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Covid-19 Vaccination update February

Here is an update covering the Covid – 19 vaccination program, allergies, autoimmune conditions and the new strains of the virus

Transcript - auto generated so typos likely

David Stokes 0:02
Hello and welcome to the latest video podcast from The Doctor Family.

Today we’re hoping to cover the latest updates on the COVID-19 vaccination programme and to answer some of the questions that have been passed on by you to our Facebook page, focusing on various aspects of the virus vaccine and the program.

Locally in Worthing, we’re now well on our way to hitting the target of hitting the first four cohorts within the vaccination program by the middle of this month, which is a great effort by all involved

We’re happy to say as well, that patients of ours that are housebound, are now being vaccinated in collaboration between ourselves in general practice and the Community Trust.

On that positive note, let’s try to answer some of the questions you’ve posed to me on the Facebook group.

The first one I’m going to try and tackle today, I received about patients who have immunosuppression. That is to say, an immune system is not working as effectively, either through a primary medical problem, or due to medications they’re treating to treat another condition, whether that’s an autoimmune disease, or perhaps cancer.

I’m happy to say that the two vaccines that we are currently using are both safe to be used in patients who have immunosuppression, because neither of them are live vaccines, there’s no chance of any active infection from them, which is the main issue with immunosuppression in general.

The main question remains over patients with immunosuppression is how effective vaccines will be at allowing them to produce a solid immune response in that will protect them from the virus in the future.

So far, things look pretty good. And it’s a good chance that you’ll have an improved immune response to COVID. Having had the vaccine, even if you’re on one of these medications. Even if the protection isn’t full, it’s likely to give you a much better ride with the disease if you did get it without having had the vaccine.

It’s worth saying as well that a lot of the drugs which are being used to treat people who are very poorly with COVID are actually trying to combat an overactive immune response from their, from their immune system in response to the infection, such as the dexamethasone steroids that you would have been hearing about, which dampens down that immune response, allowing patients to recover more quickly when they’ve got severe COVID causing problems with their immune system.

There has been some question as to whether patients should stop their immunosuppression prior to the vaccine. However, from the experts that I’ve spoken to, they feel it’s much more beneficial for the patient to get the vaccine into their arm as soon as possible, and to give them whatever protection they can from COVID ahead of time.

This leads nicely to the next question, which is around people who are extremely clinically vulnerable and what they should do after their first vaccine. I think essentially, the advice would be the same as I would give to a healthy person. People don’t get the benefit of the vaccine until at least 10 days to two weeks after the vaccine has been given.

Because it takes at least that long for the immune system to respond to the vaccine. And indeed, two doses are required for full protection with the two vaccines currently in use in the UK.

Although there are some vaccines, which are potentially coming along later, we’re only one dose will be required. Clearly, all of the studies so far based around the two vaccines we are using at the moment, are based around a two dosing regime. Therefore, the advice is clearly one should continue with that mantra of hands, face and space until we have the pandemic better controlled.

One dose of the vaccine or even two, doesn’t give you a get out of jail free card yet. It is however important because once we vaccinated enough people within the population, it’ll both reduce the risk of the infection being passed on. But also, hopefully those who do go on to get the disease will get a milder form that won’t make you as poorly and lead to as many hospitalizations. So hopefully once we are well on our way with the vaccination program life, we’ll be able to get back to normal. Another question that I have been asked around the first and second dose of the vaccine, a lot have been spoken about, about the timing of the second vaccine dose, particularly after the national vaccination committee brought out a recommendation to prolong the recommended dose between the first and second to 11 weeks.

Now, all of the testing that was done on the vaccines prior to release was based around the dosing regime of, for Pfizer, I think it was 28 days, 2128 days, and for AstraZeneca for longer 11 to 12 week window. However, after looking at the data, it was decided that the population as a whole would be better served by getting more first doses into as many people as possible. Prior to Going for that full protection given by the second dose. Therefore, they extended that to 11 weeks.

Now I can understand the logic behind this. And it seems a completely reasonable way to protect us all, although clearly causes considerable concerns to individuals who are hoping to get a second dose a bit sooner.

The question I had posed to me specifically was, should the same vaccine be given in the first and second doses, or whether a mixed dosing was possible?

That is to say, if someone got a Pfizer dose first time, would they be expecting to get a Pfizer dose for their second job, or should they be able to get an AstraZeneca one?

Again, all of the testing and evidence that would have come out in the vaccine trial so far, would have been using one particular vaccine for both jobs. And the aim with the program as it’s sets out at the moment, will be for everyone to get the second job have the same vaccine as they got in their first one.

It is not however impossible, that there could be supply problems or other issues, that would mean a booster of another type would have to be given second time. This is something that has been seen with vaccinations for other diseases.

And there is some argument that it could even give you better protection, in the same way as showing two different photos of a criminal to people going out to look for them would give them a better chance of recognising them out in the wild.

However, we are planning to be giving the same vaccine for the second dose as you get in the first and you should be recalled to the vaccination center where you had the first dose for this to be given.

This leads me on to the latest developments in the rollout of vaccinations within the UK, which has been the opening up of these larger vaccination centers for which people will when they’re in their appropriate cohort, be called by letter from the from the government to have their vaccine given at one of these bigger centers.

Unfortunately, there’s not been any way of connecting the national and the local recall systems. So you could well find yourself being invited to both. You could even be invited for the National Centre, having been given a vaccine in the local hub.

Now we’re very happy with you getting the vaccine wherever you can, as soon as you can. We’ve got plenty of people to get through. And we’re not going to run out of people to vaccinate.

However, it is really important that you need to go to the same place for your second dose as you go for your first. And if you’re being offered vaccinations at two places, please make sure you don’t accept both. Or you’ll end up taking a slot that could be used by someone else.

If you do find yourself in this situation, you can cancel appointments at the bigger hubs by calling 119.

The next question that comes up a lot is around people who have allergies, and which vaccination they should have. This has been a really difficult for one for us to manage is there’s been very limited guidance initially, although we are becoming much more confident with the vaccination as we go on.

The advice current currently is that people can receive any COVID-19 vaccination as long as they’re not allergic to any of the components of the vaccine itself.

The difficulty comes when people are not aware of the exact triggers for their allergy. The British society of allergy and clinical immunology have given advice that people who have unexplained severe allergy or anaphylaxis That is to say, anaphylaxis to something they don’t really know what’s caused it in the first place, or people who have anaphylaxis to multiple classes of drug should receive the Oxford AstraZeneca vaccine.

Also, if you have a an allergic skin reaction to the first dose, you should be going to a hospital to have the second dose for a prolonged period of time. Those who have got those unexplained allergies should be getting the AstraZeneca vaccine.

Anyone in any doubt should speak to their own GP who’s got access to your records to discuss this ahead of time.

The last question we’re going to cover today in the video podcast is around the mutations of the strains of the COVID vaccine being discovered around the world and how they’re being named.

As with everything that lives there is a natural rate of mutation that occurs every time the genetic code is multiplied.

These mutations can either have no effects on the virus, they can make it less effective or more effective. The mutations will occur at a standard rate throughout the world. And wherever they occur is purely random. They’re being named for where they’re being found. Where these strains do crop up.

If they have an increased infectivity, that is to say it’s easier for them to be passed on from person to person. Those strains will be selected for and grow more rapidly within a population. It’s survival of the fittest exactly as Darwin talks about.

The important thing to think about with these new strains and the implications of these new Viruses is are they more or less transmissible?

Do they cause cause a worse or a milder disease when you’re actually catching them?

And finally, how recognisable are they to the immune system, and in our case, talking about vaccines to the immune systems of people who’ve been vaccinated.

So, the strains you’ll be hearing most about in the news such as the UK strain, the South African strain and the Brazilian strains, which seems to be spreading a little faster, so they seem to have increased infectivity, and in some cases seem to be less well recognised by the immune system.

Some people seem to get a second infection with this. The good news is that so far, the vaccines are showing some degree of effectiveness in the combat against these diseases.

The thing that I really am waiting to hear from the data coming out is how serious the illness is in those people catching it for a second time. I can I can suspect that actually, a lot of people who are catching it for a second time may have a much milder disease, but only time will tell.

The other piece of news I wanted to put out is that I can guarantee that within certainly our area, there are no doses of vaccine being wasted. All of them are going into people, and we’re getting people vaccinated as fast as the vaccine gets delivered out to us.

Thanks so much for sticking with me so far. I hope you found this interesting and enjoyable.

If you have other questions, do connect with us on Facebook or ask questions via our website.

Do check us check out our website and please do subscribe and follow us. And if you have any other questions, don’t hesitate to get in touch. I look forward to catching up with you soon.

But in the meantime, stay safe. Catch you soon. Bye bye.

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