Covid vaccine: UK doctors criticize rescheduling of two doses physicians

Plans to delay the administration of the second dose of Covid vaccine to more than 500,000 people who received the first shot have sparked outcry among doctors who say canceling appointments is wasting time, confusing patients and potentially unethical.

On Wednesday, the government announced a change to its Covid vaccination strategy, saying the second dose of the newly approved Oxford / AstraZeneca vaccine and the previously approved Pfizer / BioNTech vaccine will now be given up to 12 weeks after the first dose.

The move applies to people scheduled to have a second dose of Pfizer jab after January 4, as well as those who have not received any jab. The government said it hoped the approach would mean as many people as possible would soon have some protection against the disease.

However, the announcement sparked controversy, with Pfizer and BioNTech warning that two doses of their vaccine were needed for maximum protection against Covid and that there was no evidence that the first single dose provided protection after three weeks.

Now, doctors have said that canceling appointments for the second dose will take a long time and could lead to confusion.

Azeem Majeed, a professor of primary care and public health at Imperial College London and a practicing family doctor, said he was shocked by the change in plans.

“We have thousands or maybe tens of thousands of people who have already booked their second jab, and these are people who are all elderly, so they often have to make special arrangements for their care or have someone to take care of them. get down. Someone will have to call all these patients to cancel their appointments and reload them, so it will create a lot of work for people as well, “he said.

“Clearly, people who make these rules do not have to apply them. I understand why the government wants to increase the supply of vaccines to make sure more people are immunized, but I think it could have been done for people from now on, rather than canceling those who have already been vaccinated. book, which is very disturbing. “

A doctor who spoke to the Guardian on condition of anonymity said he hoped to continue with the initial schedule for the second dose, rather than cancel appointments, saying that if he did otherwise, he would put the most vulnerable patients in danger. and breaks promises to patients.

The British Medical Association said it was “unreasonable and totally unfair” to expect practices to cancel and replenish appointments for the second dose.

The chairman of the BMA’s GP committee, Dr. Richard Vautrey, said: “It is grossly and obviously unfair for tens of thousands of our most at-risk patients to now try to reschedule their appointments. Local leaders tell us that it is unprofessional and impractical to change appointments for thousands of frail elderly patients, especially those who are reserved and who have already made arrangements to have their second vaccination in the next two weeks. ”

Vautrey called on the government to publish a scientifically validated justification for the new approach, adding that relocating reservations would cause huge logistical problems. “For example, to get in touch with even just 2,000 elderly or vulnerable patients, you will need a team of five employees in an office for about a week, and this is simply unbearable. The BMA believes that the existing commitment made by these patients by the NHS and local clinicians should be respected. If family doctors decide to honor these bookings in January, the BMA will support them. “

Dr Helen Salisbury, a family doctor and health adviser to the Oxford University Health Research Group, wrote on Twitter that Health Secretary Matt Hancock should help her elderly patients’ phones and explain to them why. which delayed the second jab. She said her primary care network needs to cancel and reinstate 1,160 appointments.

“At 5 minutes on a phone call, that means 193 hours of work. Not to mention the pain and anger. ” she wrote.

Salisbury asked the General Medical Council To advise. “I have been instructed to break my promise to my elderly patients and to use a vaccine outside the highlighted and approved schedule, probably putting them at risk. Please advise.”

Her comments sparked a lot of responses from other family doctors, with some wondering if it was ethical to delay the second dose when patients gave their consent for the first dose on the premise that they would receive the second three weeks later. .

However, others welcomed the change of approach. Dr. Ed Turnham, a Norwich family physician, said the Medicines and Medicines Regulatory Agency should be congratulated for his “courageous, pragmatic decision.”

He posted on Twitter: “I think most of our elderly patients will be happy that this will reduce the delay in protecting friends and relatives and reduce the risk of hospitals being overwhelmed.”