COVID-19: prioritising vaccination of healthcare workers

Our position on vaccine priority, second dose, delaying second dose, and the Pfizer and AstraZeneca vaccine.

Location: UK
Audience: All doctors
Updated: Monday 8 February 2021

The BMA’s position on vaccination of healthcare workers

Ensuring that frontline healthcare workers are vaccinated as soon as possible must be a priority. This is essential not just to protect those individuals who are most likely to be exposed to the virus, but also to stop the NHS being overwhelmed.

The BMA is now calling for vaccination of healthcare workers to be significantly accelerated – with an aim for all healthcare workers to have received their first jab no later than the end of January and those at greatest risk by the 20 January.

Pregnancy and breastfeeding

BMA agrees that pregnant and breastfeeding healthcare worker should be able to receive vaccination where the risk of exposure to SARS-CoV2 infection is high and cannot be avoided, or where the woman has underlying conditions that could lead to serious complications from COVID-19.  

Letter to trust CEOs

On 7 January we wrote a letter to all trust CEOs about the urgent need to prioritise vaccinate of their staff. The letter highlights a lack of priority to those exposed to the virus, inequitable access in certain trusts, and wastage of treatment. 

When will healthcare workers receive their second dose?

Vaccine supply is currently a key limiting factor. As such the JCVI has advised that the delivery of the first vaccine dose to as many eligible individuals as possible should be initially prioritised over delivery of a second dose.

They have stated that the second dose of the Pfizer vaccine may be given between three to 12 weeks following the first dose. The second dose of the AstraZeneca vaccine may be given between four to 12 weeks following the first dose.

 

The BMA’s position on delaying second vaccine doses

We recognise that we are now in a public health emergency and there is a need to protect as many people as possible as soon as possible.

Continuing to provide second doses of the Pfizer vaccine three weeks after the first dose was given may mean some healthcare workers not receiving a first dose at all over the coming weeks. Any delay must be used to rapidly accelerate vaccination of all frontline healthcare workers.

It is also vital that frontline healthcare workers receive full protection as soon as possible. This is particularly important for the Pfizer vaccine for which there is a lack of data on the impact of increasing the interval between doses beyond 42 days.

In line with WHO recommendations for this vaccine - that the second dose should be given within 21-28 days or as soon as possible thereafter. We will be pushing for individuals to receive their second dose as close as possible to the original schedule.

With the AstraZeneca vaccine there is some evidence that a longer interval between the first and second dose, such as twelve weeks, promotes a stronger immune response.

 

Which vaccine should healthcare workers receive?

We agree with the JCVI and UK chief medical officers that both vaccines have demonstrated high levels of protection against severe disease and have good safety profiles.

Having both vaccines available for healthcare workers will be necessary to accelerate the speed at which vaccination can be provided to this group.

 

Vaccine supply

There have been some reports of vaccine supplies being wasted – as yet these have been unconfirmed. If you have direct experience of this issue in your locality you can share your experience anonymously with the BMA by accessing our COVID-19 and winter pressures portal.

 

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