Kamis, 31 Desember 2020

Pfizer questions UK move to lengthen gap between Covid vaccine doses - Financial Times

Pfizer has criticised the UK’s decision to lengthen the gap between doses of its Covid-19 vaccine, saying the “safety and efficacy” of the new schedule had not been evaluated, as infections and hospitalisations continued to soar across the UK.

The rare intervention by the US pharma company came amid growing controversy over the move, with GPs complaining that they were having to cancel appointments and reassure anxious patients who had previously been told they needed the second dose to keep them safe.

“[Our] study . . . was designed to evaluate the vaccine’s safety and efficacy following a two-dose schedule, separated by 21 days,” the company said.

“The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design.”

The new dosing guidelines, approved by the UK’s joint committee on vaccination and immunisation and unveiled on Wednesday, allow the second dose of both the vaccine that Pfizer developed with BioNTech, and the newly approved Oxford/AstraZeneca vaccine, to be delivered as much as three months after the first.

The change is aimed at giving a first dose of vaccine to as many people as possible, in an attempt to counter spiralling case numbers caused by a viral variant of the coronavirus that has been found to be much more infectious.

There was fresh evidence on Thursday of the toll the virus is taking in the UK, with a further 964 deaths announced and fresh signs of the strain on hospitals.

NHS Providers, which represents health organisations across the UK, said Covid-19 pressures were intensifying, particularly in London and the south-east, where the surge in admissions over the past few days was “extremely worrying”.

Saffron Cordery, deputy chief executive of NHS Providers, said that as of Wednesday there were 22,713 Covid-19 patients in hospital in England — an increase of more than 27 per cent in seven days. “Over the same period the number of Covid-19 patients in critical care beds rose by 35 per cent,” she added.

Matt Hancock, UK health secretary, on Thursday sought to counter suggestions that the vaccination programme, which the government sees as vital to taming the pandemic, was falling behind schedule.

He said 944,539 people across the UK had had their first dose of a Covid-19 vaccine. “The NHS has a clear vaccine delivery plan and today’s figures show once again how our fantastic NHS has risen to this enormous task . . . Now that we have authorised a second vaccine, we can expect this number to rapidly increase in the months ahead.”

Matt Hancock said more than 940,000 people had had their first shot of a Covid-19 vaccine © Jessica Taylor/UK Parliament

Although partial protection through the vaccine appears to begin as early as 12 days after the first jab, Pfizer stressed that two doses were required to provide the maximum protection against the disease, with an efficacy figure of 95 per cent. Crucially, it said: “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

The drugmaker said decisions on alternative dosing regimens were in the hands of health authorities and that it remained committed to talking to regulators, but it stressed each recipient should be afforded the maximum possible protection, “which means immunisation with two doses of the vaccine”.

The Medicines and Healthcare products Regulatory Agency said: “The decision was made to update the dosage interval recommendations for the BioNTech/Pfizer vaccine following a thorough review of the data by the MHRA’s Covid-19 Vaccines Benefit Risk Expert Working Group. This expert group concluded that vaccine efficacy will be maintained with dosing intervals longer than 21 days.”

GPs in the UK expressed anger and concern over the switch, saying they had to spend time cancelling appointments for people who had expected to receive their top-up dose in the next few days.

Helen Salisbury, a GP in Oxford, described the situation as “a shambles” and calculated that it would take the network of practices administering the vaccine for her area 193 hours of staff time to reschedule appointments.

She questioned the judgment, and data modelling, behind the decision. “What does the science say? We don’t know.”

The British Medical Association said asking GPs to rebook appointments of tens of thousands of elderly and vulnerable patients was “unreasonable and totally unfair, and practices who honour existing appointments booked for the next few days should be supported”. 

In his new year message, Boris Johnson, UK prime minister, hailed the Oxford vaccine, saying it “offers literally a new lease of life to people in this country and around the world”.

However, he warned of “a hard struggle still ahead of us for weeks and months, because we face a new variant of the disease that requires a new vigilance”.

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2020-12-31 19:13:00Z
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Delaying second Covid jab dose will cause huge problems for partially-vaccinated elderly and vulnerable, GP - The Sun

DELAYING the second dose Covid vaccine dose will cause huge problem for those who have been partially-vaccinated, GP leaders have warned.

Regulators outlined a new dosing regimen following the approval of the Oxford vaccine yesterday - aimed at speeding up the roll-out.

⚠️ Read our coronavirus live blog for the latest news & updates

A man receives a dose of the Pfizer vaccine at a drive-thru jab centre in Manchester
A man receives a dose of the Pfizer vaccine at a drive-thru jab centre in ManchesterCredit: Reuters

Experts advising the Government, including the Joint Committee on Vaccination and Immunisation (JCVI), said that the focus should be on giving at-risk people the first dose of whichever vaccine they receive, rather than providing the required two doses in as short a time as possible.

This now means the second dose of both the Oxford/AstraZeneca and the Pfizer/BioNTech vaccines will be within 12 weeks of the first.

Health Secretary Matt Hancock explained that the data from Oxford showed "very effective protection" from the first dose.

But GPs have warned this change will affect tens of thousands of elderly and vulnerable patients.

Many were due to get their second dose of the Pfizer jab in the coming days and weeks - and will need to be rebooked.

It comes as the Government revealed more than 940,000 people in the UK have now received a Covid-19 vaccine as of December 27.

A total of 944,539 people were given a first dose between December 9 and 27, including 786,000 in England, 92,188 in Scotland, 35,335 in Wales and 31,016 in Northern Ireland.

Among those getting their second dose this week was the first Brit to get the Pfizer jab, 91-year-old Margaret Keenan.

'GROSSLY UNFAIR'

Chair of the British Medical Association's (BMA) GP committee, Dr Richard Vautrey, said: "It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments.

"The decision to ask GPs, at such short notice, to rebook patients for three months hence, will also cause huge logistical problems for almost all vaccination sites and practices.

"For example, to make contact with even just two thousand elderly or vulnerable patients will take a team of five staff at a practice about a week, and that's simply untenable."

Dr Vautrey said the BMA would support practices who honour the existing appointments for the follow-up vaccination, calling for the Government to do the same.

He added: "The Government must see that it's only right that existing bookings for the oldest and most vulnerable members of our society are honoured, and it must also as soon as possible publish a scientifically-validated justification for its new approach."

The Doctors' Association has written to Health Secretary Matt Hancock and the JCVI outlining their concerns today.

In a tweet, they said: "We have real and grave concerns about these sudden changes to the Pfizer vaccine regime.

"It undermines the consent process, as well as completely failing to follow the science."

However, Mr Hancock said the new process will allow more people to get the vaccine sooner and help the country out of the pandemic "by spring".

He told the BBC: "It's very good news for accelerating the vaccine roll-out. It brings forward the day we can get our lives back to normal."

Explaining the 12-week gap in the dosing regimen, he said: "This is important because it means that we can get the first dose into more people more quickly and they can get the protection the first dose gives you.

"The scientists and the regulators have looked at the data and found that you get what they call 'very effective protection' from the first dose.

"The second dose is still important - especially for the long-term protection - but it does mean that we will be able to vaccinate more people more quickly than we previously could."

Margaret Keenan was the first Brit to receive the Pfizer vaccine and has since had her second dose
Margaret Keenan was the first Brit to receive the Pfizer vaccine and has since had her second doseCredit: PA:Press Association

Mr Hancock said the plan is to vaccinate all vulnerable groups first but that eventually all adults, including the under-50s, will be offered a jab.

He told MPs that the vaccine would mean the day on which restrictions are lifted can be brought forward - before announcing millions more Brits would be plunged into tougher Tier 4 restrictions.

The jab, from Oxford and AstraZeneca, could give up to 70 per cent protection 22 days after the first dose, experts today revealed.

People won't need their second dose for another three months - allowing medics to roll the first jabs out to as many people as possible.

Britain has ordered 100 million doses of the vaccine, which is enough to vaccinate 50 million people, with 530,000 doses available from Monday, Mr Hancock said.

Along with the 40 million doses of Pfizer's vaccine, the UK now has enough doses ordered to vaccinate the entire population, Mr Hancock said.

PFIZER ASSESSMENT

The criticism comes after Pfizer said that it only assessed its vaccine on a two-dose regimen where people were given the jab three weeks apart, and there was "no data to demonstrate that protection after the first dose is sustained after 21 days".

In a statement, Pfizer says: "Pfizer and BioNTech’s Phase 3 study for the Covid-19 vaccine was designed to evaluate the vaccine’s safety and efficacy following a 2-dose schedule, separated by 21 days.

"The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design.

"Data from the Phase 3 study demonstrated that, although partial protection from the vaccine appears to begin as early as 12 days after the first dose, two doses of the vaccine are required to provide the maximum protection against the disease, a vaccine efficacy of 95 per cent.

"There are no data to demonstrate that protection after the first dose is sustained after 21 days."

Pfizer adds that it is working with the UK authorities on the vaccine rollout.

Speaking at a Downing Street briefing on Wednesday, Prof Wei Shen Lim, chairman of the JCVI, said that with Covid infection rates currently at a high level, the "immediate urgency is for rapid and high levels of vaccine uptake".

He added: "This will allow the greatest number of eligible people to receive vaccine in the shortest time possible and that will protect the greatest number of lives."

Speaking at the same briefing, Professor Sir Munir Pirmohamed, chairman of the Commission on Human Medicines expert working group on Covid-19 vaccines, added: "Because of the design of the trial, some people got second doses at different time intervals.

"This allowed an analysis of the effectiveness of the vaccine if you were to be able to delay between four to 12 weeks.

"This showed that the effectiveness was high, up to 80 per cent, when there was a three-month interval between the first and second doses, which is the reason for our recommendation."

The Covid-19 vaccine from Oxford University and AstraZeneca is approved for use in the UK, paving the way for rapid rollout

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2020-12-31 17:36:00Z
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Hospitals move to Covid-19 'disaster mode' amid staff shortages - The Times

Britain’s busiest hospital has only one nurse for every three Covid patients being treated in intensive care as the capital faces a tsunami of new cases, leaked correspondence shows.

The Royal London Hospital in east London has reached “disaster medicine mode” and is no longer able to provide adequate critical care, according to management.

In an email sent last night and seen by The Times, critical care staff were told: “We are now in disaster medicine mode. We are no longer providing high standard critical care, because we cannot.

“While this is far from ideal, it’s the way things are, and the way they have to be for now. Things are going to get harder before they get better.”

It comes as the hospital’s

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2020-12-31 18:00:00Z
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School closures: We've all seen this coming, say angry heads - BBC News

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Teachers and unions have criticised the government's last-minute move to delay the start of term for all secondary schools and some primaries in England.

Vice president of the ASCL headteacher's union Pepe Di'Iasio said ministers should have decided earlier.

"We've all seen this coming, and we would have preferred to have been able to plan for this before the end of last term," he told BBC News.

There is also concern over how areas have been chosen for primary closures.

On Wednesday, Education Secretary Gavin Williamson said some primary schools in Covid hot spots would remain closed - this equates to about 15% of primary schools.

But there would be a review of these every two weeks, the Department for Education said, in the same way that local tier restrictions are reviewed.

Meanwhile, Year 11 and Year 13 pupils are now due to return to face-to-face lessons on 11 January - a week later than planned - with others returning on 18 January.

Paul Whiteman, general secretary of the National Association of Head Teachers, called on ministers to explain its decisions on which primary schools will re-open.

He labelled the government's strategy as little more than "keep calm and carry on".

"There is obviously a huge amount of concern over how it can be safe for schools in some tier four areas to open," he said, "while schools in other tier four areas are being told to move to remote learning.

"In some instances that means different approaches for schools only a few roads away from each other," he added.

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  • TESTING: How do I get a virus test?
  • LOOK-UP TOOL: How many cases in your area?
  • THE R NUMBER: What it means and why it matters
  • SCHOOLS: What will happen if children catch coronavirus?
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In December - on the last day of the Christmas term for many - the government asked schools to start setting up mass testing programmes for January.

But heads and teachers said the timescale was not workable, as they would be setting up online learning for the majority of pupils in the first week of term as well.

The delay to the start of term offers schools an extra week to get their mini test and trace systems up and running.

There had been growing pressure for earlier school shutdowns as virus cases soared in many areas, including parts of London and south-east England, and as attendance figures dropped dramatically.

Mr Di'Iasio said: "I think everyone in the country has known that there's going to be a surge and a peak, particularly in January."

An earlier decision would have meant that teachers could have made preparations in time for children to go back as normal, he said.

Parent, Chihera Mai Shingi, agreed with the decision, posting on the BBC News Family and Education Facebook page: "We got Covid from our Year 7 daughter. Schools should be closed."

But Charlotte Elizabeth Hayward expressed her concerns about schools carrying out the testing: "Space? Staff? Resources (financial and otherwise).

"It's not just a quick set up. We have 1,600 kids and around 200 staff. All on an already fit to burst site. The man does not have a clue."

Chairman of the Commons Education Select Committee Robert Halfon said teachers and support staff should be made a priority for vaccinations.

"If we can make sure that they are vaccinated and they are safe, it's less likely that schools will have to close, and this two weeks has to mean two weeks.

"Schools just can't be a revolving door that never stands still, open one day, shut the next."

girl sanitises hands
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Joint general secretary of the National Education Union, Dr Mary Bousted, said she was astonished that any pupils were going back at all before 18 January.

"A longer period of online working for all primary, secondary and college students could suppress virus levels and buy time both for the roll out of the vaccine and to put in place measures that can keep schools safer."

She added: "We would like Gavin Williamson to explain, if schools are not centres of transmission, why school age pupils are now the most infected age groups?"

Richard Sheriff, executive head teacher of Harrogate Grammar School, said regular testing could be key to minimising classroom disruptions but criticised the government for announcing the plans just days before the Christmas break.

"Testing and the delayed return is a realistic program, but it still puts a huge amount of pressure on schools," he said.

"We need reassurances in the physical arrangements for testing, including extra space and support on the ground to make it happen."

The government says schools are being supported financially to set up testing and argued that they are only being closed as a "last resort" because of the rising number of cases.

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2020-12-31 14:48:00Z
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COVID-19: Nightingale hospitals being 'readied' for use as COVID patient numbers rise - Sky News

Nightingale hospitals across England are being "readied" for use if needed as COVID-19 patient numbers rise.

The NHS in London has been asked to make sure the Excel centre site is "reactivated and ready to admit patients" as hospitals in the capital struggle.

Other Nightingale hospital sites across England include Manchester, Bristol, Sunderland, Harrogate, Exeter and Birmingham.

Follow all the news on coronavirus in the UK, and across the world, live as it happens

A spokesman for the NHS said that while staff were going "the extra mile," hospitals in London were coming under significant pressure from high COVID-19 infection rates.

He added: "The NHS in London is opening more beds in NHS hospitals across the capital to care for the most unwell patients. It is crucial that people do everything they can to reduce transmission of the virus.

"In anticipation of pressures rising from the spread of the new variant infection, NHS London was asked to ensure the London Nightingale was reactivated and ready to admit patients as needed, and that process is under way."

More from Covid-19

Defence Secretary Ben Wallace said the military was standing by to staff Nightingale hospitals if the NHS exceeded its capacity of critical care beds.

Speaking to Times Radio, Mr Wallace said: "Of course we stand ready to help with Nightingales if the critical pressures go beyond the capacity of the existing NHS.

"We are on, I think, 17,000 ventilator beds currently being used, of a capacity of 21,000.

"If it starts to tip over there, then of course you'll see those Nightingales being more active and, yes, we have a number of medical staff."

He said the Army currently had 5,000 personnel deployed in the COVID-19 response.

Trusts across the country all continue to face pressure, with COVID patient numbers in England having surpassed the April first-wave peak.

And people have been urged to ring in the New Year by staying at home and not mixing. NHS England's national medical director, Professor Stephen Powis, warned: "COVID loves a crowd."

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2020-12-31 13:36:33Z
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Brexit: UK braced for changes as it cuts ties to EU - BBC News

The UK will cut ties with the European Union at 11pm - almost a year after officially leaving the 27-nation bloc.

The trade deal agreed between Boris Johnson and EU chiefs avoids the need for import taxes - tariffs - which many businesses had feared.

But there will still be major changes to rules on travel, immigration, commerce, living and working abroad - as well as crime fighting and security.

Haulage firms remain concerned about hold-ups at ports.

Fears of giant tailbacks of lorries at Dover - in the event of a no-deal exit from the EU single market and customs union - have receded, but uncertainty remains about new customs rules.

  • Dover-Calais route 'will work well on 1 January'
  • A quick guide to what's in the Brexit deal
  • Brexit: Seven things that will change

Among the things that will change from 23:00 GMT:

  • Free movement of people between the UK and EU countries will end - to be replaced in the UK by a "points-based" immigration system.
  • Anyone from the UK who wants to stay in most of the EU for more than 90 days in any 180-day period will need a visa
  • Duty-free shopping will return, with people coming back to the UK from the EU able to bring up to 42 litres of beer, 18 litres of wine, four litres of spirits and 200 cigarettes without paying tax
  • EU citizens wanting to move to the UK (except those from the Irish Republic) will face the same points-based system as people elsewhere in the world
  • UK police will lose instant access to EU-wide databases on criminal records, fingerprints and wanted persons
  • Traders in England, Scotland and Wales will have to complete more paperwork when dealing with EU countries

Unlike the rest of the UK, Northern Ireland will continue to follow many of the EU's rules, as its border with the Irish Republic remains all but invisible.

And the UK will gradually be able to keep more of the fish caught in its own waters, while the European Court of Justice will cease to have any role in deciding disputes between the UK and EU.

Analysis box by Laura Kuenssberg, political editor

If you are Boris Johnson this is huge, and exciting.

If you are a business that's affected it might mean a big new opportunity, but it might also mean really big disruption and lots of extra hassle.

The fact that there is a trade deal doesn't take all of the risk away.

The treaty contains lots of uncertainty, not least for the biggest part of the economy: the service sector. Getting the agreement finalised in the time was a big achievement for both sides but there is a lot that it just doesn't cover that will, in time, have to be worked out somehow.

2px presentational grey line

Brexit happened on 31 January 2020, but the UK has continued to follow Brussels' trade rules until now, while the deal was thrashed out.

It completes the process set in motion in June 2016, when, in a referendum, UK voters chose by 52% to 48% to leave the EU.

The free trade deal - agreed on Christmas Eve after nine months of negotiations - finally passed into UK law early on Thursday morning - having also been backed by Brussels.

Prime Minister Boris Johnson said: "The destiny of this great country now resides firmly in our hands."

Thames embankment at dawn
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But opponents say the country will still be worse off than it was while in the EU - and there is still uncertainty about what it will happen to banking and services, which are a major part of the UK economy.

The EU (Future Relationship) Bill, bringing the trade deal into UK law, was backed in the House of Commons by 521 to 73 votes on Wednesday, after Parliament was recalled from its Christmas break.

Labour supported it, with leader Sir Keir Starmer saying it was preferable to the UK severing ties with the EU without a trade deal, but other opposition parties voted against it.

European Commission President Ursula von der Leyen and European Council President Charles Michel signed the deal on Wednesday.

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2020-12-31 12:14:00Z
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We've all seen school shut down coming, say angry heads - BBC News

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Head teachers, teachers and teaching unions have criticised the government's last-minute move to keep schools closed for the majority of pupils in England.

Vice president of the Ascl head's union Pepe Di'Iasio suggested ministers should have seen this coming.

"We've all seen this coming, and we would have preferred to have been able to plan for this before the end of last term," he told BBC News.

The secondary school term has been delayed for two weeks by ministers.

Education Secretary Gavin Williamson made a statement in the Commons on Wednesday. He also said some primary schools in Covid hot spots would remain closed - this equates to about 15% of primary schools.

The government had asked schools to start setting up mass testing programmes for January in their schools on the last day of the Christmas term for many.

'Peak predicted'

But heads and teachers said the time-scale was not workable, as they would be setting up online learning for the majority of pupils in the first week of term as well.

And there had been growing pressure for earlier school shut downs as virus cases soared in many areas including parts of London and south-east England, and as attendance figures dropped dramatically.

Mr Di'Iasio said; "I think everyone in the country has known that there's going to be a surge and a peak, particularly in January."

An earlier decision would have meant that teachers could have made preparations in time for children to go back as normal, he said.

Parent, Chihera Mai Shingi, agreed with the decision, posting on the BBC News Family and Education Facebook page: "We got Covid from our Year 7 daughter. Schools should be closed."

But Charlotte Elizabeth Hayward expressed her concerns about schools carrying out the testing: "Space? Staff? Resources (financial and otherwise).

"It's not just a quick set up. We have 1,600 kids and around 200 staff. All on an already fit to burst site. The man does not have a clue."

'Revolving door'

Chairman of the Commons Education Select Committee Robert Halfon said teachers and support staff should be made a priority for vaccinations.

"If we can make sure that they are vaccinated and they are safe, it's less likely that schools will have to close, and this two weeks has to mean two weeks.

"Schools just can't be a revolving door that never stands still, open one day, shut the next."

girl sanitises hands
Getty Images

Joint general secretary of the National Education Union, Dr Mary Bousted, said she was astonished that any pupils were going back at all before 18 January.

"A longer period of online working for all primary, secondary and college students could suppress virus levels and buy time both for the roll out of the vaccine and to put in place measures that can keep schools safer."

She added: "We would like Gavin Williamson to explain, if schools are not centres of transmission, why school age pupils are now the most infected age groups?"

Richard Sheriff, executive head teacher of Harrogate Grammar School, said regular testing could be key to minimising classroom disruptions but criticised the government for announcing the plans just days before the Christmas break.

"Testing and the delayed return is a realistic program," he said, "but it still puts a huge amount of pressure on schools".

"We need reassurances in the physical arrangements for testing, including extra space and support on the ground to make it happen."

The government says schools are being supported financially to set up testing and argued that they are only being closed as a "last resort" because of the rising number of cases.

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2020-12-31 11:10:00Z
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