About the Vaccine

Q. Why am I being offered the COVID-19 vaccine? Do I have to have it?

Everyone who works at Homerton (including bank, agency, and contract partners) is being offered the free vaccination, it is not mandatory.

Since the start of the coronavirus pandemic, medical and scientific professionals have been working to develop a vaccine to help stop the spread of the virus.

We have all felt the impact of the pandemic, and this has been the most challenging year in NHS history. Happily, following extensive trials, two safe and effective vaccines for COVID-19 are now available to help protect you from the virus.

The vaccines have been through the same regulatory approval process as any medicines to ensure they meet strict safety standards and offer high levels of protection.

The vaccine cannot give you COVID-19 infection, and will reduce your chance of becoming seriously ill.

Getting vaccinated only protects you from the virus, so you will still need to follow IPC and testing measures in your workplace, and follow general advice at work, at home and when you are out and about:

The free vaccine is ready to protect you against COVID-19 so you can keep protecting others.

The vaccine is not mandatory, however we strongly encourage you to consider being vaccinated. Getting your COVID-19 vaccination as soon as you can will protect you and help protect your family and those you care for. You will need to have two doses of the vaccine. The first vaccine dose gives limited protection in the first 10 days and increases to a very good protection by day 21. It continues to provide a high level of protection from severe illness and hospitalisation in the short term. However, to achieve maximum protection the second dose remains important and everyone is urged to attend for both appointments to get the maximum level of protection.

Q. Is the vaccine safe?

Yes. Like all other medicines and devices, all of the COVID-19 vaccinations have been granted regulatory MHRA approval to ensure that they are safe and effective. The vaccines cannot give you COVID-19 infection, and while you will be given two doses, analysis shows that the first dose alone will significantly reduce your chance of becoming seriously ill within two weeks. The MHRA recently released a statement saying “The data we have collected provides further reassurance that the COVID-19 vaccines are safe and continue to meet the rigorous regulatory standards required for all vaccines. We remain confident that the benefits of these vaccines outweigh any risks” following the administration of over 12 million vaccines in the UK.  You can read the full statement here: https://www.gov.uk/government/news/latest-monitoring-data-confirms-safety-of-covid-19-vaccines

Q. How does the vaccine work?

The Pfizer vaccine is an mRNA vaccine and the Oxford AstraZeneca is a viral vector vaccine. They are similar in that they are based on nucleic acid. They introduce the sequence codes for the spike protein of the virus and the protein has been described as the part of the virus that produces the strongest immune response, this protein covers the virus. In the case of the Oxford AstraZeneca vaccine this sequence is put into a defective virus, in this case a chimpanzee virus so it does not have the ability to replicate in humans. It is very good as a backbone to introduce the sequence for the spike protein. It does not contain the full virus code and it cannot multiply, because not only is it a chimpanzee virus so cannot infect humans, but also it is replication defective so it cannot replicate, even in chimpanzees. The vaccine is given intramuscularly so the immune cells will pick it up and carry the sequence and express the protein in local lymph nodes and that is what induces the immune response. It cannot integrate into the genome, it does not have a very long life, and  it cannot replicate.

This diagram gives a clear guide on how the AstraZeneca Vaccine works: https://www.compoundchem.com/2020/12/30/viral-vector-vaccines/

And this diagram gives a clear guide on how the Pfizer Vaccine works: https://www.compoundchem.com/2020/12/02/rna-vaccines/

Q. Does the AstraZeneca vaccine contain any animal derivatives?

No, neither the Pfizer or the AstraZeneca vaccine contain any meat derivatives, porcine products, or material of foetal or animal origin. If you are concerned about ingredients due to religious reasons, please see the resource page for statements from various religious groups: https://intranet.homerton.nhs.uk/covid-19-vaccination-resources

Q. How effective is the AstraZeneca Vaccine?

No vaccine is 100% effective, the AstraZeneca vaccine is reported as 70% effective. In real terms, means that out of every 10 people vaccinated, 7 will be protected against COVID-19. This is about average for most vaccines. We do not have as wide an understanding as we do with children’s inoculations where we have many years of research. What we do know is that the vaccine will improve your immunity if you are vulnerable If you do not have the vaccine you are still at a high level of risk. What is certain is that you will not get COVID-19 from the vaccine. None of this negates the need to wear face masks and maintain social distancing.

Q. Is the vaccine effective in people over the age of 65?

The efficacy of the vaccine in the over-65s came into question as during the clinical trials not enough people over the age of 65 contracted the virus to provide sufficient data on efficacy. However, lab tests show that the vaccine stimulated an immune response in older age groups similar to that seen in younger people.  The World Health Organisation (WHO) have now backed the use of the AstraZeneca vaccine for adults of all ages (read more here: https://www.who.int/news-room/feature-stories/detail/the-oxford-astrazeneca-covid-19-vaccine-what-you-need-to-know).

Q. Why is the vaccine not given to children?

The risk of children contracting the virus and becoming significantly unwell with it is quite low. Children were also not included in the trial, so the benefit of giving them the vaccine is not as clear as for adults. Some clinical trials are now starting with young people aged 14-18.

Q. Can I still spread the virus once I’ve had the vaccine?

We do not know yet whether it will stop you from catching and passing on the virus, so it is crucial that you continue to wear the correct PPE, follow good hand hygiene practices and social distance.

Q: Once I have the vaccine does this mean I can’t catch Covid-19?

Like all medicines, no vaccine is completely effective – some people may still catch the virus despite having a vaccination however it should be less severe.

Q: Do I need to start/continue with Lateral Flow Testing for Covid-19 if I have had the Covid-19 vaccine?

Yes, you should be testing twice weekly even if you have had the vaccine.

Q: Will the vaccination be for life, or similar to flu in than annual vaccines are required?

We do not have enough data available to know for sure yet, however it is likely we will need annual vaccines and the vaccine is likely to be adapted to new variants to ensure it remains effective a snew strains emerge. The good news is that both the Oxford AstraZeneca and Pfizer vaccines allow for much quicker changes and adjustments, taking approximately 3-4 weeks to make adjustments, compared to the influenza vaccine which can take up to a year. 

Q: Are there any known risks to people who have already had COVID-19 and then get the vaccination?

There is no evidence of this, and the recommendation is that if you have recently had COVID-19 you should wait 28 days from when you first identified the symptoms to get your vaccination (or 28 days from your positive test if you were asymptomatic). The reason for this is because you have side effects from the vaccine you may not be able to tell if they are from the vaccine or caused by your illness. If you have had a confirmed COVID-19 infection there is no immediate urgency to be vaccinated as we know that antibodies after a natural infection last for at least 3 months. However, this is something you can discuss with occupational health or your vaccinator to assess when is the best time to get your vaccine following illness. There have been reports that some people who have had COVID-19 already have a stronger response to the vaccine when they have the first dose of the vaccine, this is a normal and natural response

Q: Can I have the COVID-19 Vaccine after/before having the flu vaccine?

You must wait seven days after having a flu vaccine before having the Covid-19 vaccine. You must wait 14 days after your second Covid-19 vaccination before having your flu jab.

Q: I have already had coronavirus do I still need to get a vaccine?

Yes. There is no evidence of any safety concerns from vaccinating individuals with a past history of COVID-19 infection, or with detectable COVID-19 antibody. Vaccination of individuals who may be infected or asymptomatic or incubating COVID-19 infection is unlikely to have a detrimental effect on the illness. Vaccination should be deferred in those with confirmed infection to avoid confusing the differential diagnosis. As clinical deterioration can occur up to two weeks after infection, ideally vaccination should be deferred until clinical recovery to around four weeks after onset of symptoms or four weeks from the first confirmed positive specimen in those who are asymptomatic.

Safety, Side Effects, and Allergies

Q: Is the NHS confident the vaccines are safe?

Yes. The NHS will not offer any Covid-19 vaccinations to the public until independent experts have signed off that it is safe to do so. The MHRA, the official UK regulator, has said that both of these vaccines have good safety profiles and offer a high level of protection, and we have full confidence in their expert judgement and processes.   

As with any medicine, vaccines are highly regulated products. There are checks at every stage in the development and manufacturing process, and continued monitoring once they have been authorised and is being used in the wider population.  

The MHRA recently released a statement saying “The data we have collected provides further reassurance that the COVID-19 vaccines are safe and continue to meet the rigorous regulatory standards required for all vaccines. We remain confident that the benefits of these vaccines outweigh any risks” following the administration of over 12 million vaccines in the UK.  You can read the full statement here: https://www.gov.uk/government/news/latest-monitoring-data-confirms-safety-of-covid-19-vaccines

Q. The vaccine was developed and approved extremely quickly, does that mean it has not been properly tested?

The speed of approval was due to the cutting of red tape rather than cutting corners.

Three COVID vaccines have been approved by the MHRA, including the Oxford AstraZeneca vaccine that we administer at Homerton. All vaccines approved by the MHRA have to go through the same rigorous processes, and have been tested on hundreds of thousands of people worldwide.

The COVID vaccines were developed, approved, and produced in record time due to worldwide scientific collaboration and committing all the money and resources required, plus overlapping various trial stages. The result being faster vaccine development than ever seen before, but without cutting back on testing and safety measures.

You can read more about the timeline of vaccine development and how this was adapted to safely develop and approve the COVID vaccines much faster here: https://wellcome.org/news/quick-safe-covid-vaccine-development

Q: Are there any known or anticipated side effects?

Like all medicines, vaccines can cause side effects. Most of these are mild and short-term, and not everyone gets them. It is recommended to take paracetamol following your vaccine to minimise potential side effects (follow dosage instructions on the packet) Even if you do have symptoms after the first dose, you still need to have the second dose.

Very common side effects include:

  • having a painful, heavy feeling and tenderness in the arm where you had your injection. This tends to be worst around 1-2 days after the vaccine
  • feeling tired
  • headache
  • general aches, or mild flu like symptoms

Although feeling feverish is not uncommon for 2 to 3 days, a high temperature is unusual and may indicate you have COVID-19 or another infection - please contact Occupational Health if this happens who will advise if you should have a COVID test. Please note that the vaccine cannot give you COVID-19, if you develop COVID-19 following a vaccine it means you were infected either just before getting the vaccine or before the vaccine had provided full imunity.

If you have side effects, you can take the normal dose of paracetamol (follow the advice in the packaging - do not exceed the stated dose), stay hydrared, and rest to help you feel better.

These symptoms normally last less than a week. If your symptoms seem to get worse or if you are concerned, call NHS 111. If you do seek advice from a doctor or nurse, make sure you tell them about your vaccination (show them the vaccination card) so that they can assess you properly.

You are encourage to report suspected side effects of vaccines and medicines online through the Yellow Card scheme or by downloading the Yellow Card app.

Q. I had unpleasant side effects to my first dose of the vaccine, will the side effects of the second dose be better or worse?

The trials have shown that the side effects of the second dose are generally a lot milder than what you experience in the first dose. You should still have the second dose, this is required for full vaccination.

Q. What is the allergy advice regarding the Oxford AstraZeneca vaccine for someone with serious allergies?

Serious allergic reactions have been associated with an ingredient in the Pfizer vaccine called polyethylene glycol (PEG), the AstraZeneca vaccine does not contain PEG and no serious allergic reactions have been associated with it. You should not have the vaccine if you are allergic to any ingredients in the vaccine (ingredient list can be found here). Please inform your vaccinator of any allergies you have and they will properly assess with you to ensure it is safe for you to have the vaccine.

Everybody will also be screened for potential allergic reactions before getting vaccinated, this is the same with any vaccine and is to ensure you can receive the vaccine safely. All vaccinators will have the training they need to deal with any rare cases of adverse reactions, and all venues will be equipped to care for people who need it – just like with any other vaccine.

Q. I had a reaction to the Pfizer vaccine, will I be able to have another vaccine and will I be fully protected?

The type of reaction you had will need to be assessed to be sure it is safe for you to have a different vaccine. If it is assessed as safe then we can give you a second dose with a different vaccine. With regards to whether it will provide effective protection, there is a trial that has just recently started recruiting in the UK specifically looking at that question so hopefully we will have some data on that in a few months’ time

Q. Does the AstraZeneca Vaccine cause blood clots?

On 7th April 2021, the MHRA and JCVI issued new advice, concluding a possible link between the AstraZeneca Vaccine and extremely rare blood clots.

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 specifc types of blood clots because of medical conditions.

As of 31st March 2021 20.2 million doses of the AstraZeneca vaccine had been given in the UK, the MHRA had received 79 UK reports of blood clotting events alongside low levels of platelets following the first dose of the AstraZeneca vacccine, meaning the overall risk of these blood clots is approximately 4 people in a million.

The data suggests there is a slightly higher incidence reported in the younger adult age groups.

(NB: the following advice is for health and care workers eligble for vaccination at the Homerton vaccination hub. Patients should discuss options and concerns with their GP)

First doses

If you are under the age of 30 and are at low risk of severe COVID-19 disease, you are advised to contact your GP to discuss the benefits and risks of receing the AstraZeneca or another vaccine. If you choose to still receive the AstraZeneca vaccine, before vaccinating a clinician will first discuss the potential risks with you and if no futher risk factors are identified you may make an informed decision to receive the AstraZeneca. If you'd like to discuss this option, please email the vaccination helpdesk at huh-tr.staffvaccinationhelpdesk@nhs.net  and request a call back from a clinician.

If you are over the age of 30 or otherwise have risk factors that put you at a higher risk of severe COVID-19 disease - the JCVI advise that the benefits of prompt vaccination with the AstraZeneca vaccine far outweigh the risk of adverse events for those who are over the age of 30 and/or at high risk of developing severe COVID-19 disease.

If you are still concerned, please email the vaccination helpdesk at huh-tr.staffvaccinationhelpdesk@nhs.net and request a call back from a clinician to discuss your concerns.

Second doses

There have been no reports of these rare blood clots following the second dose of the AstraZeneca vaccine

If you have already received your first dose and you did not experience any blood clotting with low levels of platelets then you should still receive the second dose, irrespective of age, to ensure full protection.

Signs and symptoms of thromboembolism (blood clots) and/or thrombocytopenia (low levels of platelets)

The likelihood of this occurring remains extremely rare, however as a precautionary measure anyone with the following symptoms four days or more after vaccination is advised to seek prompt medical advice:

  • a new onset of severe or persistent headache, blurred vision, confusion or seizures
  • develop shortness of breath, chest pain, leg swelling or persistent abdominal pain
  • unusual skin bruising or pinpoint round spots beyond the injection site

Please click the following link to read the letter from Dr Deblina Dasgupta, Medical Director, for full details on the updated guidance: AstraZeneca Covid-19 Vaccine Guidance Update - 8th April 2021 [pdf] 779KB

Q. A recent report from the Lancet showed data that during clinical trials, some participants were given a lower dose and showed higher efficacy (90%)than in those who received two standard doses (62%). Why are we still administering two full doses if this is the case?

In the AstraZeneca clinical trial only a small number of subjects from only one of the sites received the low dose/standard dose combination as the first low dose was given in error. None of them were over 55 years old. For this reason this paper states that The heterogeneity in vaccine dosage was fortuitous in uncovering a potentially highly efficacious formulation but was unplanned, and needs further evaluation in older adults and to confirm the unexpected results”. As the authors of the paper cannot advocate for the use of the low dose/standard dose combination without further research, using the standard dosing (supported by statistical analysis of data) is indeed practicing evidence-based medicine.

In any case, the analysis of trial data in detail is a consideration for the experts in the MHRA (the Medicines and Healthcare products Regulatory Agency for the UK) and JCVI (Joint Committee for Vaccination and Immunisation) and individual NHS Trusts cannot deviate from the licensed dose approved for use. For more information on the vaccine from the MHRA follow this link:  https://www.gov.uk/government/collections/mhra-guidance-on-coronavirus-covid-19. You can also see JCVI recommendations here: https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation

Additionally, recent research – also published in the Lancet- has found that protection against severe disease is very much higher than 60%, with no hospitalisations found amongst 17,117 participants (UK, Brazil and SA) of the AZ trial https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3777268. Protection against severe disease is the key to end the effects of the pandemic as it will reduce mortality and pressure on healthcare, which are the reasons for the several lockdowns we have experienced over the last year. The beneficial effect of the vaccine programme can already been seen in UK data: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/972592/COVID-19_vaccine_impact_on_mortality_240321.pdf

 

Allergies

Q: Are there any groups that shouldn’t have the vaccine?
People with history of a severe allergy to the ingredients of the vaccines should not be vaccinated.

MHRA have updated their guidance to say that pregnant women and those who are breastfeeding can have the vaccine but should discuss it with a clinician to ensure that the benefits outweigh any potential risks. 

Q: Where can I find advice for people with allergies or who are pregnant and breastfeeding?
Advice from the MHRA for people with allergies or who are pregnant and/or breastfeeding can be found here.  

Additionally, detailed information is here.

This states (for pregnancy) that:
“There is no known risk associated with giving inactivated, recombinant viral or bacterial vaccines or toxoids during pregnancy or whilst breast-feeding. Since inactivated vaccines cannot replicate, they cannot cause infection in either the mother or the fetus… though the available data do not indicate any harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy. JCVI has advised that vaccination in pregnancy should be considered, however, where the risk of exposure to Covid infection is high and cannot be avoided, or where the woman has underlying conditions that put them at very high risk of serious complications of Covid. In these circumstances, clinicians should discuss the risks and benefits of vaccination with the woman, who should be told about the absence of safety data for the vaccine in pregnancy.

And (for breastfeeding):
There is no known risk associated with giving non-live vaccines whilst breastfeeding. JCVI advises that breastfeeding women may be offered vaccination with the Pfizer-BioNTech or AstraZeneca COVID-19 vaccines. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for immunisation against COVID-19, and the woman should be informed about the absence of safety data for the vaccine in breastfeeding women.

Q: Has the guidance on allergies changed?
The original MHRA advice was that anybody with a known allergy to specific ingredients in the vaccine should not be vaccinated. This has been amended to:

“Checking for allergies is a routine part of the process before giving any vaccine or new medicine. Having these conversations – as well as being able to deal with allergic reactions in the rare case they do happen, is a central part of training for vaccinators. But these are new vaccines and so the NHS and the MHRA are being extra vigilant and responding quickly to ensure everyone across the NHS is totally clear on these requirements”.

Q: What about the allergic reactions that have been reported?
These vaccines are safe and effective for the vast majority of people – they have been tested on tens of thousands of people and assessed by experts.

Any person with a history of immediate-onset anaphylaxis to the ingredients contained in the vaccines should not receive them. A second dose of the Pfizer/BioNTech vaccine should not be given to those who have experienced anaphylaxis to the first dose of Pfizer/BioNTech vaccination.

Everybody will also be screened for potential allergic reactions before getting vaccinated. All vaccinators will have the training they need to deal with any rare cases of adverse reactions, and all venues will be equipped to care for people who need it – just like with any other vaccine.

Pregnancy, Breastfeeding, and Fertility

Pregnancy and Breastfeeding

(jump to fertility FAQs)

Q. How can we be sure the vaccine is safe for pregnant people as it was not tested on any pregnant people

(Information taken from the RCOG website, which is kept up to date with the latets information: https://www.rcog.org.uk/en/guidelines-research-services/guidelines/coronavirus-pregnancy/covid-19-virus-infection-and-pregnancy/#vaccines)

"Pregnant women and women who are breastfeeding are already routinely and safely offered vaccines in pregnancy, for example to protect against influenza and whooping cough. Many of these vaccines also protect their babies from infection. However, specific clinical trials of COVID-19 vaccines in pregnant women have not yet been carried out. Different vaccines work in different ways, and for some of the COVID-19 vaccines, previous studies on similar vaccines (such as the whooping cough or influenza vaccine) may provide some insight into effects in pregnancy and reassurance about safety.

The Toyal College Obstetricians and Gyanecologists (RCOG) and Toyal College of Midwives (RCM), with leading academics across the UK, are calling on the UK government to fund research studies to establish the suitability of approved COVID-19 vaccines in pregnant and breastfeeding women. These pages will be updated as soon as we have any more information. We continue to urge pregnant women to follow government advice about social distancing, to get their free flu vaccination to protect them and their baby against flu this winter, and to get the whooping cough vaccine to protect their newborn baby."

Q. Will pregnant people receive a COVID-19 vaccine?

The Joint Committee on Vaccination and Immunisation (JCVI) state that although available data does not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy.

Pregnant people may be offered the vaccine is they have a high risk medical condition or work in a high risk environment. However, the benefits and risks should be discussed with your midwife or doctor on an invidual basis to allow you to make an informed decision on whether or not to take the vaccine.  This information sheet can help you prepare for the discussion with your midwife/doctor: https://www.rcog.org.uk/globalassets/documents/guidelines/2021-01-12-covid-19-vaccine-info-sheet.pdf

Q. Is it safe to take the vaccine while breastfeeding?

There are no data on the safety of COVID-19 vaccines in breastfeeding or on the breastfed infant. Despite this, COVID-19 vaccines are not thought to be a risk to the breastfeeding infant, and the benefits of breast-feeding are well known. Because of this, the JCVI has recommended that the vaccine can be received whilst breastfeeding. If you have concerns, please discuss with your doctor.

Conceiving and Fertility

Q. Is it safe to conceive following vaccination?

The Joint Committee on Vaccination and Immunisation (JCVI) states those who are trying to become pregnant do not need to avoid pregnancy after vaccination.

If you have received your first dose of vaccine before a pregnancy it is best to receive a second dose to ensure your protection is boosted. If, however, you find yourself pregnant after the first dose, the Royal College of Obstetricians and Gynaecologists (RCOG) advises you to defer the second dose of vaccine until you have completed your pregnancy as the effects of the vaccine on early pregnancy remained un-researched. There is nothing untoward about this lack of research on pregnancy, research could not occur in such a short time as the priority for developing the vaccine during the pandemic was lifesaving. If you receive a dose of the vaccine before finding out you are pregnant, or unintentionally while you are pregnant, you should be reassured that it will not affect the vaccine’s success and the risk of harm to your baby is very low.

Q. Will taking the vaccine affect my fertility (female)?

No. There is nothing in the vaccine that can adversely affect fertility.

Q. Will taking the vaccine affect my fertility (male)?

Post-COVID vaccination males without fertility problems may experience transient mild fever and this is likely to depress sperm counts. This is normal observation for any infection or fever because the sperm cells are more sensitive compared to all other cells. There is nothing to worry about here nor is any pregnancy related complication foreseen because the egg can repair any sperm DNA damage caused. Fevers and infection will also lead to leukocytes presence which will further depress the sperm quality, but any sperm damage is easily reversible.

Please watch this short video from our Fertility doctor who explain in more detail how and why your fertility is not affected by the vaccine

The RCOG and the RCM respond to misinformation around Covid-19 vaccine and fertility

Dr Edward Morris, President at the Royal College of Obstetricians and Gynaecologists, has said: “We want to reassure women that there is no evidence to suggest that Covid-19 vaccines will affect fertility. Claims of any effect of Covid-19 vaccination on fertility are speculative and not supported by any data. There is no biologically plausible mechanism by which current vaccines would cause any impact on women's fertility. Evidence has not been presented that women who have been vaccinated have gone on to have fertility problems.”

Q. Should I take the vaccine if I have started, or plan to start, fertility treatment?

There is no evidence in deferring the vaccination but it makes sense not to complicate the issues such as if sperm banking or ovarian stimulation has started. Women who have had any significant side effects from COVID-19 vaccination, such as an allergic reaction, should defer treatment and take advice from their specialist doctor.

In the absence of information on the effect of the COVID-19 vaccine on oocytes and sperm, embryo implantation and early stages of pregnancy, and to allow time for antibody development, allow a few days after the completion of vaccination (i.e. after the second dose) for the immune response to settle, although a more cautious approach could be also considered (i.e. postpone the start of ART treatment for up to 2 months).

Dr Gulam Bahadur, a Consultant Clinical Andrologist in our fertility unit, created this Q&A document regarding fertility, pregnancy, and breastfeeding that you may find useful: Fertility and Pregnancy with the COVID vaccine [pdf] 1MB

 

Black and Minority Ethnic Communities

Q: Why have Black and South Asian people been hit hardest by COVID-19?
The Office for National Statistics (ONS) have researched this and the results point to social and economic factors such as the type of job, for instance healthcare and size of household.
Full details can be found on the ONS website.

Q: What is being done to encourage vaccine uptake in black, Asian, minority ethnic and other disproportionately affected communities/groups?
Some communities have specific concerns and may be more hesitant in taking the vaccine than others. The NHS is working collaboratively with partners to ensure vaccine messages reaches as diverse an audience as possible and are tailored to meet their needs. This includes engagement with community and faith-led groups, charities and other voluntary organisations.

Q: What is the evidence to show the vaccine is safe for BAME communities?
The phase three study of the Pfizer BioNTech COVID-19 vaccine demonstrated a vaccine efficacy of 95%, with consistent efficacy across age, gender and ethnicity. The participants were White, Black or African American, Hispanic/Latino, Asian and Native American/Alaskan.

The safety data for the AstraZeneca vaccine from over 20,000 participants enrolled across four clinical trials in the UK and Brazil and South Africa has shown that there were no serious safety events related to the vaccine. Participants were from diverse racial and geographic groups who are healthy or have stable underlying medical conditions.

Q: 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 increasing attention has been given to reducing health inequalities and we have invested more than £4 million into research into COVID-19 and ethnic disparities so that we can go further.

Medical conditions

Q: Can I have the vaccine if I am receiving anticoagulant therapy or have a bleeding disorder? It is best to speak with your doctor to check before having the vaccine

Individuals with bleeding disorders may be vaccinated intramuscularly if, in the opinion of a doctor familiar with the individual’s bleeding risk, vaccines or similar small volume intramuscular injections can be administered with reasonable safety by this route

Q. Can I have the vaccine if I am taking Immunosuppressants?

People receiving immunosuppressive therapy are a high priority for receiving the vaccine. You may wish to discuss your treatments with your GP

Q. Will the Covid-19 vaccine trigger flare ups in those with autoimmune conditions?

Covid-19 infection in itself has been associated with the appearance of autoimmune and auto inflammatory diseases (Sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7598743/ ,  https://www.nature.com/articles/s41584-020-0448-7). If you have experienced a flare up following a flu vaccination, then in theory other vaccines could also contribute to a flare up as the immune system needs to be activated by the vaccine in order to produce immunity. However, as having Covid-19 itself seems to cause flare ups and triggers the appearance of auto-immune diseases (plus risk of death/severe disease and longer term issues that we are still learning about), the risk-benefit balance of a vaccine triggering the existing disease vs having Covid-19 disease is thought to be clearly on the vaccine side.

At the moment medicine regulators have not issued any cautions for people with autoimmune disease conditions having the Covid-19 vaccine. In fact, people with auto-immune disease are likely being prioritised for vaccination as many will be on immunosuppressant medication and therefore fall into the “immunosuppressed” clinical risk group, who has been prioritised for vaccination by the JCVI (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/961287/Greenbook_chapter_14a_v7_12Feb2021.pdf). It is also possible that people with autoimmune disease might not mount as good an immune response (https://www.immunology.org/sites/default/files/BSI_Briefing_Note_2021_immunity_COVID19.pdf) as healthy people but it is still very important for them to get vaccinated as it will offer a certain amount of protection against catching the disease.

 In summary, there is currently no specific data available on the safety of COVID-19 vaccines in this particular group of patients but after many millions of people have been vaccinated no special precautions have been issued by any medicine regulatory agencies regarding people with auto immune disease so the risk benefit assessment is indeed favourable to vaccination. Nevertheless, if you are still unsure it might be a good idea to discuss any concerns about a possible flare up with the specialist team treating your autoimmune conditions.

Q. Should those with thyroid conditions (e.g. Grave's disease) have the vaccine?

In addition to the advice and evidence above, some thyroid specialist sites do clearly encourage vaccination - including in people with autoimmune disease (Covid-19 and vaccines | British Thyroid Foundation (btf-thyroid.org), https://www.thyroid.org/wp-content/uploads/2021/02/Public-Health-Committee-COVID-Vaccine-FAQ-for-Patients_FINAL_2_2_21.pdf). Please do talk to your medical team if you have any specific concerns about your condition and having the vaccine.

Q: Will I have any side effects to the vaccine?

As with other vaccines there may be some local reactions at the injection site such as pain and tenderness. In addition, some people might experience side effects such as headache, fatigue and fever. This is not the disease itself – it is the body's response to the vaccine. You are advised to take paracetamol following your vaccine (as per dosage instructions on the packet), rest, and stay hydrated.

Faith considerations

Q: What is in the vaccines? Are they vegan/vegetarian friendly? Do they include any parts from foetal or animal origin?

The vaccines do not contain any meat derivatives or porcine products or material of foetal or animal origin. A detailed review of the vaccines and their ingredients have been provided by the MHRA and can be found at the following links:

The British Islamic Medical Association have produced a helpful guide for the Muslim community which can be found here.

Q: Are the Covid-19 vaccines suitable for Catholics?

Yes, the Pope has said that it's "morally acceptable" to receive a vaccination for COVID-19. You can read the full announcement here.

 

Please see the COVID-19 resources page for further information on whether the vaccine is suitable for your faith considerations: https://intranet.homerton.nhs.uk/covid-19-vaccination-resources