompatible with the religious requirements of some people?
The Covid vaccine does not have any traces of pig or foetuses.

14. Dr Chand Nagpaul from the British Medical Association (BMA) has pointed out that BAME communities have a lower life expectancy than their white counterparts. In his view, priority should be given to BAME communities. London mayor Sadiq Khan has emphasised that BAME Londoners should also be given the vaccine as a priority. What do you think?
We do know that BAME people have been certainly more affected. But the biggest risk factor for dying from this Covid virus is still age related. Ideally, the groups being recommended by age – regardless of ethnicity – is still the best and safest way to carry out immunisation. Obviously, there will be an overlap – such as where I am working in Newham, because 73 per cent of the population are ethnic minorities. But we need to think about who’s most at risk and how many lives we can save quickly with this vaccination.

15. How can messaging related to the vaccine be culturally competent?
We have to ensure the (immunisation) messages are out in different languages other than English. But I am aware that the BAME community has a bit more resistance and concern regarding the side effects of this vaccine. So, the messaging has to emphasise how safe the vaccine has been during trials and how effective they seem to be. I have not seen so far anything that makes me think that I would not want to take the vaccine myself.

16. Were there any specific side effects noted among British Asians during the vaccine trials?
Nothing has come out in the licensing (on the information we have so far) to say that the BAME community is more at risk or will have certain side effects. We have not been told anything in the
medical profession about it.

17. How many people will have to be vaccinated before we consider the community not at extra risk? How quickly could this potentially happen?
It is a new vaccine. So, we do not know if there will be herd immunity. Certainly, for other diseases – like child immunisation that protects against polio – we look at 92 per cent. We do not know if that will be the case for this vaccine.

How quickly can it happen? It depends on many factors, such as the supply of vaccination and the level of uptake. That is why we are going with the most vulnerable ones first. We hope that by April 2021 a proportion of the population will be vaccinated. We need the BAME community to come forward and be vaccinated.

18. How will the vaccine be distributed? How will people be given the vaccine?
Currently, the Pfizer vaccination has to be stored at minus 70 degrees (-70°C). That is one of the reasons why we, as the GP community, are not doing this as per normal practice.

This is the biggest mass vaccination I have seen in my lifetime. We, at the GP and local pharmacy, know our patients well. I run a practice with 5,000 patients, and I know some of them very well. So, it is about encouraging them.

We will be part of a group of practices (67,000 people), and vaccine will be delivered to one site in every single borough. We will all then go to that one site to immunise our patients from there. Vaccines will come to that site and we will all be working extra hours, seven days a week, 8am-8pm, so that people can come in and get vaccinated. There is going to be a national notification system by the government, and we can also do local callings such as GP letters and texts.

19.Will you yourself get the vaccination? Would you advise your family members of all ages to have it too?
I will be offered the vaccine as a healthcare professional and I will be taking it. My children are teenagers, so they will be very low in priority because they are fit and healthy. But when they are offered, definitely (they will take it).

20. If a person gets a flu shot, what is the time gap between getting the flu jab and the virus vaccine?
There should be a time gap of full seven days in between both shots.

21. Is the vaccine compulsory by law? If it is compulsory, who will keep a track of those vaccinated and those who are not?
The vaccine is not compulsory by law. But we would hope people would use their common sense and come forward to take the vaccine.

22. Is the vaccine for UK residents only or can visitors from overseas avail of it?
Anybody entitled to NHS treatment as residents would be eligible to, even if they have been away for a while. Generally, visitors who are allowed to stay under six months in the UK will not be eligible for the vaccine.

23. Can we have a vaccine that is 100 per cent effective?
I know we are seeing the early studies of the coronavirus vaccine, but I have never known a vaccine that is 100 per cent effective.

24. Do you think vaccination means we can go back to living normally, back to our old lives?
That’s the hope. However, when that will happen is still an unanswered question. It depends on how long the vaccine lasts for and how many people get vaccinated. I don’t think that we should get complacent about face masks and hand washing as well as social distancing. Letting fresh air into homes regularly is also important. But certainly, that is the hope and ambition of this vaccination programme. I certainly think this vaccine will be lifesaving and I hope it will help us get back to normality in the future.

Pfizer-BioNTec Covid-19 vaccine – Guidance on managing allergic reactions
THE MHRA advises that any person with a history of immediate-onset anaphylaxis to a vaccine, medicine or food should not receive the Pfizer-BioNTech vaccine. Anyone due to receive their vaccine should continue with their appointment and discuss any concerns or medical history of serious allergies with the healthcare professional prior to administration.

Advice for breastfeeding and pregnant women
THE Pfizer-BioNTech Covid-19 vaccine has not yet been assessed in pregnancy, and so it has been advised that until more information is available, those who are pregnant should not have this vaccine.

Evidence so far reviewed by the MHRA raises no concerns for safety
in pregnancy. However, because of the new formulation of this particular vaccine, the MHRA wants to see more non-clinical data before finalising the advice in pregnancy.

It is standard practice when waiting for such data on any medicine to avoid its use in those who may become pregnant or those who are breastfeeding. This will be kept under review as more evidence becomes available.

Here are the key points you should consider until we have more evidence:

  • if you are pregnant you should not be vaccinated – you can be vaccinated after your pregnancy is over
  • if you think you may be pregnant you should delay vaccination until you are sure you are not
  • if you are planning to get pregnant in the next three months you should delay your vaccination
  • if you know you are not pregnant you can start the two-dose course now and you should avoid getting pregnant until at least two months after the second dose
  • if you have had the first dose and then become pregnant, you should delay the second dose until after the pregnancy is over
  • If you are breastfeeding you should wait until you have finished breastfeeding and then have the vaccine. If you were breastfeeding when you had the first dose, you are advised not to have the second dose until you have finished breastfeeding. This advice is precautionary until additional evidence is available to support the use of this vaccine in pregnancy and breastfeeding. It may then be possible to have the Pfizer-BioNTech vaccine. Until that advice is changed, you may be able to have one of the other Covid-19 vaccines that are expected.

The covid-19 vaccine is being made available across the UK starting with those most in need. When it’s your turn, you will be invited by the NHS to book an appointment to get one

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