Doctors seek review of UK’s 12-week gap between vaccine doses

LONDON — A major British doctors’ group says the UK government should “urgently review” its decision to give people a second dose of the Pfizer-BioNTech coronavirus vaccine up to 12 weeks after the first, rather than the shorter gap recommended by the manufacturer and the World Health Organization.

The UK, which has Europe’s deadliest coronavirus outbreak, adopted the policy in order to give as many people as possible a first dose of vaccine quickly. So far almost 5.5 million people have received a shot of either a vaccine made by US drugmaker Pfizer and Germany’s BioNTech or one developed by UK-Swedish pharmaceutical giant AstraZeneca and Oxford University.

AstraZeneca has said it believes a first dose of its vaccine offers protection after 12 weeks, but Pfizer says it has not tested the efficacy of its shot after such a long gap.

Pfizer says its vaccine is around 52% effective after the first dose, and increases to about 95% a number of days after the second dose. The company tested the vaccine with the two doses 21 days apart.

In Israel, coronavirus czar Nachman Ash had questioned the effectiveness of the vaccine after just one dose and suggested that a first shot of Pfizer’s vaccine may provide less protection than the firm initially indicated. He also cautioned that the vaccine may not protect against new strains of the virus. Ash’s comments were later walked back by the Israeli Health Ministry which said the comments were “out of context and not accurate.”

Israel’s coronavirus czar Prof. Nachman Ash visits the Ziv hospital in Safed, December 24, 2020 (David Cohen/Flash90)

Israel is currently leading the world in vaccination on a per capita basis, according to the Oxford-based Our World in Data. Close to 2.5 million Israelis have been given the first Pfizer dose with over 900,000 receiving the 2nd after the recommended 21-day gap, according to Health Ministry figures as of Saturday.

More than a month into Israel’s vaccination campaign, Health Ministry officials had hoped to see a dramatic drop in daily infections and serious cases, but there is no such trend at this time. The more contagious virus variants — particularly the British strain — are being blamed for the difficulty in bringing down illness rates and easing the heavy load on hospitals, despite the lockdown and mass vaccinations.

A medical worker prepares a COVID-19 vaccine at a Clalit vaccination center in Jerusalem, on January 21, 2021. (Photo by Yonatan Sindel/Flash90)

According to the ministry, 7,316 new cases were confirmed Friday, after peaking at over 10,100 earlier in the week. Along with another 1,632 cases since midnight, the total number of infections recorded in Israel reached 593,578.

The death toll stood at 4,326, with 81 new fatalities recorded Friday.

Growing concern

The British Medical Association on Saturday urged England’s chief medical officer to “urgently review the UK’s current position of second doses after 12 weeks.”

In a statement, the association said there was “growing concern from the medical profession regarding the delay of the second dose of the Pfizer-BioNTech vaccine as Britain’s strategy has become increasingly isolated from many other countries.”

“No other nation has adopted the UK’s approach,” Dr. Chaand Nagpaul, chairman of the BMA council, told the BBC.

He said the WHO had recommended that the second Pfizer vaccine shot could be given up to six weeks after the first but only “in exceptional circumstances.”

“I do understand the trade-off and the rationale, but if that was the right thing to do then we would see other nations following suit,” Nagpaul said.

People wait after receiving their Pfizer-BioNTech vaccination at Salisbury Cathedral in Salisbury, England, Wednesday, Jan. 20, 2021. (AP/Frank Augstein)

Yvonne Doyle, medical director of Public Health England, defended the decision as “a reasonable scientific balance on the basis of both supply and also protecting the most people.”

Researchers in Britain have begun collecting blood samples from newly vaccinated people in order to study how many antibodies they are producing at different intervals, from 3 weeks to 24 months, to get an answer to the question of what timing is best for the shots.

The doctors’ concerns came a day after government medical advisers said there was evidence that a new variant of the virus first identified in southeast England carries a greater risk of death than the original strain.

Chief Scientific Adviser Patrick Vallance said Friday “that there is evidence that there is an increased risk for those who have the new variant,” which is also more transmissible than the original virus. He said the new strain might be about 30% more deadly, but stressed that “the evidence is not yet strong” and more research is needed.

Research by British scientists advising the government said although initial analyses suggested that the strain did not cause more severe disease, several more recent ones suggest it might. However, the number of deaths is relatively small, and fatality rates are affected by many things, including the care that patients get and their age and health, beyond having COVID-19.

Britain has recorded 95,981 deaths among people who tested positive for the coronavirus, the highest confirmed virus toll in Europe.

The UK is in a lockdown to try to slow the latest surge of the virus, and the government says an end to the restrictions will not come soon. Pubs, restaurants, gyms, entertainment venues and many shops are closed, and people are required to stay largely at home.

The British government is considering tightening quarantine requirements for people arriving from abroad. currently, travelers must self-isolate for 10 days, but enforcement is patchy. Authorities are considering requiring arrivals to stay in quarantine hotels, a practice adopted in other countries, including Australia.

“We may need to go further to protect our borders,” Prime Minister Boris Johnson said Friday.