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Plans to delay the administration of the second dose of a Covid vaccine to more than 500,000 people who have received the first shot have sparked outrage among doctors who say that canceling appointments is a waste of time, causes confusion among patients and is potentially unethical.
On Wednesday, the government announced a change to its vaccination strategy against Covid, saying that second doses of the recently approved Oxford / AstraZeneca vaccine and the previously approved Pfizer / BioNTech vaccine will now be administered up to 12 weeks after the first dose.
The measure applies to people scheduled to receive their second dose of the Pfizer jab after January 4, as well as those who have not yet received it. The government said it hoped the approach would mean that as many people as possible soon have some protection against the disease.
However, the announcement caused controversy, with Pfizer and BioNTech warning that two doses of their vaccine were required for maximum protection against Covid and that they had no evidence that the first dose alone offered protection after three weeks.
Now doctors have said that canceling appointments for the second dose will take a great deal of time and could lead to confusion.
Azeem Majeed, a professor of primary care and public health at Imperial College London and a GP, said he was surprised by the change in plans.
“We have thousands or maybe tens of thousands of people who have already booked their second jabs, and they are all older people, so they often have to make special arrangements for their care or have someone take them down. Someone will have to call all these patients to cancel their appointments and rebook them, so it will also create a lot of work for people, ”he said.
“Clearly, the people who create these rules are not the ones who have to enforce them. I understand the rationale for the government wanting to increase the supply of vaccines to make sure more people are immunized, but I think that could have been done for people from now on, rather than canceling those who have already been enrolled, which It’s very important. disruptive.”
A doctor who spoke to The Guardian on condition of anonymity said they hoped to continue the original schedule for the second dose rather than cancel appointments, and said doing otherwise would put their most vulnerable patients at risk and break promises to them. patients.
The British Medical Association said it was “unreasonable and totally unfair” to expect the practices to cancel and re-book appointments for a second dose.
BMA GP committee chair Dr. Richard Vautrey said: “It is blatantly and grossly unfair to tens of thousands of our highest risk patients to now attempt to reschedule their appointments. Local leaders tell us that it is unprofessional and impractical to reschedule appointments for thousands of frail elderly patients, particularly those who have booked and have already arranged to receive their second vaccination in the next two weeks. ”
Vautrey asked the government to publish a scientifically validated justification for the new approach, adding that changing the citations would cause huge logistical problems. “For example, to make contact with even just 2,000 elderly or vulnerable patients, a team of five staff members will be in a consultation for about a week, and that is simply unsustainable. The BMA believes that the existing commitment to these patients by the NHS and local doctors must be respected. If GPs decide to keep these appointments booked in January, the BMA will support them. “
Dr Helen Salisbury, GP and medical adviser to the University of Oxford Health Experiences Research Group, tweeted that Health Secretary Matt Hancock should help phone his elderly patients and explain why their second puncture was delayed . He said his primary care network needed to cancel and rebook 1,160 appointments.
“At 5 minutes per phone call, that’s 193 hours of work. Not to mention the pain and anger. ” she wrote.
Salisbury asked the General Medical Council To give an advice. “I have been instructed to break my promise to my elderly patients and use a vaccine outside of its approved and evidenced schedule, probably putting them at risk. Please notify.”
His comments unleashed a flood of responses from other GPs, with some questioning whether it was ethical to delay a second dose when patients had consented to the first dose on the premise that they would receive the second three weeks later.
However, others welcomed the change in approach. Norwich GP Dr Ed Turnham said the Medicines and Healthcare Products Regulatory Agency must be congratulated for his “courageous and pragmatic decision.”
He tweeted: “I think most of our elderly patients will be happy that this reduces the delay in protecting their friends and family, and it will reduce the risk of hospitals being overwhelmed.”
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