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Some British family doctors said on Thursday they would defy government instructions to postpone patient appointments for a second dose of the coronavirus vaccine, a sign of unease in the medical community over Britain’s new plan to delay second injections to give more. people partial protection from a single dose.
British medics, who have been instructed to start rescheduling second dose appointments that had been set for next week, said they were loath to ask older and vulnerable patients to wait two more months for their booster shots of the Pfizer-BioNTech vaccine. They said these patients were counting on full two-dose protection, had already arranged for caregivers to help them get to their doctor’s office, and couldn’t afford to rely on a new, untested vaccination strategy. .
Beyond that, doctors said, it was logistically impossible to reach thousands of older patients in a matter of days and then fill those windows with the first beneficiaries.
The British Medical Association, a union of doctors, said on Thursday it would support doctors who have decided to keep second dose appointments which have been booked for January.
“It is patently unfair for tens of thousands of our most at risk patients to try now to reschedule their appointments,” Dr. Richard Vautrey, chair of the union’s family physicians committee, said in a statement. “The government must see that it is fair that existing reservations for the oldest and most vulnerable members of our society are honored, and it must also publish as soon as possible a scientifically validated rationale for its new approach.
A spokeswoman for the UK’s National Health Service said in a statement that the service was providing family doctors with “additional financial and logistical support” to “help thousands more get the vaccine quickly.”
Vaccines against covid19>
Answers to your questions about vaccines
With the distribution of a coronavirus vaccine starting in the United States, here are the answers to some questions you might be wondering:
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- If I live in the United States, when can I get the vaccine? While the exact order of vaccinees can vary by state, most will likely prioritize medical workers and residents of long-term care facilities. If you want to understand how this decision is made, this article will help you.
- When can I resume a normal life after being vaccinated? Life will only return to normal when society as a whole is sufficiently protected against the coronavirus. Once countries authorize a vaccine, they will only be able to immunize a few percent of their citizens in the first two months. The unvaccinated majority will always remain vulnerable to infection. A growing number of coronavirus vaccines show strong protection against the disease. But it is also possible for people to spread the virus without even knowing they are infected, as they show only mild symptoms, if any. Scientists do not yet know if the vaccines also block the transmission of the coronavirus. So for now, even vaccinated people will have to wear masks, avoid crowds inside, etc. Once enough people are vaccinated, it will become very difficult for the coronavirus to find vulnerable people to infect. Depending on how quickly we, as a society, reach this goal, life may start to move closer to something normal by fall 2021.
- If I have been vaccinated, do I still have to wear a mask? Yes, but not forever. Here’s why. Vaccines against the coronavirus are injected deep into the muscles and stimulate the immune system to produce antibodies. This appears to be enough protection to prevent the vaccinated person from getting sick. But what’s not clear is whether it’s possible for the virus to bloom in the nose – and either sneeze or breathe out to infect other people – even though antibodies elsewhere in the body have mobilized to prevent the vaccinated person to get sick. Clinical vaccine trials have been designed to find out whether vaccinated people are protected from the disease – not whether they might still spread the coronavirus. Based on studies of the flu vaccine and even of patients infected with Covid-19, researchers have reason to hope that those vaccinated will not spread the virus, but more research is needed. In the meantime, everyone, even those who have been vaccinated, will have to think of themselves as possible silent spreaders and continue to wear a mask. Learn more here.
- Will it hurt? What are the side effects? The Pfizer and BioNTech vaccine is given by injection into the arm, like other typical vaccines. The injection into your arm won’t be different from any other vaccine, but the rate of short-lived side effects seems higher than a flu shot. Tens of thousands of people have already received the vaccines, and none of them have reported serious health problems. Side effects, which can resemble symptoms of Covid-19, last for about a day and seem more likely after the second dose. Initial reports of vaccine trials suggest that some people may need to take time off work because they feel unwell after receiving the second dose. In the Pfizer study, about half developed fatigue. Other side effects occurred in at least 25-33% of patients, sometimes more, including headache, chills and muscle pain. While these experiences are not pleasant, they are a good sign that your own immune system is developing a potent response to the vaccine that will provide long-lasting immunity.
- Will mRNA vaccines change my genes? No. Moderna and Pfizer vaccines use a genetic molecule to stimulate the immune system. This molecule, known as mRNA, is ultimately destroyed by the body. The mRNA is packaged in an oily bubble that can fuse with a cell, allowing the molecule to slip inside. The cell uses mRNA to make proteins from the coronavirus, which can stimulate the immune system. At any given time, each of our cells can contain hundreds of thousands of mRNA molecules, which they produce to make their own proteins. Once these proteins are made, our cells then shred the mRNA with special enzymes. The mRNA molecules made by our cells can only survive for a few minutes. The mRNA in vaccines is designed to resist the enzymes in the cell for a bit longer, so that the cells can make additional viral proteins and elicit a stronger immune response. But mRNA can only last a few days at most before being destroyed.
“The NHS must follow” the new guidelines, the statement said, “in order to increase the number of vulnerable people protected from Covid over the next three months, potentially saving thousands of lives.”
Delaying second doses of vaccine could double the number of people who receive a vaccine soon, and possibly ease the virus’s toll in Britain, where hospitals face a deluge of cases of a new, more contagious variant of the coronavirus. While anyone may be in a better position to receive the second dose quickly, some scientists say society as a whole benefits if more people get partial protection from just one dose at this time.
Other scientists, however, believe Britain has exceeded the available evidence, potentially leaving older people and healthcare workers without the full protection of two doses of the vaccine amid terrible winter surges. Britain made the decision without the town halls or voluminous briefings that preceded US regulatory decisions. No trial has explicitly tested the long-term efficacy of a single shot.
And what limited evidence exists on the protection offered by a single dose contradicts scientists’ fears that antibody responses will decline over time, potentially falling below a threshold of protection.
Some family doctors in Britain have said they are worried about the lack of evidence showing patients will be protected for many weeks against Covid-19 after a single injection of the Pfizer-BioNTech vaccine.
“I have been asked to break my promise to my elderly patients,” said Dr. Helen Salisbury, family physician at Oxford, said on Twitter Thursday morning, “And use a vaccine outside of their proven and approved schedule, which likely puts them at risk.”
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