UK COVID-19 Update: Vaccine Mixing Side Effects, Infections Falling, Record Backlog

Tim Locke

May 13, 2021

These are the UK coronavirus stories you need to know about today.

Vaccine Mixing Side Effects

Preliminary data from Oxford's Com-Cov study on mixing and matching first and second vaccine doses shows it increases frequency of mild to moderate side effects. The results are published in a research letter in The Lancet.

Participants who had Pfizer/BioNTech followed by Oxford/AstraZeneca, and Oxford/AstraZeneca followed by Pfizer/BioNTech, 4 weeks apart, saw more reactions than those who had two doses of the same vaccine.

Chief Investigator, Matthew Snape, said: "Whilst this is a secondary part of what we are trying to explore through these studies, it is important that we inform people about these data, especially as these mixed-doses schedules are being considered in several countries. The results from this study suggest that mixed dose schedules could result in an increase in work absences the day after immunisation, and this is important to consider when planning immunisation of healthcare workers. 

"Importantly, there are no safety concerns or signals, and this does not tell us if the immune response will be affected. We hope to report these data in the coming months. In the meantime, we have adapted the ongoing study to assess whether early and regular use of paracetamol reduces the frequency of these reactions."

Delaying Vaccine Doses

US modelling published in the BMJ found the UK's approach to delaying second Pfizer and Moderna COVID-19 vaccine doses reduces deaths by up to 20%.

Dr Peter English, retired consultant in communicable disease control, commented via the Science Media Centre: "There have been concerns expressed about the lack of evidence for effectiveness if the prime-boost interval is extended by delaying the second dose. These concerns are misplaced. Everything we already knew about vaccines also tells us that a longer prime-boost interval enhances the breadth and depth of the immune response, giving longer-lasting immunity that is likely to provide greater cross-protection against variant strains."

Meanwhile, NHS England is now inviting 38-39 year olds to book vaccination appointments.

Infections Falling, Antibodies Rising

The latest data from Imperial's REACT-1 study show COVID-19 infections in England falling by around 45% between 15 April-3 May. Prevalence fell from 0.2% to 0.11%.

Out of 127,408 swab results, 115 were positive, including 24 B.1.1.7  UK/Kent variant cases, and 2 B.1.617.2 Indian variant cases.

Infections fell in all age groups except 25 to 34-year-olds.

Imperial's Professor Paul Elliott said: "It is very encouraging that infections have continued to fall while rules have been relaxed in England, and it’s likely that the vaccine rollout has played a key part in helping keep the virus at bay. We need to continue to monitor trends in the coming weeks as restrictions are eased further, and in the meantime, we must continue to stick to the rules to help keep infections down and enable the vaccination programme to continue to protect people."

Latest Test and Trace data for England show a 9% fall in positive test results  29 April to 5 May 2021 compared with the previous week.

Latest Office for National Statistics (ONS) infection survey estimates for the number of adults testing positive for antibodies in the week beginning 19 April 2021 were:

  • England 69.3%

  • Scotland 59.2%

  • Wales 63.2%

  • Northern Ireland 63.5%

Sarah Crofts from ONS said: "The impact of the vaccination programme is clear as antibody levels remain high across the UK."

New Record Backlog

There were 4.95 million people in England waiting to start hospital treatment at the end of March, the highest since records began in 2007.

Fifty-two week waits are also at a record high of 436,127.

The British Heart Foundation said there had been 130,000 fewer heart procedures and operations since the pandemic began, and Cancer Research UK highlighted 45,000 fewer patients starting cancer treatment.

NHS England is getting £160 million funding for initiatives to tackle the elective waiting list backlog that's grown under the pandemic. This will include pop-up clinics, virtual wards, home assessments, at-home antibiotic kits, and 'pre-hab' for patients before operations.

BMA Council Chair Dr Chaand Nagpaul said the funding was nowhere near enough: "In a recent report the BMA estimated that it will cost £4bn just to clear the backlog of patients in England needing elective care and that doesn’t even take into account the 20m fewer patients not seen in outpatient clinics last year. So to trumpet a cash boost of £160m is wholly disingenuous."

He said patients would be treated by an "exhausted and depleted workforce".

NHS Confederation leaders have written to Health Secretary Matt Hancock calling for a review of social distancing across the NHS over the summer months to help tackle the pandemic backlog.

Chief Executive Danny Mortimer said: "As COVID-19 cases have declined dramatically and with over half of the adult population vaccinated now is the right time to look again at some of the rules including on social distancing and how PPE is used in order to help free up extra capacity across the NHS."

‘Mask Off’

The Sun reported the Government is planning 'the Great British Mask Off' in shops and offices in England on June 21 in the next planned date for easing lockdown.

Prime Minister Boris Johnson didn't confirm the report but said more announcements would be made at the end of this month: "I think we have to wait a little bit longer to see how the data is looking but I am cautiously optimistic about that and provided this Indian variant doesn’t take off in the way some people fear, I think certainly things could get back much, much closer to normality."

Vaccine Messaging

COVID-19 vaccine messaging should focus on the personal benefits of vaccination to help tackle vaccine hesitancy, according to a University of Oxford study involving 18,885 UK adults published today in  The Lancet Public Health.

Professor Daniel Freeman, study lead for the Oxford Coronavirus Explanations, Attitudes, and Narratives Survey (OCEANS III), said: "Much of the official messaging around COVID-19 vaccination draws on the idea of collective responsibility – that it benefits all of us to get the jab. For most people in the UK, it’s a message that definitely resonates. But for the significant minority of people who remain sceptical about COVID-19 vaccination, another approach may be needed. Our study suggests that the best approach now may be putting personal benefits front and centre in media campaigns."

More News

  • Worse COVID-19 outcomes for people with obesity are cited in the Government's plans to introduce calorie labelling in larger cafes and restaurants in England next year. Almost two-thirds of adults are overweight or obese, and 1 in 3 children leave primary school overweight or obese.

  • ONS data for the second wave show there were higher age-standardised COVID-19 mortality rates among people identifying as Muslim, Hindu, Sikh, or Jewish compared with those in the Christian groups. Those in the no religion group had lower rates than the Christian groups.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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