What COVID-19 vaccine will I receive if I am aged under 40?

On Friday 7 May, the Joint Committee on Vaccination and Immunisation (JCVI) advised the UK government a preference for adults aged 30 to 39 without underlying health conditions to receive an alternative to the Oxford/AstraZeneca vaccine – where available and only if this does not cause substantial delays in being vaccinated. More information is available here.

As at Friday 7 May, vaccinations aren’t currently being carried out for patients aged under 40, except to avoid vaccine wastage.

Should I be concerned about media coverage of a possible link between blood clots and the Oxford/AstraZeneca COVID-19 vaccine?

UPDATED: Friday 7 May 2021

What does the Medicines and Healthcare products Regulatory Agency say?
On Wednesday 7 April, the Medicines and Healthcare products Regulatory Agency (MHRA) issued new advice, concluding a possible link between COVID-19 Vaccine AstraZeneca and extremely rare, unlikely to occur blood clots. They also said that the benefits of vaccination continue to outweigh any risks but the MHRA advises careful consideration be given to people who are at higher risk of specific types of blood clots because of their medical condition.

The Joint Committee on Vaccination and Immunisation (JCVI) has advised:

·         Under-30s with no underlying health conditions should be offered an alternative to the AstraZeneca vaccine where available

·         Those who have received their first dose of the AZ jab should continue to be offered a second dose of the same jab

What does the European Medicines Agency say?
On Wednesday 7 April, European Medicines Agency’s safety committee (PRAC) concluded that unusual blood clots with low blood platelets should be listed as very rare side effects of Vaxzevria (formerly COVID-19 Vaccine AstraZeneca) but confirmed that the overall benefit-risk remains positive.

Updated preference given on Friday 7 May
On Friday 7 May, the Joint Committee on Vaccination and Immunisation (JCVI) advised the UK government a preference for adults aged 30 to 39 without underlying health conditions to receive an alternative to the Oxford/AstraZeneca vaccine – where available and only if this does not cause substantial delays in being vaccinated. More information is available here.

As at Friday 7 May, vaccinations aren’t currently being carried out for patients aged under 40, except to avoid vaccine wastage.

What should I do if I suspect I may have had an allergic reaction to a COVID vaccination, based on previous reactions to vaccination or medication?

If you suspect that you may have an allergic reaction to a COVID vaccination, based on previous reactions to vaccination or medication, then please discuss your concerns with your GP who can advise you on the best course of action.

Why vaccines are important

  • Vaccines are the most effective way to prevent infectious diseases.
  • Vaccines save lives. After clean water, vaccination is the most effective public health intervention in the world.
  • Vaccination is the most important thing we can do to protect ourselves and our children against ill health. Vaccines prevent up to 3 million deaths worldwide every year.
  • Vaccines are the only way to eradicate disease. We have eradicated smallpox and are near to eradicating polio, both through using vaccines.
  • Measles vaccination alone has prevented 20 million measles cases and 4,500 deaths in the UK.
  • Vaccines teach your immune system how to create antibodies that protect you from diseases. It's much safer for your immune system to learn this through vaccination than by catching the diseases and treating them. Once a vaccine has trained your immune system to know how to fight a disease, it can often protect you for many years.
  • Neither HIV nor malaria have vaccines, which shows just how challenging the process of developing a vaccine can be.

How vaccines work

To create a vaccine for a disease, the germ which causes it is weakened, or completely inactivated so that it cannot cause the disease in question. When this weakened or ‘dead’ germ is introduced to the immune system, it trains the immune system to recognise the disease and fight it off if you come into contact with it in the future.

Vaccines are now safer than ever before. Any vaccine must first go through the usual rigorous testing and development process and be shown to strict standards of safety, quality and effectiveness before it can be deployed.

What is the government doing about the spread of disinformation?

False information about COVID-19 vaccines could cost lives. The government is working with health experts to provide information and advice at every possible opportunity. The Government’s Counter Disinformation Unit, led by DCMS works to tackle disinformation and misinformation relating to COVID-19. The Unit works closely with social media platforms to help them identify and take action to remove incorrect claims about coronavirus, and to promote authoritative advice and information.

The Government published the Full Government Response to the Online Harms White Paper consultation in December 2020, which sets out new expectations on companies to keep their users safe online. The new laws will have robust and proportionate measures to deal with disinformation that could cause significant physical or psychological harm to an individual, such as false information about Covid-19 and COVID-19 vaccines.

We have developed the SHARE checklist which aims to increase audience resilience by educating and empowering those who see, inadvertently share and are affected by false and misleading information. The checklist provides the public with five easy steps to identify false content, encouraging users to stop and think before they share content online.  We have also partnered with the University of Cambridge to create a game called “Go Viral!”. Our aim is to build the public’s resilience to false information, mitigating the risk of undermining the uptake of Covid-19 vaccines, treatments and diagnostics.

What vaccines for COVID-19 are currently available?

Following extensive trials, two safe and effective vaccines for COVID-19 have been approved by regulators and are now available. A third vaccine (Moderna) has been approved and will be available in the spring.

Vaccines are now being delivered in hundreds of hospital hubs, local vaccination services and care homes. The NHS is continuing to prioritise those the JCVI and government has decided will benefit the most.

Can people choose what vaccine they have? It has been suggested that vaccines could be mixed and matched?

No. Any vaccines that are available will have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from coronavirus.

The Pfizer/BioNTech vaccine is being rolled out as fast as possible by the NHS across the UK. Now authorised, the AstraZeneca/Oxford vaccine will be deployed alongside the Pfizer/BioNTech vaccine to increase the pace and volume of the UK programme. There are no current plans to mix these vaccines.

The Government’s Vaccine Taskforce keeps its approach under review, ensuring the UK is in the strongest position to protect people. The science is uncertain about how mixing vaccines could produce a better immune response, so trials and testing will continue to assess and test vaccine responses.

In rare cases can the Pfizer/BioNTech and AstraZeneca/Oxford vaccine be mixed and matched?

We do not recommend mixing the COVID-19 vaccines – if your first dose is the Pfizer vaccine you should not be given the AstraZeneca vaccine for your second dose and vice versa. However, there may be extremely rare occasions where the same vaccine is not available, or where it is not known what vaccine the patient received.

Our guidance is very clear that every effort should be made in these instances to give the same vaccine to the patient, but where this is not possible it is better to give a second dose of another vaccine than not at all. This is a reasonable measure on a very exceptional basis, when the alternative is to leave someone with an incomplete course – which is the greater concern, especially if the individual is likely to be at immediate high risk or is considered unlikely to attend again.

In these rare circumstances, as both vaccines are based on the spike protein, it is likely the second dose will help to boost the response to the first dose. While there is no evidence on the interchangeability of the COVID-19 vaccines at this time, this is a pragmatic and scientific approach agreed by many scientists and vaccine experts, including the UK’s Deputy Chief Medical Officer.

How was the Covid-19 vaccine developed so fast?

Vaccine technology and the technological approaches to making vaccines are getting better and better and we couldn’t have done it in this timeframe if we went back to the 2009 pandemic and we had a new virus about which we knew very little. We’re in a different place today because of the technology. 

It was very clear that it was a global public health emergency from the word go and governments were prepared to put in lots of funding to manufacturers, without any guarantee of success, but hoping that they would find a solution

Manufacturers knew this had to be a straight run through; they didn't have time for investment decisions and pausing or thinking about a commercial market at the end of it. It had to happen with real urgency. 

But the vaccine trials have been just the same as normal vaccine trials. Phase one, phase two and phase three. Where time has been saved is by recruiting participants in advance, so at the moment the study protocol is in place, the Ethics Committee is in place, so are the vaccine trial participants – which speeds up the process. And that happened at phase one, phase two and phase three and therefore things ran very fast.

How was the UK able to approve the Pfizer/BioNTech and Oxford/AstraZeneca vaccine more quickly than other countries?

Public safety has been and continues to be the Government’s top priority. No vaccine would be authorised for supply in the UK unless it meets high standards of safety, quality and effectiveness.

Following a series of rigorous clinical trials, experts at the Medicines and Healthcare products Regulatory Agency have concluded that both the Pfizer/BioNTech and the Oxford/AstraZeneca vaccines have met its strict standards of safety, effectiveness and quality.

The MHRA has already expressed that scientific rigour has been followed according to strict guidelines, and the vaccine has only been approved after passing these standards. The MHRA is recognised across the world for its high standards and professionalism.

The Medicines and Healthcare products Regulatory Agency (MHRA) is a world leader in its field and followed rigorous international standards in its assessment of the Pfizer/BioNTech and Oxford/AstraZeneca vaccine to make sure it meets strict standards of safety, effectiveness and quality.

This has been a rigorous assessment with the rolling review starting in October as soon as data from the clinical trials became available. The MHRA also sought advice from independent experts from the Commission on Human Medicines before authorising the vaccine.

The way in which the MHRA has worked is equivalent to all international standards. The public can be absolutely confident that the standards we have worked to are equivalent to those around the world.

Has this outcome only been made possible through Brexit?

The MHRA is globally recognised for requiring strict standards for quality, and safety in its medicines regulation. They made these vaccines their top priority whilst upholding the very highest safety standards. 

Whilst the UK has approved these vaccines first, it maintains strong relations with its EU counterparts, including on the response to this pandemic. We are committed to strengthening our collaboration with the EU outside of the joint procurement initiative, which includes collaborating on vaccine development, distribution and manufacturing.  

How can people be confident there won’t be long term side effects?

Every single vaccine authorised for use in the UK has been authorised by the MHRA and the three components of authorisation are a safety assessment, an effectiveness assessment and a manufacturing quality assessment.

When will the Moderna vaccine be available in the UK?

On Friday 8 January, the Moderna vaccine became the third Covid vaccine to be approved for use in the UK. We expect supplies of this vaccine to arrive in the spring.

How will the Moderna vaccine be deployed?

When doses are available for deployment, the Moderna vaccine will become available through the COVID-19 immunisation programme, which is already successfully deploying doses of the Pfizer/BioNTech and Oxford-AstraZeneca vaccines throughout the UK to those most at risk of COVID-19.

Should I contact my GP or hospital to arrange getting the COVID-19 vaccination?

No. When it is the right time people will receive an invitation to come forward. For most people this will be a letter, either from their GP or the national NHS. This letter will include all the information you will need to book appointments, including your NHS number. We know lots of people will be eager to get protected but we are asking people not to contact the NHS to get an appointment until they get their letter.

I’m currently ill with COVID-19, can I get the vaccine?

People currently unwell and experiencing COVID-19 symptoms should not receive the COVID-19 vaccine until they have recovered.

What about people who are immunocompromised who can’t benefit from a vaccine?

The Government is exploring all avenues available to us, to ensure that a treatment for COVID-19 is found.  

Treatments containing COVID-19 neutralising antibodies have been secured from AstraZeneca to support immunocompromised people who will not be able to benefit from a COVID-19 vaccine.   

The antibody treatment currently being developed by AstraZeneca is a combination of two monoclonal antibodies and has the potential to be given as a preventative option for people exposed to the virus, and to treat and prevent disease progression in patients already infected by the virus if successful. 

Why do the JCVI’s recommendations focus on reducing people’s individual risk and not stopping transmission?

The most important thing is that we protect those who are most at risk of dying. At the start of any vaccination programme, we won’t know the impact of the vaccine on transmission and so we will vaccinate those who are at highest risk of serious illness and death. This includes older people and care home residents.  

 

As vaccination programmes roll out globally, our understanding of the safety and effectiveness of each vaccine will increase, and these data will be used to develop advice on the next phase of the programme. 

When will you know if the vaccines prevent transmission?

Public Health England will employ existing surveillance systems and enhanced follow-up of cases to monitor how effective the vaccine is at protecting against a range of outcomes including: infection, symptomatic disease, hospitalisations, mortality and onwards transmission. It is likely to be some time until we have sufficient data to provide a clear picture of how vaccination impacts on onward transmission.

How long will the vaccines protect people for?

Public Health England  will employ existing surveillance systems and enhanced follow-up of cases to monitor how effective the vaccine is at protecting against a range of outcomes including: infection, symptomatic disease, hospitalisations, mortality and onwards transmission. It is likely to be some time until we have sufficient data to provide a clear picture of how long the protective effect of vaccination lasts.

Why is vaccination not recommended for children?

Almost all children with COVID-19 have no symptoms or mild disease and the vaccines not yet been tested in younger children. The Committee advises that only children at very high risk of catching the virus and serious illness, such as older children with severe neuro-disabilities in residential care, should be offered vaccination. 

Is the vaccine safe for people with pre-existing conditions?

The trials have involved people with chronic underlying conditions deliberately, and they have involved people from very broad age ranges and quite a lot of people in the elderly bracket. The JCVI have looked at this, there’s no indication that there should be any difficulty in giving it to people with chronic underlying conditions. 

The JCVI has picked out, not just by age, but people 18 to 65 with at-risk conditions and the reason for that is that they are at extremely high risk from coronavirus compared with the general population.

How do you monitor for problems, such as injuries or allergic reactions?

Each COVID-19 vaccine candidate is assessed on a case-by-case basis and will only be approved by the independent regulator, the MHRA, once it has met robust standards of effectiveness, safety and quality. Right through the tests and the trials, teams of scientists and clinicians carefully, methodically, scientifically rigorously review all data on safety, effectiveness and quality as soon as they become available. 

The independent expert working group have supported MHRA proposals for a proactive safety monitoring strategy. This comprises the Yellow Card scheme and a special active monitoring programme which we are inviting people to join.  

Approved COVID-19 vaccines will be monitored continuously after roll out by the MHRA and Public Health England to ensure that the benefit of the vaccines continues to outweigh any risk. 

You can report suspected side effects to COVID-19 vaccines through the Coronavirus Yellow Card reporting portal https://coronavirus-yellowcard.mhra.gov.uk/ 

The MHRA will work in collaboration with partners in the health system to rapidly assess all available safety data in real time and communicate any emerging issues, as necessary.

Are there any side effects?

Like all medicines, vaccines can cause side effects. Most of these are mild and short-term, and not everyone gets them. These are important details which the MHRA always consider when assessing candidate vaccines for use. For the Pfizer/BioNTech vaccine, like lots of others, they have identified that some people might feel slightly unwell, but they report that no significant side effects have been observed in the over 43,000 people involved in trials. All patients will be provided with information on the vaccine they have received, how to look out for any side effects, and what to do if they do occur, including reporting them to the MHRA.

If there are any significant medical incidents, could rollout be halted?

Each COVID-19 vaccine candidate is assessed on a case-by-case basis and will only be approved once it has met robust standards of effectiveness, safety and quality. Right through the tests and the trials, teams of scientists and clinicians carefully, methodically, scientifically rigorously review all data on safety, effectiveness and quality as soon as they become available.  

Once a vaccine has been rolled out, PHE will continue to closely monitor safety data. In the rare instance of a medical incident, DHSC will review the available data. The government are clear that all vaccines being rolled out must continue to meet high standards of safety and efficacy. 

Can pregnant women have the Pfizer/BioNTech or Oxford/AstraZeneca vaccines?

The JCVI has amended its previous precautionary advice on Covid-19 vaccines and pregnancy or breastfeeding. The new advice sets out that vaccination with either vaccine in pregnancy should be considered where the risk of exposure SARS-CoV2 infection is high and cannot be avoided, or where the woman has underlying conditions that place her at very high risk of serious complications of Covid-19, and the risks and benefits of vaccination should be discussed.

The Pfizer/BioNTech vaccine should only be considered for use in pregnancy when the potential benefits outweigh any potential risks for the mother and baby. Women should discuss the benefits and risks of having the vaccine with their healthcare professional and reach a joint decision based on individual circumstances. Women who are breastfeeding can also be given the vaccine.

Those who are trying to become pregnant do not need to avoid pregnancy after vaccination, and breastfeeding women may be offered vaccination with either vaccine following consideration of the woman’s clinical need for immunisation against COVID-19. The UK Chief Medical Officers agree with this advice. 

Can I go back to work after having my vaccine?

Yes, you should be able to work as long as you feel well. If your arm is particularly sore, you may find heavy lifting difficult. If you feel unwell or very tired you should rest and avoid operating machinery or driving.

The vaccine cannot give you COVID-19 infection, and two doses will reduce your chance of becoming seriously ill. However, you will need to continue to follow the guidance in your workplace, including wearing the correct personal protection equipment and taking part in any screening programmes.

Will unpaid carers be included in the JCVI prioritisation?

The Joint Committee on Vaccination and Immunisation (JCVI) have advised that the vaccine should be prioritised for care home residents and staff, followed by people over 80 and health and social care workers – including home carers. We recognise the vital role unpaid carers play in caring for vulnerable individuals and we will provide further details on their access to the vaccine in due course.

How long does immunity last for after the vaccination?

COVID-19 remains a new infection and close observation by experts continues. At this stage it is unclear whether the vaccine will need to given yearly, like the flu vaccine, or less frequently.

Trials for length of vaccine protection continue and will also inform how vaccination for COVID-19 is recommended in the future.

Does the vaccine contain the ‘live’ virus? Can it give me or anyone around me COVID-19?

No. The vaccines are designed to produce an immune response to just a small part of the virus, the spike protein. This is the part of the virus that allows it to enter into human cells and cause infection. No whole COVID-19 virus or live virus is used in the vaccines. This means the vaccine cannot give you COVID-19 and does not make you infectious after you have had the vaccine. This means it is also safe for people with a suppressed immune system.

Do you have to have a test for COVID-19 before you have a vaccine?

No. You are not required to have a test prior to your vaccination, however if you have any symptoms of COVID-19 infection you must follow government guidelines and must not attend the appointment. You should follow advice you have been given to re-book your appointment.

Does the vaccine cure COVID-19 if you are positive?

You should not have the vaccine if you have had confirmed COVID-19 infection in the previous 28 days unless you are advised by your doctor that it is suitable for you to do so.

Are there any non-intramuscular options non-injection options such as a nasal spray or pill?

Not at this time.

Do people who have already had COVID-19- get vaccinated?

Yes, if they are in a priority group identified by the Joint Committee on Vaccination and Immunisation (JCVI). We don’t yet know how long immunity lasts after having been infected with COVID-19, so getting vaccinated is just as important for those who have already had it as it is for those who haven’t.

If I have antibodies do I need a vaccine?

Yes; it is unclear how long antibodies produced following infection may provide protection and whether the protection is as effective as that provided by vaccination. It is therefore recommended you have a vaccine if offered one.

Can people pick which vaccine they want?

No. The vaccine given will be based on availability, except for when a patient’s medical history means a specific vaccine must be used. Any vaccines that are available will have been approved by the medicine regulatory authorities so you should be assured that whatever vaccine you are offered, it is safe and effective.

Once vaccinated can people stop wearing a mask/social distancing?

No. While the vaccination prevents the development of the infection in around 90-95% of people, there is still a chance of contracting the virus or transmission to others. It is therefore very important to continue wearing a mask, social distancing and practicing good hand hygiene.

How will GPs be told who to vaccinate?

The JCVI will set criteria on an ongoing basis for who should get the vaccine when. GPs will be able to call in or go out to patients based on this, using their patient records. A national invite and recall system, drawn from GP patient records, may also be used. 

How many people need to receive the Covid-19 vaccine in JCVI’s first phase?

The JCVI recommendations of vaccination by age and risk factors is estimated to cover over 25 million people in phase 1. The vaccination of the top two cohorts is estimated to cover over 6 million people.

Why aren’t BAME groups being prioritised?

There is clear evidence that certain Black, Asian and minority ethnic (BAME) groups have higher rates of infection, and higher rates of serious disease and mortality. The reasons are multiple and complex.   

There is no strong evidence that ethnicity by itself (or genetics) is the sole explanation for observed differences in rates of severe illness and deaths. What is clear is that certain health conditions are associated with increased risk of serious disease, and these health conditions are often overrepresented in certain Black, Asian and minority ethnic groups. 

Prioritisation of people with underlying health conditions will also provide for greater vaccination of BAME communities who are disproportionately affected by such health conditions.   

Tailored local implementation to promote good vaccine coverage in Black, Asian and minority ethnic groups will be the most important factor within a vaccine programme in reducing health inequalities in these groups. 

The NHS will provide advice and information at every possible opportunity, including working closely with BAME communities, to support those receiving a vaccine and to anyone who has questions about the vaccination process. 

Throughout the pandemic, we have prioritised protecting the most vulnerable in our society and have invested more than £4 million into research into Covid-19 and ethnic disparities so that we can go further.

Why are care home workers prioritised over NHS staff?

There is evidence that infection rates are higher in residential care home staff, than in those providing home care or in healthcare workers. Care home workers are therefore considered a very high priority for vaccination. 

Why aren’t you vaccinating economically active people? Surely that would be a good approach to get the economy back up and running again?

The full impact of vaccination on infection and transmission of the virus will not become clear until a large number of people have been vaccinated.  

The Joint Committee on Vaccination and Immunisation (JCVI) are the independent experts who advise Government on which vaccine/s the United Kingdom should use and provide advice on prioritisation at a population level.  

The Committee have advised that the first priorities for any COVID-19 vaccination programme should be the prevention COVID-19 mortality and protection of health and social care staff and systems. Secondary priorities could include vaccination of those at increased risk of hospitalisation and at increased risk of exposure, and to maintain resilience in essential public services.  

Given the current epidemiological situation in the UK, all evidence indicates that the best option for preventing morbidity and mortality in the initial phase of the programme is to directly protect persons most at risk of morbidity and mortality.

Why no priority for certain occupations?

The JCVI have considered evidence on the risk of exposure and risk of mortality by occupation. Under the priority groups advised, those over 50 years of age, and all adults in a risk group, would be eligible for vaccination within the first phase of the programme.   

This prioritisation captures almost all preventable deaths from COVID-19, including those associated with occupational exposure to infection. As such, JCVI does not advise further prioritisation by occupation during the first phase of the programme. 

Are you going to prioritise giving teachers the vaccine so schools can reopen?

We are following the advice from independent experts on the JCVI on which groups of people to prioritise for Covid-19 vaccines.

The Committee advised the immediate priority should be to prevent deaths and protect health and care staff, with old age deemed the single biggest factor determining mortality. 

We understand this is a challenging period for many, and the NHS is working hard to vaccinate those most at risk as soon as possible.

Will key workers, such as teachers and taxi drivers be offered the vaccine?

Not at this stage unless they fall into one of the priority groups. The priority groups are reviewed by the Joint Committee on Vaccines and Immunisations (JCVI) and, if it is deemed necessary, other groups may also be invited for a vaccination.

Who is being offered a COVID-19 vaccine currently?

The NHS is currently in the process of offering the vaccine to people aged 80 and over, those who live or work in care home, and frontline health and social care staff. When everyone in these groups has had the chance to get their first dose of the vaccine the programme will expand to other people that are at risk either due to their age group or medical condition in line with the advice from the Joint Committee on Vaccinations and Immunisations.

Read the latest JCVI advice on priority groups for the COVID-19 vaccination on the GOV.UK website.

Will people who have had their vaccination through a hospital, GP or care home still receive a letter to book through the national system?

This may happen in a small number of cases. If people have had their first vaccination through a hospital or GP service, or are a care home residents, this will be noted through the national system. In some cases, the letter may have been printed to be sent before the national system is updated. This is explained in the booking letter. If you have already had your first dose, please do not book through the details included on the letter.

When will clinically extremely vulnerable people be offered a vaccine?

People classed as clinically extremely vulnerable should have already been contacted should have already received a letter from the NHS. If you have not been contacted and think you should have been, please speak to your GP or hospital care team. People defined as clinically extremely vulnerable are listed on the GOV.UK website.

As one of the top four priority groups, clinically extremely vulnerable people should be contacted for their first vaccine appointment in the coming weeks, with all clinically vulnerable people expected to have been offered a vaccine by February 15.

If I live with or care for someone who has a vaccine appointment, can I be seen at the same time?

If you provide unpaid care or live with someone eligible to receive a vaccine, at this time we are not able to also offer you a vaccine. All eligible people will be contacted. If you have not been contacted, please be patient as the vaccine rollout continues. We recognise the vital role unpaid carers play in caring for vulnerable individuals and we will provide further details on their access to the vaccine in due course.

Care home staff are in the highest priority group, and are currently being vaccinated alongside care home residents.

Can I pay for a COVID-19 vaccine privately or at a pharmacy?

No, the COVID-19 vaccination is only available through the NHS to eligible groups and it is a free vaccination.