• Dear Guest, and welcome to RailUK Forums. Our non-railway discussion forums are currently restricted until members have five or more posts, and you will not be able to make a new thread or reply to an existing one in this section until you have made five or more posts elsewhere on the forum.

Second jab delayed beyond 12 weeks

Status
Not open for further replies.

DerekC

Established Member
Joined
26 Oct 2015
Messages
1,608
Location
Hampshire (nearly a Hog)
We have just been told by our GP surgery that we won't be getting our second jab by the 12-week deadline. The problem seems to be supplies of the Pfizer vaccine to rural GP centres. If you booked an appointment for your first jab online you got an appointment for the second one at the same time, but not if you were contacted by your GP. Presumably nobody wants to change the pre-booked appointments, so my guess is that the available vaccine is going to them first. Is anyone else in a similar position?
 
Sponsor Post - registered members do not see these adverts; click here to register, or click here to log in
R

RailUK Forums

nlogax

Established Member
Joined
29 May 2011
Messages
3,918
Location
London & Scotland
We have just been told by our GP surgery that we won't be getting our second jab by the 12-week deadline. The problem seems to be supplies of the Pfizer vaccine to rural GP centres. If you booked an appointment for your first jab online you got an appointment for the second one at the same time, but not if you were contacted by your GP. Presumably nobody wants to change the pre-booked appointments, so my guess is that the available vaccine is going to them first. Is anyone else in a similar position?
Are you able to get to one of the mass vaccination centres at all? If so you may be able to secure a second jab there by calling 119 and letting them know your situation. Can't harm to give it a go.
 

johnnychips

Established Member
Joined
19 Nov 2011
Messages
2,986
Location
Sheffield
I’ve literally had my second vaccination today, only ten weeks after the first, as have many of my colleagues. I don’t think it’s the end of the world if it’s a couple of weeks either way: the first vaccine gives most immunity, the second is a booster.
 

swt_passenger

Veteran Member
Joined
7 Apr 2010
Messages
25,944
I also expect there’s a bit of a spread allowed either side of the 12 week mark on the GP booking systems, my second was booked online today at the 11 week point.
 

arbeia

Member
Joined
16 Sep 2019
Messages
112
Location
South Shields
Was given Tuesday 4th of May for second jab when I had the first jab. Tuesday this week, email saying it was cancelled due to shortage of vaccine that week. Played a hunch which was what day of the week does their week start on? Like a lot of society I thought it would be a Monday. So wife phoned up for both of us to rebook. Outcome of it was I was right with the hunch, and we were slotted in three days earlier on Saturday 1st! Something to bear in mind.
 

DerekC

Established Member
Joined
26 Oct 2015
Messages
1,608
Location
Hampshire (nearly a Hog)
Thanks for the information, all. Appreciate that it's not the end of the world and a few days delay doesn't faze me, but it's good to know whether others are in the same position. We have a grumpy GP receptionist who doesn't appreciate questions! I tried phoning 119 and got a helpful person who tried to get us a second jab via a vaccination centre, but "computer said no" because we had had the first one via GP. Will hope for a slot next week!
 

Mojo

Forum Staff
Staff Member
Administrator
Joined
7 Aug 2005
Messages
18,668
Location
0035
Are you able to get to one of the mass vaccination centres at all? If so you may be able to secure a second jab there by calling 119 and letting them know your situation. Can't harm to give it a go.
You can’t. If you’ve booked via your GP then you aren’t able to book through the NHS system as it returns a message advising that it isn’t possible.
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
I don't think it's right to see it as a "deadline"; 12 weeks is very arbitrary and there is no evidence that waiting longer will be detrimental.

Indeed I think, on the balance of probability, it's more likely to be beneficial in the longer term than detrimental.

I also think it's more likely than not that better efficacy might be achieved by you having the Oxford vaccine as your booster, but until the mix & match trial data becomes available I think it's unlikely we will see much mixing and matching, but that's another story.

I can understand you are keen to get the booster, but do bear in mind a single dose offers excellent protection against severe symptoms and also that there is no evidence of any long term reduction in efficacy by waiting a bit longer.
 

Butts

On Moderation
Joined
16 Jan 2011
Messages
10,386
Location
Stirlingshire
I don't think it's right to see it as a "deadline"; 12 weeks is very arbitrary and there is no evidence that waiting longer will be detrimental.

Indeed I think, on the balance of probability, it's more likely to be beneficial in the longer term than detrimental.

I also think it's more likely than not that better efficacy might be achieved by you having the Oxford vaccine as your booster, but until the mix & match trial data becomes available I think it's unlikely we will see much mixing and matching, but that's another story.

I can understand you are keen to get the booster, but do bear in mind a single dose offers excellent protection against severe symptoms and also that there is no evidence of any long term reduction in efficacy by waiting a bit longer.

Some people (myself included) are anxious to receive the second dose as whatever it's merits or rights and wrongs, it may be the key to Foreign Travel through some form of Vaccine Passport.
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
Some people (myself included) are anxious to receive the second dose as whatever it's merits or rights and wrongs, it may be the key to Foreign Travel through some form of Vaccine Passport.
I don't think it would be fair for you to be able to travel abroad before me, but that's a whole new topic (probably covered by an existing thread; if not feel free to create one)
 

DerekC

Established Member
Joined
26 Oct 2015
Messages
1,608
Location
Hampshire (nearly a Hog)
I don't think it's right to see it as a "deadline"; 12 weeks is very arbitrary and there is no evidence that waiting longer will be detrimental.

Indeed I think, on the balance of probability, it's more likely to be beneficial in the longer term than detrimental.

I also think it's more likely than not that better efficacy might be achieved by you having the Oxford vaccine as your booster, but until the mix & match trial data becomes available I think it's unlikely we will see much mixing and matching, but that's another story.

I can understand you are keen to get the booster, but do bear in mind a single dose offers excellent protection against severe symptoms and also that there is no evidence of any long term reduction in efficacy by waiting a bit longer.
I wasn't looking for comfort, merely to try to see whether this is a widespread issue. The data from the government's vaccination site suggests that the average delay between first and second doses is considerably less than twelve weeks. The following is information from:

https://coronavirus.data.gov.uk/details/vaccinations

Cumulative total of first doses on 31st Jan: 9,296,367 (when I received the first dose)

Cumulative total of second doses on 16th April: 9,431,231 (10 weeks 5 days later)

Cumulative total of second doses on 25th April: 12,897,123 (12 weeks later)

But does this disguise a considerable scatter in the actual dates achieved for individuals? And does it matter? Twelve weeks may be arbitrary in scientific terms, but it is very widely publicised as though it was a deadline, not least in NHS guidance to vaccinators. And presumably this is on the basis of a calculation of the balance of probability by those with the competence needed to make such a judgement.

My suggestion (which I have put to our MP, who says she has raised it with the Minister) is that an additional piece of information should be published, which is the percentage of people getting their second dose within 12 weeks of the first. That would put some focus on achievement of the target which government set itself. I am not holding my breath, though!
 

nlogax

Established Member
Joined
29 May 2011
Messages
3,918
Location
London & Scotland
My partner's scheduled for her first jab on May 7th and the second is scheduled 6 weeks later. This could an NHS Scotland thing.

I'm still waiting for my second one to be scheduled (via GP surgery in England) but I fully expect to be on the common 11 to 12 week schedule as the first one was mid March.
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
I wasn't looking for comfort
OK but I am aware that some people have had those concerns, so I felt it important to address them.

Furthermore...

But does this disguise a considerable scatter in the actual dates achieved for individuals? And does it matter? Twelve weeks may be arbitrary in scientific terms, but it is very widely publicised as though it was a deadline, not least in NHS guidance to vaccinators.
...is exactly why I made my point.

And presumably this is on the basis of a calculation of the balance of probability by those with the competence needed to make such a judgement.
I am not sure what you are suggesting there, but if you have any evidence of any negative impacts in long term efficacy from a longer gap, I'd be interested to read this, as it goes against the experts I've been listening to.
My suggestion (which I have put to our MP, who says she has raised it with the Minister) is that an additional piece of information should be published, which is the percentage of people getting their second dose within 12 weeks of the first. That would put some focus on achievement of the target which government set itself. I am not holding my breath, though!
I disagree; it's the wrong emphasis in my opinion, and would only strengthen any misconceptions that 12 weeks is some sort of "deadline" from an immunological point of view; it isn't.
 

Domh245

Established Member
Joined
6 Apr 2013
Messages
8,014
Location
nowhere
I don't think it's right to see it as a "deadline"; 12 weeks is very arbitrary and there is no evidence that waiting longer will be detrimental.

Indeed I think, on the balance of probability, it's more likely to be beneficial in the longer term than detrimental.

The advantage of delayed and/or different second doses applies mostly to viral vector vaccines (Ox/AZ and J&J) where there is a chance of the immune system developing immunity to the viral vector itself, which reduces their effectiveness. mRNA vaccines (Pfizer and Moderna) don't seem to have this same issue, and whilst there's no harm in a longer dosing interval, there's no particular (personal) benefit either.

Whilst 12 weeks is an arbitrary deadline, it is the one that the vaccines are currently approved/recommended on. Individual vaccinators (vaccine centres/pharmacies/GPs, etc) deviating from the official recommendations is not a great precedent, regardless of how safe it may be
 

steamybrian

Established Member
Joined
26 Nov 2010
Messages
1,437
Location
Kent
You can’t. If you’ve booked via your GP then you aren’t able to book through the NHS system as it returns a message advising that it isn’t possible.
Being a "senior citizen" I had my first jab in January locally booked through my local GP and the second one booked for first week April. As I booked a holiday had to re-arrange my second jab but could not do it through local GP as they were fully booked. Had to book through NHS system and the nearest available was ExCel Centre in London. As it was the during the week commencing 12th April I booked it and enjoyed my first rail journey for a few months and a trip on the DLR.
 

Red Onion

Member
Joined
4 Apr 2012
Messages
154
Location
Aberdeen
I’ve been 8 weeks since my first and still awaiting an appointment for my second, though given I took a severe adverse reaction to the AZ one it looks as if I’m potentially getting a different vaccine and possibly have to start the course again.
 

30907

Veteran Member
Joined
30 Sep 2012
Messages
11,810
Location
Airedale
We have just been told by our GP surgery that we won't be getting our second jab by the 12-week deadline. The problem seems to be supplies of the Pfizer vaccine to rural GP centres.
Pfizer is difficult for GPs even in urban areas (my daughter is one) because of the stringent storage issues and the large quantities in which it is supplied.
 

johnnychips

Established Member
Joined
19 Nov 2011
Messages
2,986
Location
Sheffield
A load of our staff, me included, had our second injection (Pfizer) ten weeks after the first rather than twelve. Nobody was bothered.
 

TravelDream

Member
Joined
7 Aug 2016
Messages
419
Pfizer is difficult for GPs even in urban areas (my daughter is one) because of the stringent storage issues and the large quantities in which it is supplied.

I know in Wales Pfizer vaccines aren't being sent to GPs and are only being distributed at vaccine centres and hospitals.

Difficulty in transportation and storage were given as the reasons.
 

HSTEd

Veteran Member
Joined
14 Jul 2011
Messages
13,562
Supposedly Spain is delaying it to sixteen weeks now.
 

MotCO

Established Member
Joined
25 Aug 2014
Messages
2,243
A load of our staff, me included, had our second injection (Pfizer) ten weeks after the first rather than twelve. Nobody was bothered.

Same here. Had my second Pfizer jab yesterday at 10 weeks. (So far, arm less achy than first jab)
 

DelW

Established Member
Joined
15 Jan 2015
Messages
1,943
I had my second this week, 10 weeks and 6 days after the first (both Pfizer). Both were booked by the GP surgery phoning me, and my taking the first appointment they offered.

About 10 weeks after my first, I'd rung the surgery to check whether I needed to do anything about arranging the second, and they said no, you'll be contacted in the next couple of weeks (and in fact the call came within a week).

Both vaccinations were done at a big centre with about 15 "booths" doing the injections, which I suspect is why it was Pfizer - as mentioned above, the complicated transport and storage it needs means it's better suited to big venues.

I was fortunate, no significant side effects from either, just a slight ache in the upper arm for a few hours.
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
The advantage of delayed and/or different second doses applies mostly to viral vector vaccines (Ox/AZ and J&J) where there is a chance of the immune system developing immunity to the viral vector itself, which reduces their effectiveness. mRNA vaccines (Pfizer and Moderna) don't seem to have this same issue, and whilst there's no harm in a longer dosing interval, there's no particular (personal) benefit either.
I strongly disagree.

Many of the articles I've read and the experts on immunology who I've listened to have stated that a longer delay is more likely to induce greater longer term immunity.

We know that booster doses increase in efficacy as the prime-boost interval increases. (There’s good reason to expect that the 12-week prime-boost interval recommended in the UK will lead to stronger, longer lasting immunity than the shorter doses recommended by the manufacturers.) And heterologous boosting, using a different product, may be more effective than a repeat dose of the same vaccine – similar effects may be arising when the priming is provided by natural infection.


And here is a specific example where it was discovered that two doses of a particular vaccine was sufficient to replace a 3 dose reigmen by optimising the delay:
This study shows that two doses of a recombinant hepatitis B vaccine (10 micrograms or 20 micrograms of HBsAg per dose), administered 6 months apart to young, healthy adults, can induce an antibody (anti-HBs) response similar to that expected with the standard three-dose regimen of this vaccine given at intervals of 0, 1, and 6 months.
A trial is currently underway to compare the shorter vs longer intervals of the Sars-CoV-2 vaccines; based on what I've read/heard from many experts, I expect the longer interval to win over the shorter interval.

Whilst 12 weeks is an arbitrary deadline, it is the one that the vaccines are currently approved/recommended on. Individual vaccinators (vaccine centres/pharmacies/GPs, etc) deviating from the official recommendations is not a great precedent, regardless of how safe it may be
I stand by what I said; your post offers no evidence that a longer gap will reduce longer term effectiveness.
 

DerekC

Established Member
Joined
26 Oct 2015
Messages
1,608
Location
Hampshire (nearly a Hog)
I disagree; it's the wrong emphasis in my opinion, and would only strengthen any misconceptions that 12 weeks is some sort of "deadline" from an immunological point of view; it isn't.
On thinking about this further, the risk to an individual is integrated over time, and the later the second dose is given, the longer the period of lower level protection given by the first dose, which probably outweighs any marginal increase as the second dose is delayed further. That's probably why government decided on twelve weeks rather than delaying the second dose until all adults had been given the first one - particularly since more vulnerable individuals have been vaccinated first.

So even though large variations between individuals in the period between first and second doses probably doesn't affect the overall numbers very much, it certainly feels unfair to those at the wrong end of the bell curve, as Mrs C is very keen to tell me! And Mr Hancock hasn't helped today by announcing that all over-70s have had the second dose!! At least we now only have to wait until Friday. By then roughly twice as many people will have had the second dose, as had had the first dose when we received it on 31st January.
 

Domh245

Established Member
Joined
6 Apr 2013
Messages
8,014
Location
nowhere
I stand by what I said; your post offers no evidence that a longer gap will reduce longer term effectiveness.

I never said that a longer gap would reduce longer term effectiveness, just that it was unlikely to provide any particular benefit, though the studies you've quoted do give pause for thought. With the Pfizer vaccine at least, it feels like it'd be "tweaking around the edges" though when it's 95% effective* at the 3 week interval (presumably it's already higher with the 12 week interval) so chasing a handful of percent by delaying past 12 weeks seems, odd. Putting it a different way, getting the 2nd dose of Pfizer in whatever timeframe will grant 95% efficacy, but I'd be surprised if the difference between having it at 3 weeks or 13 weeks is appreciable. Where I suppose it may have an effect is on the longer-term immunity mechanisms (Memory T & B cells) but a quick look hasn't turned up any studies on this.

I note though you've not said anything what I felt was the rather key point around pharmacies and vaccination centres going 'doubly off-label'. Whilst most of the people running the vaccine centres will obviously be highly trained individuals, I doubt that they have any particular additional-knowledge around immunology and vaccine mechanics above any well-read member of the public. I've happily supported going off-label by moving to 12 weeks as this has been backed by the UK's CMOs, a taskforce of vaccine experts, and increasing scientific consensus now, but my local GP going off-label because "they read a paper online that suggests it may work better" would set off alarm bells, regardless of how well intentioned unless I knew that they were a proper specialist in that area (which being a GP, they likely won't). That way quackery lies, I fear

*for all the clinical trail efficacies are worth, though numbers coming out of real-world studies are coming out in the same ballpark
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
I never said that a longer gap would reduce longer term effectiveness, just that it was unlikely to provide any particular benefit, though the studies you've quoted do give pause for thought.
In glad you agree that long term effectiveness is more likely to be increased with a longer interval.

With the Pfizer vaccine at least, it feels like it'd be "tweaking around the edges" though when it's 95% effective* at the 3 week interval (presumably it's already higher with the 12 week interval) so chasing a handful of percent by delaying past 12 weeks seems, odd.
But surely it depends on what you re measuring efficacy against?

While I agree the only thing that really matters, in terms of ending the pandemic, is efficacy measured against severe symptoms, if you set the bar lower than that, such as being infectious, the efficacy is clearly lower than 95 per cent, so there is room for improvement.

I am not necessarily saying we hold be increasing the delay between doses, at least not at this stage, but I am keen to dispel the myth that a longer gap is in any way likely to be detrimental.

Putting it a different way, getting the 2nd dose of Pfizer in whatever timeframe will grant 95% efficacy, but I'd be surprised if the difference between having it at 3 weeks or 13 weeks is appreciable.
A trial is underway to determine that, but I'm glad you agree that such a wait is not a concern.

...it may have an effect is on the longer-term immunity mechanisms (Memory T & B cells) but a quick look hasn't turned up any studies on this.
Give it a few months and we should have more data on this.
I note though you've not said anything what I felt was the rather key point around pharmacies and vaccination centres going 'doubly off-label'. Whilst most of the people running the vaccine centres will obviously be highly trained individuals, I doubt that they have any particular additional-knowledge around immunology and vaccine mechanics above any well-read member of the public. I've happily supported going off-label by moving to 12 weeks as this has been backed by the UK's CMOs, a taskforce of vaccine experts, and increasing scientific consensus now, but my local GP going off-label because "they read a paper online that suggests it may work better" would set off alarm bells, regardless of how well intentioned unless I knew that they were a proper specialist in that area (which being a GP, they likely won't). That way quackery lies, I fear

*for all the clinical trail efficacies are worth, though numbers coming out of real-world studies are coming out in the same ballpark
I don't think my GP is going to deliberately wait, but there is no suggestion of this, is there?

I was addressing the fact that some people are concerned about the effects of a further delay.
 

Domh245

Established Member
Joined
6 Apr 2013
Messages
8,014
Location
nowhere
I am not necessarily saying we hold be increasing the delay between doses, at least not at this stage, but I am keen to dispel the myth that a longer gap is in any way likely to be detrimental.
...
I don't think my GP is going to deliberately wait, but there is no suggestion of this, is there?

I was addressing the fact that some people are concerned about the effects of a further delay.

I think we came in to this from different angles. Correct me if I'm wrong, but you've come into it from the point of view of "it's fine if you don't get the 2nd dose within 12 weeks, as it won't be harmful and may in fact be beneficial", whereas I've come in from the point of view of "GPs and vaccination centres shouldn't be scheduling 2nd doses outside of the 12 week window".

I've not seen any suggestions of GPs deliberately delaying giving 2nd doses, but as we are seeing in this case there are situations where the doses are not being scheduled within the current recommended timescale (not through bad intentions or "I know what'd work better", but seemingly bad planning at some level in the system) - I would have hoped that GPs would have had visibility on how many doses they were expecting to receive, and would have been able to schedule more 2nd doses earlier (or fewer first doses in light of how many second doses were due), or flagged this issue to higher ups - either to secure more doses or to have their patients sent to vaccination centres which do have it.
 

Purple Orange

Established Member
Joined
26 Dec 2019
Messages
2,879
Location
The North
I’ve been 8 weeks since my first and still awaiting an appointment for my second, though given I took a severe adverse reaction to the AZ one it looks as if I’m potentially getting a different vaccine and possibly have to start the course again.
What qualifies as a severe adverse reaction that results in getting a different vaccine 2nd time around? I was rather ill after my first (AZ) but I’m unsure how out of the ordinary that is. I’m happy to take the 2nd AZ dose though.
 

yorkie

Forum Staff
Staff Member
Administrator
Joined
6 Jun 2005
Messages
55,172
Location
Yorkshire
I’ve been 8 weeks since my first and still awaiting an appointment for my second, though given I took a severe adverse reaction to the AZ one..
What sort of reaction?

An anaphylactic reaction or just a more severe form of fever symptoms?

If the former, this surprises me, given an anaphylactic reaction is much more likely with an mRNA vaccine than a viral vector vaccine.

If the latter, then the good news is that people who suffer an adverse reaction to the first dose are unlikely to have an adverse reaction to the second dose.

it looks as if I’m potentially getting a different vaccine and possibly have to start the course again.
What do you mean by "have to start the course again" ? Have you been told the viral vector may not have taken effect in you or something? If so, I've not heard anything like this before, so am interested to hear more.

I think we came in to this from different angles. Correct me if I'm wrong, but you've come into it from the point of view of "it's fine if you don't get the 2nd dose within 12 weeks, as it won't be harmful and may in fact be beneficial", whereas I've come in from the point of view of "GPs and vaccination centres shouldn't be scheduling 2nd doses outside of the 12 week window".

I've not seen any suggestions of GPs deliberately delaying giving 2nd doses, but as we are seeing in this case there are situations where the doses are not being scheduled within the current recommended timescale (not through bad intentions or "I know what'd work better", but seemingly bad planning at some level in the system) - I would have hoped that GPs would have had visibility on how many doses they were expecting to receive, and would have been able to schedule more 2nd doses earlier (or fewer first doses in light of how many second doses were due), or flagged this issue to higher ups - either to secure more doses or to have their patients sent to vaccination centres which do have it.
I really don't see any issue and experts have said it really does not matter if it's received after 13 weeks.
 
Joined
23 Jan 2016
Messages
135
I am not necessarily saying we hold be increasing the delay between doses, at least not at this stage, but I am keen to dispel the myth that a longer gap is in any way likely to be detrimental.
detrimental.

Wasn’t there a report claiming that the Pfizer one wasn’t producing antibodies after 12 weeks in immune compromised individuals? I’d have to hunt it out. For “normal” people the 12 week gap was fine, and justified the decision to delay Pfizer until 12 weeks but there was definitely something about it being questionable for CEV.
 
Status
Not open for further replies.

Top