Changing vaccination policies is a high-stakes game

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According to the manufacturer of the Pfizer/BioNTech vaccine, its effectiveness was only tested for two doses, three weeks apart. The suggestion that a single dose is protective after three weeks is therefore hypothetical (Covid vaccine: chief medical officers defend rescheduling of second doses, Dec. 31).

If they do not receive protection as a result, it would be truly devastating to vaccinate millions of recipients with the Pfizer/BioNTech vaccine (at significant effort and financial cost), with a twelve-week period between doses. It is worth remembering that there is possibly a link between antibody response and infection protection. In order to verify the amount of neutralizing antibody present four weeks after the first dose, subjects who have already received two doses could therefore be required to give a small blood sample.

To check their levels at the four-week time point, recipients whose second dose was delayed after Jan. 4 should give a similar sample starting on Jan. 11.

This could be explained by a relatively limited number of volunteers (perhaps 20 or 30 in each group). If there is little to no difference between the two classes, we should applaud our representatives on their acumen and continue with the new dosing plan, with additional possibilities over time to track the levels of antibodies and the occurrence of infection in both groups. On the other hand, there will be an opportunity to return to the three-week schedule and make up for what could otherwise turn out to be a horrible mess if a single dose does not yield a comparable neutralizing antibody response. Grizelda GeorgeOxford- There is the question of consent, far apart from the huge administrative work that will fall on family practices due to the shift in vaccination policy.

In my practice, after a series of questions from a psychiatrist, those who got their first dose of the vaccine were asked for their approval. This was administered on the basis of the knowledge that three weeks later, on a specified date, a second dose would be given.

Since Pfizer/BioNTech says their knowledge is based on a 21-day booster vaccine, who is liable if something goes wrong? While I support the idea behind the move, it would surely have been better to proceed with the second dose dates collection, given that the number of recipients is relatively small to date? Having seen the administrative challenge involved as a member of my practice’s patient participation program, I can not imagine how the workers would feel when they are already under pressure.

My sympathies are with them; there seems to be little comprehension of this aspect by those at the top. Jan MortimerLewes, East Sussex- I do not see how the newly implemented strategy of delaying the second dose for people receiving the Covid vaccinations is meant to raise the trust of people in the immunization program. On the contrary, they possibly could not have done better if the government and the NHS decided to weaken trust in the program…. Even with continued precautions by Covid 19, people who are at risk or have protected themselves are unlikely to feel safe and may prefer to hide indoors. Others may decide that it is not worth the vaccine, or feel emboldened to spread the word that it is not working. We don’t have the confidence that frontline staff are properly covered at high risk of infection. It seems as if the situation in the NHS is now so severe that even our scientists are panicking and not following the research.

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