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Too early to know if UK Covid revaccination scheme needed, says Van-Tam

<span>Photograph: John Sibley/AFP/Getty Images</span>
Photograph: John Sibley/AFP/Getty Images

It is too early to know if a flu-like revaccination programme will be needed to combat Covid-19 in the future, Prof Jonathan Van-Tam, England’s deputy chief medical officer, has said.

However, it was important to have further vaccines available in case revaccination was required, he said.

“It is really unknowable at this point. But it is very much something that I see now as one of the goals only just over the horizon to get my head around, what if – and if – we will at any point in the future need to think about revaccination,” he told the BBC.

The UK has became the first country in the world to give the go-ahead for the Pfizer/BioNTech jab after approval by the Medicines and Healthcare products Regulatory Agency (MHRA), with vaccinations due to be rolled out next week.

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Van-Tam stressed it would be a challenge to get them into care homes, as the vaccine needed to be kept at -70C and can be exposed to warmer temperatures only under strict conditions and for a limited time.

Every effort would be made to get it to elderly care home residents, he told the BBC, but there were considerable constraints. “It’s not just about that when you thaw a batch from -70C to a normal domestic fridge-type temperature that you’ve then got five days in which you can use the vaccine, it’s about the number of times you open the door and take the vaccine out of the fridge. So that really makes it quite a challenge. If we can get into care homes then we absolutely will.”

He stressed it was also too early to say when the vaccine programme would enable restrictions to be lifted. If a point was reached where the NHS was managing in a much more normal way than at present, politicians had the option to think about what could be done next to make life more normal for people, he said.

“It’s not my job to give you a magic number here or a magic calendar date because so much depends on how quickly the vaccine programme is rolled out, whether the people called forwards for the vaccine accept it.”

Now that the UK has authorised the first Covid vaccine, who will get it first?

The government’s Joint Committee on Vaccination and Immunisation (JCVI) says its priority is to prevent Covid-related deaths and protect health and social care staff and systems.

Elderly care home residents and their carers are first on the JCVI’s list because their risk of exposure to the virus is higher and because the risk of death closely correlates with older age. They are followed in priority by anyone else over 80 and frontline health and social care workers.

Even so, for pragmatic reasons NHS staff are likely to be the first group to receive the Pfizer/BioNTech jab. This is because the vaccine needs to be stored at ultra-cold temperatures, which can be achieved more easily by using hospital facilities

Are there enough doses to reach all the priority groups?

Together, care home residents, their carers and the over-80s make up nearly 6 million people, and frontline NHS staff a further 736,685. Matt Hancock, the health secretary, has said he expects 10m doses of the Pfizer/BioNTech vaccine to be available this year, so if this is the only vaccine authorised, everyone else would have to wait until further doses become available next year.

Where will I go for the vaccine?

Covid-19 vaccines are expected to be delivered at three types of venue: NHS trust “vaccine hubs” at hospital sites; mass vaccination centres, which are in the process of being set up at places such as football stadiums, conference buildings and racecourses – these are expected to vaccinate up to 5,000 people a day; and at GP surgeries and pharmacies. GPs can also visit care home residents and housebound patients at home without them needing to travel.

How far apart will the two doses be administered, and will I protected after the first?

While there is some evidence to indicate high levels of short-term protection from a single dose of vaccine, a two-dose schedule is what has been approved by the MHRA.

The second dose will need to be delivered at least 21 days after the first, and both will be injected into the deltoid muscle – the thick triangular muscle we use to raise each arm.

For the Pfizer vaccine, its efficacy rate was calculated seven days after the second shot. It is likely that people will have some protection before this, but this is how long it will take for full protection to kick in. We will learn more about the extent of protection and how long it lasts as data from ongoing clinical trials comes in.

Can I pay to get the vaccine privately?

Unlikely. England’s deputy chief medical officer, Jonathan Van-Tam, has said he believes Covid-19 vaccines should be delivered according to clinical priority rather than allowing people to jump the queue if they can afford it.

Will I be able to choose which vaccine I have?

Also unlikely, at least in the short to medium term. Assuming more than one vaccine is approved, the priority will be distributing any available doses to the people who need it as quickly as possible.

Linda Geddes

Even after people were vaccinated, he added, they would not be able to return to normal life immediately, and rules would need to apply until there was proper confidence the vaccine had worked and disease levels were dropping.

On the question of vaccination certificates, which could make it easier for people to access services and venues, he said he could not give any firm information at present, but said the NHS would have a clear digital record of who had been vaccinated.

Reassuring those with anxieties about the vaccine, he said he was confident enough in the jab that he had told his 78-year-old mother she must have it.

“I genuinely have said to my 78-year-old mum, who’s probably listening now: ‘Mum, you must have this vaccine, or any of the vaccines that the MHRA approves as soon as they are available. This is really important, because you are so at risk.’

“So that’s a kind of personal piece, if you like. I’m very confident in the assessments the MHRA makes.”