Monday, June 21

Some U.K. doctors plan to defy instructions to wait longer on vaccine booster shots. – The New York Times

Some family doctors in Britain said on Thursday that they would defy the government’s instructions to postpone patients’ appointments for a second dose of coronavirus vaccine, a signal of unease in the medical community over Britain’s new plan to delay second shots as a way of giving more people the partial protection of a single dose.

British doctors, who have been instructed to begin rescheduling second-dose appointments that had been set for next week, said they were loath to ask older, vulnerable patients to wait an extra two months for their booster shots of the Pfizer-BioNTech vaccine. They said those patients had been counting on having the full protection of two doses, had already arranged for caregivers to help them get to their doctors’ offices, and could ill afford to rely on a new and untested vaccination strategy.

Beyond that, doctors said, it was logistically impossible to make contact with thousands of older patients in a matter of days, and then fill those slots with first-time recipients.

The British Medical Association, a trade union for doctors, said on Thursday that it would support doctors who decided to keep second-dose appointments that have been booked for January.

“It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments,” Dr. Richard Vautrey, the chairman of the trade union’s family doctor committee, said in a statement. “The government must see that it’s only right that existing bookings for the oldest and most vulnerable members of our society are honored, and it must also as soon as possible publish a scientifically validated justification for its new approach.”

A spokeswoman for Britain’s National Health Service said in a statement that the service was giving family doctors “extra financial and logistical support” in order to “to help ensure thousands more receive the vaccine quickly.”

“The N.H.S. has to follow” the new guidance, the statement said, “so as to increase the number of vulnerable people protected against Covid over the next three months, potentially saving thousands of lives.”

Delaying second vaccine doses could double the number of people who receive a shot soon, and eventually lighten the toll of the virus in Britain, where hospitals are facing a deluge of cases of a new and more contagious coronavirus variant. While any one person may be better off getting the second dose promptly, some scientists said, society as a whole benefits if more people are given the partial protection of a single dose for the time being.

Other scientists, however, believe that Britain overshot the available evidence, potentially leaving older people and health care workers without the full protection of two vaccine doses amid dreadful wintertime surges. Britain made the decision without the public meetings or voluminous briefings that have preceded American regulatory decisions. No trials have explicitly tested the long-term efficacy of a single shot.

And what limited evidence exists about the protection afforded by a single dose clashed with scientists’ fears that antibody responses would wane over time, potentially falling below a protective threshold.

Some family doctors in Britain said that they were uneasy about a lack of evidence showing that patients would be protected for many weeks from Covid-19 after a single shot of the Pfizer-BioNTech vaccine.

“I have been instructed to break my promise to my elderly patients,” Dr. Helen Salisbury, a family doctor in Oxford, said on Twitter on Thursday morning, “and use a vaccine outside its evidenced and approved schedule, probably placing them at risk.”

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