DATA showing Israel’s widespread vaccination policy has dramatically reduced hospital admissions is “real world evidence” that the UK governments were right to delay second doses of the Pfizer vaccine, a clinical expert has said.
The British Medical Association, which represents doctors, is continuing to lobby for frontline workers to be offered the booster earlier than 12 weeks because while the “short-term” efficacy of the first dose for preventing serious illness is 90 per cent, it is unclear when this starts to wane,
Dr Thomas Williams, a clinical lecturer at Edinburgh University, said that he empathised with his clinical colleagues but said the Government had to be pragmatic in the face of surging cases and new variants of Covid-19.
He said: “At the end of the day if it’s a choice between slightly less protection for you or one of your patients dying then surely you would have to go for the protection of patients.”
The latest figures show that 2.43 million people in Israel have now received at least one shot of the two-dose vaccines, around 27% of the country and more than anywhere else in the world, although the government has faced criticism from human rights groups for failing to commit to protecting Palestinians.
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Figures show 4,500 people were diagnosed with Covid after having one dose of the vaccine. Of those 244 were hospitalised in the first week, 124 in the second week and seven, more than 15 days from when they received the vaccine, which Dr Thomas said “suggests higher efficacy from two weeks”.
Israel’s coronavirus tsar has warned that a single dose of the Pfizer/BioNTech vaccine may be providing less protection than originally hoped. Those who had received their second dose of the Pfizer vaccine had a six- to 12-fold increase in antibodies, according to data released by Sheba Medical Center in Tel Hashomer on Monday.
The country has struck a deal with Pfizer, promising to share medical data in exchange for the continued flow of its hard-to-get vaccine.
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However, Dr Williams, who is also a paediatrician, said the latest JCVI data which suggests the Pfizer vaccine is most effective between day 15 and 21 was “reassuring” and said the priority for scientists will be to study re-infection rates after this time.
One GP has suggested that the longer delay in administering the booster “could be like administering a first jag by 12 weeks” and said he would be acting as if he had not been vaccinated.
“I think that’s wise in any situation. No vaccine is going to be 100% effective,” said Dr Williams.
“Until we have got really low rates of the virus we should not be changing our behaviour and that’s the message we have been given consistently.
“In principle a single dose could be less effective and wane over time, but we don’t have any data for this yet. Israel is probably the best real world evidence we have and suggests that it seems to work pretty well from day 15.
“There are two risks. The first is that immunity wanes and isn’t as much as the JCV study says which is 89% after the first dose, that’s a theoretical possibility but we haven’t seen evidence of that yet.
“The second is the risk of mutations occurring in the virus and you have got incomplete immunity. That’s a theoretical risk. I know that it’s a priority for those who are sequencing the virus to look at immunised people and re-infections but we won’t know that for a little while yet.
“The Government had to balance out giving out a second dose to follow the trial for 96% efficacy after your second dose and fully protecting everyone as much as they could do with protecting people in care homes.
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“Other countries have decided to vaccinate younger people but I think we have too many cases to do that in the UK."
None of the trials of the three vaccines approved for use in the UK have demonstrated that they prevent infection altogether, or reduces the spread of the virus in a population.
This leaves open the chance that those who are vaccinated could remain susceptible to asymptomatic infection — and could transmit that infection to others who remain vulnerable
Asked if the policy of delaying the second dose is likely to change Dr William said: “I think so.
"At the moment we don’t have enough vaccines and that’s because they are difficult to make.”
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