COVID-19 vaccines which can be administered nasally are currently in early clinical trials. Any route to approval of such treatments will be subject to the developer seeking regulatory approval from the United Kingdom’s independent medicines regulator, the Medicines and Healthcare products Regulatory Agency.

Public Health England (PHE) publishes weekly COVID-19 vaccine surveillance reports which include the latest evidence on vaccine effectiveness against different outcomes. The following table shows the latest summary of evidence on vaccine effectiveness against different outcomes, including transmission, for Pfizer/BioNTech and University of Oxford/AstraZeneca as of 1 July.

Source: Table 3 https://www.gov.uk/government/publications/covid-19-vaccine-surveillance-report

Notes:

1. *High Confidence - Evidence from multiple studies which is consistent and comprehensive
2. **Medium Confidence - Evidence is emerging from a limited number of studies or with a moderately level of uncertainty
3. ***Low Confidence - Little evidence is available at present and results are inconclusive
4. ^effectiveness in reducing symptomatic secondary cases in households of a symptomatic index case

PHE plans to publish vaccine effectiveness data for Moderna when more evidence becomes available.

We received Public Health England’s full report on 12 June. The report was shared with all with all relevant Government departments and discussed with senior advisors.

Further work is underway to establish the level of protection COVID-19 vaccines provide against mortality from the Delta variant.

There are no delays in administering the Pfizer vaccine. We have clear plans in place with Pfizer to ensure sufficient supply of the vaccine throughout 2021 and to prevent any shortages. There has been a regular and steady supply of vaccine doses arriving into the United Kingdom since early December and we have sufficient doses to maintain our vaccination programme as it continues to accelerate, working closely with Pfizer to ensure vaccines keep arriving into the UK.

We have sufficient vaccines available to administer second doses for Moderna, Pfizer and AstraZeneca, in line with the Medicines and Healthcare products Regulatory Agency and the Joint Committee on Vaccination and Immunization) guidance. The decision to offer second doses from 8 weeks for cohorts 1 – 9 factored in that there was sufficient supply to honour the plan. There are no known issues around availability to deliver the first or second dose plan for any vaccine.

On 16 April 2021, the Joint Committee on Vaccination and Immunisation has advised that it is preferable for pregnant women in the United Kingdom to be offered the Pfizer/BioNTech or Moderna vaccines where available, as these vaccines currently have the most safety data for use in pregnant women. Since 13 May, pregnant women have been able to book their vaccine appointment through the National Booking Service and will be directed to centres offering Pfizer/BioNTech and Moderna.

The Medicines Healthcare and Regulatory products Regulatory Authority’s guidance on the authorisation of the Oxford/AstraZeneca vaccine, last updated on 15 April, provides advice on the authorisation conditions of the vaccine. Its contra-indications advice states that people who experienced blood clots with low platelet counts after their first AstraZeneca dose should not receive their second dose.

Mixing vaccines is not advised at this time, as evidence on the effects of mixing a two-dose schedule of vaccines is still emerging. Subsequently offering a two-dose schedule of a different vaccine to patients who experienced such blood clots is not advised as the effects of adding such a schedule are unknown. Those who experienced blood clots with low platelet counts from their first AstraZeneca vaccination should talk to their doctor.

The Joint Committee on Vaccination and Immunisation (JCVI) are the independent body made up of scientific and clinical experts who advise the Government on which vaccines the United Kingdom should use and provide advice on prioritisation at a population level.

The Government has accepted the JCVI's advice, updated on 19 April, which now indicates that women who are pregnant should be offered vaccination at the same time as non-pregnant women, based on their age and clinical risk group. Clinicians should discuss the risks and benefits of vaccination with the woman, who should be told about the limited evidence of safety for the vaccine in pregnancy. The Pfizer/BioNTech and Moderna vaccines are the preferred vaccines for pregnant women of any age, because of more extensive experience of their use in pregnancy. Pregnant women who commenced vaccination with Oxford/AstraZeneca are advised to complete with the same vaccine.

Pregnant women may wish to contact their general practitioner, who will identify the available vaccination centres where the person is able to receive the Pfizer/BioNTech or Moderna vaccines. If a woman finds out she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product unless contra-indicated. Alternatively, vaccination should be offered as soon as possible after pregnancy.

The Joint Committee on Vaccination and Immunisation (JCVI) are independent and advise the Secretary of State for Health and Social Care through published statements and letters on GOV.UK. The Secretary of State’s acceptance of their advice is also published on GOV.UK.

The information is not currently held in the format requested.

We have sufficient doses to maintain our vaccination programme. We are in constant contact with the vaccine manufacturers, including Pfizer, and remain confident that the supply of vaccine to the United Kingdom will not be disrupted. We are on track to meet our target to offer a vaccine to all adults by the end of July.

Vaccine supplies have already been set aside for everyone who has already received their first dose and there are currently no delays in the administration of the second dose of the vaccine. If an individual is invited for a COVID-19 vaccination via a general practitioner, a second vaccination appointment can then be offered to the patient in the following 12-week period.

Where a patient has been invited to book their own appointment, they will be required to book their second appointment in a time slot 11 to 12 weeks on from their first appointment. NHS England’s guidance states that all vaccination centres should ensure that all second dose appointments are booked in by the twelfth week.

The Government has not made an assessment of the named British Medical Journal report.

An independent assessment of the data from Israel, published by the Norwich Medical School, concluded that estimated vaccine effectiveness is zero 14 days after vaccination, this rose to about 90% at day 21, before levelling off. Further information is available at the following link:

www.medrxiv.org/content/10.1101/2021.02.01.21250957v1.full

The Joint Committee on Vaccination and Immunisation (JCVI) has not undertaken a specific assessment. The JCVI’s position is that there is high efficacy with the first dose of the Pfizer vaccine. The JCVI continues to advise two doses of the vaccine, with a three to 12 week interval.

Whilst there are currently no plans to change the dosage interval for the Pfizer/BioNTech vaccine, or for the other vaccine presently being deployed, this is kept under review.

This information is not currently available.

There is no data on the efficacy of the Moderna or Pfizer/BioNTech vaccine 12 weeks after the first dose. Given the high effectiveness and durability of responses to the first dose seen in United Kingdom data, it is not expected that protection will reduce rapidly after 12 weeks.

The Secretary of State for Health and Social Care regularly discusses a range of issues related to the pandemic with the Secretary of State for Foreign, Commonwealth and Development Affairs, including COVID-19 vaccines. Ministers and officials are regularly in discussions with other countries to share learning and collaborate internationally on the vaccination programme.

Updating the dosing interval is in line with the advice of the Joint Committee on Vaccination and Immunisation (JCVI). Whilst the National Health Service across the United Kingdom will prioritise giving the first dose of the vaccine to those in the most high-risk groups, everyone will still receive their second dose within 12 weeks of their first.   The JCVI’s statement on changing the dose interval is available at the following link:

www.gov.uk/government/publications/prioritising-the-first-covid-19-vaccine-dose-jcvi-statement/optimising-the-covid-19-vaccination-programme-for-maximum-short-term-impact

Due to the potential security risk, we are unable to provide details of companies delivering the vaccine.

There are no companies authorised to administer the COVID-19 vaccine. Only the National Health Service can offer and administer the vaccine.

The decision to extend the dosing interval to up to twelve weeks was based on advice from the Joint Committee on Vaccination and Immunisation (JCVI) and the United Kingdom’s four Chief Medical Officers (CMOs) and was designed to maximize the impact of the vaccination programme.

After studying all the available data, the JCVI concluded that the first dose of either Pfizer/BioNTech or Oxford/AstraZeneca vaccine provided substantial protection from severe COVID-19 disease within two to three weeks of vaccination.  Whilst the second vaccine dose is important to sustain the protection and extend its duration, in the short term the additional impact of the second dose is likely to be modest and most of the initial protection from clinical disease is after the first dose of vaccine.

The four UK CMOs agreed with the JCVI that prioritising the first doses of vaccine for as many people as possible on the priority list would protect the greatest number of at-risk people in the shortest possible time. The evidence underpinning the JCVI’s advice and the statement of the four CMOs can be found at the following links:

www.gov.uk/government/publications/prioritising-the-first-covid-19-vaccine-dose-jcvi-statement/optimising-the-covid-19-vaccination-programme-for-maximum-short-term-impact

www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-the-prioritisation-of-first-doses-of-covid-19-vaccines

This policy is compatible with guidance issued by the manufacturer. The Medicines and Healthcare products Regulatory Agency’s (MHRA’s) Information for Healthcare Professionals regarding the Pfizer vaccine states that the second dose should be given at least 21 days after the first dose. This advice is based on clinical trial data and other information submitted to the MHRA by the manufacturer.

The interim guidance for use of the Pfizer Vaccine, set out by the World Health Organization on 8 January 2021, was not available to assess when the decision to extend the dose interval in the UK was made on 30 December 2020. Different organisations will come to their own view as to the vaccination approach appropriate to their respective situations, and compatibility with the advice of external organisations or institutions is not a pre-requisite for approaches taken within the Government’s vaccine deployment programme.

The United Kingdom’s decision to delay the second dose of the Pfizer vaccine has been taken based on advice from the Joint Committee on Vaccination Immunisation (JCVI), as well as the Medicines and Healthcare products Regulatory Agency.

After studying the available data, it’s clear both vaccines provide substantial protection within two to three weeks of vaccination from severe COVID-19 disease. The Government is advised on the safety, efficacy and strategy for the vaccines by independent scientists including those from the JCVI and the Commission on Human Medicines Expert Advisory Group. While we are monitoring different countries’ vaccination plans and rollouts, the approach taken in the UK is based on the advice of the world’s leading clinicians and scientists.

Public Health England (PHE) has been monitoring the effectiveness of the vaccines. Early data has shown that the Pfizer vaccine is highly effective in reducing COVID-19 infections among older people aged 70 years old and over. Since January, protection against symptomatic COVID-19 four weeks after the first dose ranged from 57-61% for one dose.

PHE has also undertaken their first analysis of the early effects of COVID-19 vaccination using routine testing and vaccination data across England. This data, published in a pre-print on 1 March 2021, provides early evidence that a single dose of the Pfizer vaccine is having a significant effect on the reduction of COVID-19 infection, hospitalisations and deaths in those over 70 years old. The Pfizer vaccine was shown as approximately 60-70% effective, rising to 85-90% after two doses. This analysis is available at the following link:

https://khub.net/documents/135939561/430986542/Early+effectiveness+of+COVID+vaccines.pdf/ffd7161c-b255-8e88-c2dc-88979fc2cc1b?t=1614617945615

After studying all the available data, the Joint Committee on Vaccination and Immunisation (JCVI) concluded that the first dose of either Pfizer-BioNTech or Oxford/AstraZeneca vaccine provided substantial protection from severe COVID-19 disease within two to three weeks of vaccination.  Whilst the second vaccine dose is important to sustain the protection and extend its duration, in the short term the additional impact of the second dose is likely to be modest and most of the initial protection from clinical disease is after the first dose of vaccine.

The latest data from Public Health England, published on 1 March showed that  both the Pfizer and Oxford/AstraZeneca vaccines are highly effective in reducing COVID-19 infections among older people aged 70 years old and over. Since January protection against symptomatic COVID-19, four weeks after the first dose, ranged between 57 and 61% for one dose of Pfizer and between 60 and 73% for the Oxford/AstraZeneca vaccine.

No specific assessment has been made.   The decision to extend the dosing interval to up to twelve weeks was based on advice from the JCVI and United Kingdom’s four Chief Medical Officers.