Covid Watch 113: Your Covid Vaccination Questions Answered (2) – Vaccination Basics

These questions are answered by Dr Catherine Beanland, Portcullis Surgery; Dr Caron Morton, Station Drive Surgery; Rachel Robinson, Director of Public Health for Shropshire.

• If we are given the first dose with one vaccine and the second with the other, how might this alter the effectiveness of vaccination?
• Why is the second dose being delayed and do we have to have it?
• Why are individuals not first screened for pre-existing immunity with an antibody test before being offered the vaccine? Should people who have had Covid-19 still have a vaccination?
• Must I have a vaccination if it is offered, especially if everyone else I know is vaccinated?
• What are the risks or restrictions for people who have significant allergies or a fever?
• I have an autoimmune condition. I am taking immunosuppressants. Can I still be vaccinated?
• What are the side effects of vaccination?

This article is the second in a series.

Andy Boddington and Tracey Huffer, Shropshire Councillors for Ludlow North and East

Q5. If we are given the first dose with one vaccine and the second with the other, how might this alter the effectiveness of vaccination?

The preferred option is that people have the same vaccine for both doses. Due to supply constraints this may not always be possible. The Pfizer and Oxford vaccines both result in a specific part of the virus (known as the spike protein) being recognised by your immune system, triggering antibodies and developing immunity. Further research into this is already underway but you are still likely to produce a good immune response even if the second dose of vaccine is different from the first.

Q6. Why is the second dose being delayed and do we have to have it?

Like all viruses, the coronavirus will not disappear although, in time, populations will become more immune to it.

The imperative is to get as many people vaccinated as possible. A single dose offers a high level of immunity though not as high as two doses. Covid-19 is a highly transmissible disease and the priority is to give as many people as much immunity we can as quickly as we can.

The second dose is essential to ensure that we achieve maximum immunity as quickly as possible. We know that a high proportion of patients develop adequate immunity after the first dose, some develop a moderate immunity and a small proportion a low immunity. The second dose acts as a booster for those with good immunity and ensures the two other smaller groups have suitable immunity.

The current advice is that a second vaccination should be administered approximately 12 weeks after the first jab.

Q7. Why are individuals not first screened for pre-existing immunity with an antibody test before being offered the vaccine? Should people who have had Covid-19 still have a vaccination?

The benefits of having the vaccine outweigh the need to screen. Not all tests give the correct result and we do not yet know for how long the vaccines will give immunity. The additional resources that would be required for mass screening would detract from the pressing need for vaccination.

Covid-19 vaccination will be offered to you regardless of whether you have already had a Covid-19 infection. The trials of the vaccines have not revealed any safety issues with people who have had Covid-19 receiving the vaccine.

Q8. Must I have a vaccination if it is offered, especially if everyone else I know is vaccinated?

Vaccination is not compulsory. Vaccination protects both you and those around you, reducing the spread of the virus. When enough people are vaccinated it will create ‘herd immunity’ protecting those people who cannot get vaccinated, for example because they are too young or have a health condition. By remaining unvaccinated, you increase the possibility of contacting Covid-19, getting sick yourself, perhaps seriously so and spreading it to others. That will increase the pressure on health services.

Q9. What are the risks or restrictions for people who have significant allergies or a fever?

Anyone who has had a severe allergic reaction which has required hospitalisation or has had to use adrenalin to counter an allergic reaction should discuss having the vaccine with their GP or pharmacist before attending their vaccination appointment. Those with penicillin allergies can have the vaccine.

A mild fever or infection, such as a cold, are not reasons to delay vaccination.

Ring 111 if your temperature is 37.8°C or greater and do not leave your home.

Q10. I have an autoimmune condition. I am taking immunosuppressants. Can I still be vaccinated?

Neither vaccine is a live vaccine. This makes it safe for patients who are immunocompromised, including those on high dose steroids, disease modifying and biologic therapies such as methotrexate and rituximab, anyone with haematological malignancy, anyone undergoing chemotherapy or radiotherapy and transplant recipients. There is a possibility that the vaccine may not stimulate as strong an antibody response in immunosuppressed people but this is expected to still be better than not having been vaccinated. National guidance specifically identifies immunosuppressed people as a priority clinical risk group that should receive the immunisation.

Q11. What are the side effects of vaccination?

Some people will suffer side effects as the vaccine prepares the body to fight the disease. A sore arm and a light fever are common and some people may have flu-like symptoms. Fatigue and headaches are also known side effects. In a small number of people, these side effects may interfere with daily activities. These side effects only last for 48 hours at the most. Should they last longer, contact 111 for advice.

Serious side effects are extremely rare.

Local experience with the Pfizer vaccine suggests side effects are minor and mostly limited to a sore arm and light fever.