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Supporting health and social care providers in Devon

DCC vaccination: Frequently Asked Questions

1. What vaccine for COVID-19 is currently available?
Both the Pfizer/BioNTech and Oxford/AstraZeneca COVID-19 vaccines are now available. Both vaccines have been shown to be safe and offer high levels of protection and have been given regulatory approval by the MHRA.

The Government has in principle secured access to seven different vaccine candidates, across four different vaccine types, totalling over 357 million doses. This includes:

  • 40 million doses of the BioNTech/Pfizer vaccine
  • 100m doses of the Oxford/AstraZeneca vaccine
  • 7 million doses of the Moderna vaccine, which is also being assessed by the Medicines & Healthcare products Regulatory Agency (MHRA).

2. Why are care home workers amongst the first groups to receive the vaccine?
The Joint Committee of Vaccination and Immunisation (JCVI) have put patient-facing health and social care staff into a priority group because of their heightened risk of exposure to the virus and the risk of passing it on to vulnerable groups.

3. How do care home workers and residents get the vaccine?
The NHS will offer vaccinations using different models for different groups who are eligible to receive it. For care home residents and workers, GP-led teams are delivering the vaccines to care homes through mobile units. This is in addition to hospital hubs and local vaccination services which have already been vaccinating some residents and staff.
We are keeping the operational plans under constant review and if further vaccines are licensed by the (MHRA) we will examine the use of these for care home residents.

4. I am in a Tier 4 area. Will vaccines still be provided/should I still attend my appointment?
Yes. Getting the COVID-19 vaccine, or any other vaccine, is an important medical appointment and so is within the rules wherever you live. Vaccinations will continue as normal in all areas regardless of what tier they are in. If you have booked or are offered an appointment, please attend it. The place that you choose to have your vaccine will keep you safe from COVID-19 through a range of measures including cleaning and disinfecting and having social distancing in waiting areas. Please also wear a face covering to your appointment. You should also take the usual steps to minimise your risk as you travel to your appointment.

5. Will the vaccine work with the new strain?
There is no evidence currently that the new strain will be resistant to the vaccine we have, so we are continuing to vaccinate people as normal. Scientists are looking now in detail at the characteristics of the virus in relation to the vaccine. Viruses, such as the winter flu virus, often branch into different strains but these small variations rarely render vaccines ineffective.

6. Why are you postponing second doses?
The UK Chief Medical Officers have agreed a longer timeframe between first and second doses so that more people can get their first dose quickly and because the evidence shows that one dose still offers a high level of protection. This decision will allow us to get the maximum benefit for the most people in the shortest possible time and will help save lives.
We recognise for some people a longer wait might be worrying and clinicians have the discretion to vaccinate people sooner if they think this is needed.
Getting both doses remains important so we would urge people to return for it at the right time.

7. How effective is the vaccine/how long does the vaccine take to become effective?

We have received reports from care homes and other settings of people becoming unwell and testing positive with Covid-19 within a relatively short period post vaccination. This has understandably caused Care Home colleagues to worry that the vaccines may not have been effective. Please be reassured that the vaccines are very effective after one dose, however, it can take 2-3 weeks for an individual to develop immunity to COVID-19 after they have been vaccinated.

In the national situation that we have at present, where COVID-19 is circulating in the community at high levels, we know that it is possible that people may have been exposed and already be incubating the virus at the time of their vaccination. There will also be people who are exposed to the virus in the week(s) post vaccination and before the immune response has developed. In these situations, the vaccine will not always be able to stop these people from developing the infection. This is not a failure of the vaccine or the vaccination programme, it’s just that the person has already been exposed and there wasn’t enough time for the vaccine to work before the infection developed.

In situations where there are cases or outbreaks in a care home, for example, or where a person has already had COVID-19, it is important to ensure that all eligible individuals still get both the first and second dose. However, you should wait 28 days after a positive test to receive the vaccine. There is no evidence so far that having a vaccine after having had COVID-19 causes harm or makes the infection worse, it is just that the symptoms could become confused and wrongly attributed to the vaccine or the infection and this possibility is minimised if there is a 28-day gap.

Finally, no vaccine can be 100% safe or 100% effective and there is a slim chance therefore that you or your residents may develop COVID-19 even after having the vaccine. We know that the vaccine is very effective at preventing serious illness and that it stops people from needing to be admitted to hospital or from dying if they catch it and this is why the programme is being rapidly rolled out to those most at risk at the moment. What we don’t yet know is if the vaccine stops a person from passing the virus on to other people, so the advice is still to remain vigilant and make sure that everyone follows good infection control guidelines, including use of PPE, and continue to promote the Hands, Face, Space message at all times so that everyone remains as safe as possible whether they have had the vaccine or not.

8. Why is it important to get your COVID-19 vaccination?
If you’re a frontline health and care worker, you are more likely to be exposed to COVID-19 at work.
Getting your COVID-19 vaccination as soon as you can, should protect you and may help to protect your family and those you care for. The COVID-19 vaccine should help reduce the rates of serious illness and save lives and will therefore reduce pressure on the NHS and social care services.

9. Is it mandatory, and what happens if care home staff or residents don’t want the jab?
There are no plans for a COVID-19 vaccine to be compulsory. We are confident that the vast majority of staff and residents will choose to protect themselves by getting the vaccine.

10. Is the vaccine vegan/vegetarian friendly?
There is no material of foetal or animal origin in either vaccine. All ingredients are published in healthcare information on the MHRA’s website.

The Pfizer/BioNTech vaccine information

The Oxford/AstraZeneca vaccine information

11. Will care home staff and residents need to pay for the vaccine?
No, the COVID-19 vaccination is only available through the NHS to eligible groups and it is a free vaccination.

12. Who cannot have the vaccine?
People with history of a severe allergy to the ingredients of the vaccines should not be vaccinated.
The 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.

13. Can staff go back to work after having the vaccine?
Yes, you should be able to work as long as you feel well. If your arm is particularly sore, you may find heavy lifting difficult. If you feel unwell or very tired you should rest and avoid operating machinery or driving.
The vaccine cannot give you COVID-19 infection and two doses will reduce your chance of becoming seriously ill. However, you will need to continue to follow the guidance in your workplace, including wearing the correct personal protection equipment and taking part in any screening programmes.

14. Is the NHS confident the vaccine is safe?

The vaccines approved for use in the UK have met strict standards of safety, quality and effectiveness set out by the independent Medicines and Healthcare products Regulatory Agency (MHRA).

Any coronavirus vaccine that is approved must go through all the clinical trials and safety checks that all other licensed medicines are required to go through. The MHRA follows international standards of safety and all standards have been thoroughly applied before these vaccines have been approved for use.
Other vaccines are also being developed. Like the Pfizer and AstraZeneca vaccines, these new vaccines will only be authorised and made available on the NHS once they have been thoroughly tested to make sure they are safe and effective.

More than 5 million people have now been given a COVID-19 vaccine in the UK and reports of serious side effects, such as allergic reactions, have been very rare. The MHRA is constantly monitoring the vaccine via the Yellow Card scheme and no other complications or safety concerns have been reported.

15. How are you raising awareness of the vaccine with the health and care workforce?
The Cabinet Office has developed a campaign to raise awareness of the vaccine with the public and health and social care staff. This includes specific engagement with BAME communities and workforce.

16. I’m currently ill with COVID-19. Can I get the vaccine?
People currently unwell and experiencing COVID-19 symptoms should not receive COVID-19 vaccine until they have recovered.

17. Do people who have already had COVID-19 get vaccinated?
Yes, they should get vaccinated. 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 so people who have had COVID-19 disease (whether confirmed or suspected) can still receive COVID-19 vaccine.

18. 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. Even if you do have symptoms after the first dose, you still need to have the second dose. You may not be protected until at least seven days after your second dose of the vaccine.

Very common side effects include:

Pfizer BioNtech known side effects post vaccination Oxford/Astra Zeneca known side effects post vaccination
Very common: may affect more than 1 in 10 people

  • pain at injection site
  • tiredness
  • headache
  • muscle pain
  • chills
  • joint pain
  • fever
Very common: may affect more than 1 in 10 people

  • tenderness, pain, warmth, redness, itching, swelling or bruising where the injection is given
  • generally feeling unwell
  • feeling tired (fatigue)
  • chills or feeling feverish
  • headache
  • feeling sick (nausea)
  • joint pain or muscle ache
Common: may affect up to 1 in 10 people

  • injection site swelling
  • redness at injection site
  • nausea
Common: may affect up to 1 in 10 people

  • a lump at the injection site
  • fever
  • being sick (vomiting)
  • flu-like symptoms, such as high temperature, sore throat, runny nose, cough and chills
Uncommon: may affect up to 1 in 100 people

  • enlarged lymph nodes
  • feeling unwell
Uncommon: may affect up to 1 in 100 people

  • feeling dizzy
  • decreased appetite
  • abdominal pain
  • enlarged lymph nodes
  • excessive sweating, itchy skin or rash
Rare side effects: may affect up to 1 in 1,000 people

  • temporary one-sided facial drooping

As with all vaccines, appropriate treatment and care will be available in case of a rare anaphylactic event following administration.
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 can also report suspected side effects of vaccines and medicines online through the Yellow Card scheme or by downloading the Yellow Card app.

19. How many doses of the vaccine will be required and when?
You are required to have two doses of the COVID-19 vaccine, up to 12 weeks apart. You will get a good level of protection from the first dose but will not get maximum protection until at least 7 to 14 days after your second dose of vaccine.

20. I had my first dose of the vaccine at my local hospital. Can I get my second dose at the care home where I work?
You should get both doses in the same place. This is so we can avoid people missing their second dose.

21. What consent needs to be obtained before care home staff and residents are vaccinated?
Decisions around vaccinations should be made on the basis of informed consent. A care home will be supported and supplied with consent forms in advance of the vaccination taking place.
Further details can be found in this guidance.

22. I have had my flu vaccine. Do I need the COVID-19 vaccine as well?
Yes. The flu vaccine does not protect you from COVID-19. As you are eligible for both vaccines you should have them both, but normally separated by at least a week.

23. Will the COVID-19 vaccine protect me from flu?
No, the COVID-19 vaccine will not protect you against the flu. If you have been offered a flu vaccine, please try to have this as soon as possible to help protect you, your family and patients from flu this winter.

24. What happens if a person has the first jab but not the second?
Both vaccines have been authorised on the basis of two doses up to 12 weeks apart because the evidence from the clinical trials shows that this gives the maximum level of protection. The evidence doesn’t show any direct risk to not having the second dose and you will get a good level of protection from the first dose but will not get maximum protection until at least 7 to 14 days after your second dose of vaccine.
We would urge everyone to show up for both of their appointments for their own protection as well as to ensure we don’t waste vaccines or the time of NHS staff.

25. How were vaccines developed so quickly?
Medicines including vaccines are highly regulated and that is no different for the approved COVID-19 vaccines.
There a number of enablers that have made this ground-breaking medical advancement possible and why it was possible to develop them relatively quickly compared to other medicines:

  1. The different phases of the clinical trial were delivered to overlap instead of run sequentially which sped up the clinical process
  2. There was a rolling assessment of data packages as soon as they were available so experts at the MHRA could review as the trial was being delivered, ask questions along the way and request extra information as needed as opposed to getting all information at the end of a trial
  3. Clinical trials managed to recruit people very quickly as a global effort meant thousands of people were willing to volunteer.

26. Were the trial participants reflective of a multi-ethnic population?
The Public Assessment Reports contain all the scientific information about the trials and information on trial participants.
For the Pfizer trial, participants included 9.6% black/African, 26.1% Hispanic/Latino and 3.4% Asian.
For the Oxford/AstraZeneca vaccine 10.1% of trail recipients were Black and 3.5% Asian.
There is no evidence either of the vaccines will work differently in different ethnic groups.

27. Was it tested on high risk groups?
For both vaccines trial participants included a range of those from various ages, immune-compromised and those with underlying health conditions and both found the efficacy of the vaccine translates through all the subgroups.
Details of trial participants for both vaccines are published online.

The Pfizer/BioNTech vaccine information

The Oxford/AstraZeneca vaccine information

28. Does the vaccine include any parts from foetal or animal origin?
There is no material of foetal or animal origin in either vaccine. All ingredients are published in healthcare information on the MHRA’s website.

The Pfizer/BioNTech vaccine information

The Oxford/AstraZeneca vaccine information

29. Can the vaccine alter your genetic material?
There is no evidence to suggest that individual genetic material will undergo an alteration after receiving the vaccine.

30. How does the vaccine work?
The vaccine works by making a protein from the virus that is important for creating protection.
The protein works in the same way they do for other vaccines by stimulating the immune system to make antibodies and cells to fight the infection.

31. How long will the Pfizer vaccine be effective for?
We expect these vaccines to work for at least a year if not longer. This will be constantly monitored.

32. 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.
The 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.

33. Does the vaccine work on those taking immune suppressants?
Although the vaccine was not tested on those with very serious immunological conditions, the vaccine has been proven to be very effective and it is unlikely that the vaccine will have no effect at all on these individuals.
There may be a very small number of people with very complex or severe immunological problems who can’t make any response at all but the vaccine should not do any harm to these individuals. Individuals meeting these criteria may want to discuss the vaccine further with their specialist doctor.

34. Who will be delivering vaccines? 
They will either be existing NHS staff or those recruited by the NHS specifically for the programme, including those who signed up to the NHS Bring Back scheme. There are a number of roles within the vaccination programme and these will require different levels of qualifications and experience.
Legislation allows a wider group of people to administer vaccines, including more health care professionals as well as others who have passed a programme of training developed by PHE and HEE. New vaccinators will be assessed in person and closely supervised to ensure their and patients’ safety.

34. Are they qualified? What is the training?
PHE and HEE have compiled comprehensive training which includes anaphylaxis and Basic Life Support training, injection administration, training on vaccines in general and the specific ones that will be used. Importantly new vaccinators will be supervised and assessed by senior clinicians to ensure both their safety and of course the safety of the people they are vaccinating, just like any other vaccinator.

35. On the day of vaccinations for staff will they need their NHS number?
Yes, this will be used as a unique identifier for an individual and is logged onto the Pinnacle vaccine record system, once the vaccine has been given. This link provides more information about how to get a NHS number, if you don’t already have one.

36. When will working age adults with Learning Disabilities and/or Mental Health problems who reside in care homes expect to receive the vaccine?
The NHS is currently offering the COVID-19 vaccine to people most at risk from coronavirus.
The order in which people will be offered the vaccine is based on advice from the Joint Committee on Vaccination and Immunisation (JCVI).

It’s being given to:

  • people aged 80 and over
  • people who live or work in care homes
  • health and social care workers at high risk

The vaccine will be offered more widely as soon as possible.
JCVI advice on priority groups for the COVID-19 vaccination on GOV.UK

It is anticipated that learning disability and mental health care homes vaccinations will start in February 2021 (phase 2 of the vaccination programme).

37. How many people can be vaccinated by one vial of each vaccine?
Pfizer BioNTech: 6 doses.
Oxford Astrazeneca: 8-10 doses.

38. Can staff/residents choose which vaccine they would prefer to have?
No, one type of vaccine will be available. Care homes will be notified which vaccine will be used.

39. How long after a positive COVID test can staff be vaccinated?
28 days from onset of symptoms or test date if no symptoms.

40. Who makes the decision regarding previous positive test results and the clinical position of the person is it the GP or the vaccinator?
The current guidance ‘COVID-19 vaccination in care homes that have cases and outbreaks‘, page 1, states ‘Whilst vaccination against COVID-19 may be temporarily deferred in some individuals e.g. acutely unwell or still within four weeks of onset of COVID-19 symptoms, all other staff and care home residents should receive prompt COVID-19 vaccination. 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.’

41. Will care homes need to Lateral Flow Device (LFD) test the vaccination team who are visiting?
The current guidance ‘COVID-19 vaccination in care homes that have cases and outbreaks‘ . The vaccination teams have an LFD test on the morning of the vaccination day, but the care home should check this on arrival of the vaccination team.

42. Will care homes need to have PPE ready for the vaccination team or will they supply their own?
The vaccination teams will bring their own PPE to the care home. They will wear surgical facemasks, and change aprons and gloves for each vaccination.

43. Should residents wear a mask whilst being vaccinated?
If residents are happy to wear a mask, then they should.

44. What are the timescales between first and second dose of vaccine?
You are required to have two doses of the COVID-19 vaccine, up to 12 weeks apart. You will get a good level of protection from the first dose but will not get maximum protection until at least 7 to 14 days after your second dose of vaccine.

45. Are the number of vaccinators based on the size of the home and the team?
The Care Home Vaccination Mobilisation Support Pack and Checklist (page 4) shows the suggested configuration of the vaccination team and advises that if extra support is needed to liaise with your local Primary Care Network contact.
The COVID Standard Operating Procedure also explains the set-up of care homes for vaccinations (page 35).

46. Will the administrative support person accompany the vaccinator to the care home?
Yes, they will arrive together and stay together during the vaccination process to record vaccinations given.

47. Can the Pfizer vaccination be transported in a lift?
The Pfizer vaccination is very fragile and must be handled extremely carefully. The COVID Standard Operating Procedure (page 6) outlines process for safe and secure handling and management of COVID-19 vaccine.

48.  Now that I have been vaccinated, is it OK for me to mix with others?
The first dose of the COVID-19 vaccine should give you good protection from coronavirus. But it may take a week or two for your body to build up some protection. You also need to have the two doses of the vaccine to give you longer lasting protection. Like all medicines, no vaccine is completely effective – some people may still get COVID-19 despite having a vaccination, but this should be less severe.
For these reasons, even though you have been vaccinated, to protect yourself, your family, friends and colleagues, you still need to:

  • follow the current guidance both inside and outside of work
  • follow the current shielding guidance until the guidance changes
  • continue to implement all of the usual infection prevention and control measures, including regular cleaning and ensuring good ventilation
  • practice social distancing both inside and outside of work, including when working in communal areas and when socialising
  • wear face coverings and PPE in line with the guidance
  • wash your hands carefully and frequently

49. Our whole home was vaccinated and now we are seeing residents and staff with COVID-19 symptoms. Can the vaccine give us COVID?
You cannot catch COVID-19 from the vaccine. But you may have caught COVID-19 shortly before being vaccinated and developing any symptoms. It also takes a week or two for your body to build up some protection after the first dose of COVID-19 vaccine, so it is possible to catch COVID during this time.
The most important symptoms of COVID-19 are recent onset of any of the following:

  •  a new continuous cough
  • a high temperature
  • a loss of, or change in, your normal sense of taste or smell.

If you have the symptoms above, stay at home and arrange to have a test.
Like all medicines, vaccines can cause side effects. Most of these are mild and short term, and not everyone gets them. 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 2-3 days, a high temperature is unusual. This may mean that you picked up COVID-19 shortly before being vaccinated or after being vaccinated but before your body has built up some protection. You may also have another infection. You can rest and take the normal dose of paracetamol (follow the advice in the packaging) to help you feel better. Symptoms following vaccination normally last less than a week. If your symptoms seem to get worse or if you are concerned, call NHS 111.

50. Our care home currently has a COVID-19 outbreak. Can we still be vaccinated?
If your care home has a COVID-19 outbreak this is not a reason to delay vaccination. The GP/vaccinator will need to make an individual risk assessment for each resident and staff member, based on the Green Book advice, which gives detailed and clear instructions that can be applied to each person. However, in those with confirmed COVID-19 infection, they should wait for 28 days from the start of their COVID symptoms (or the date of their first positive test if tested without symptoms) before getting vaccinated.

There is no evidence of any safety concerns from vaccinating individuals with a past history of COVID-19 infection.
Generally, you should not attend a vaccine appointment if you are self-isolating or waiting for a COVID-19 test.
You do not need to delay immunisation if you have a minor illness without fever. But if an individual is very unwell, immunisation may be delayed until they have fully recovered.

Useful links

Resources to support care home staff
Information is available on the nhs.uk website and this covers:

  • Who can get the COVID-19 vaccine
  • Advice if you’re of childbearing age, pregnant or breastfeeding.
  • How safe is the COVID-19 vaccine
  • How effective is the COVID-19 vaccine
  • Side effects.

Social media

Care homes are encouraged to share their stories of staff and residents being vaccinated on social media. Including the hashtag #CovidVaccine and tagging in @NHSEngland, @AgeingWellNHS and your local CCG will allow NHS communications teams to amplify them.
NHS organisations are also posting messages about the safety of the vaccine so please encourage members to retweet these.

Additional tips

We have summarised below five tips for staff uptake campaigns based on insight and what the most successful employers already do for flu:

  • Show evidence about the safety/efficacy/side effects
  • Emphasise and repeat that the vaccine will reduce transmission of the virus
  • Reassure that immunisation will be made easy
  • Encourage the use of senior/influential colleagues as vaccine champions
  • Acknowledge and profile those staff who have had the vaccine.

JCVI healthcare worker definition

The JCVI has identified frontline healthcare workers as the initial priority group to receive the vaccine. The following term for healthcare worker is used by the JCVI as:

all individuals working in healthcare regardless of their direct employer.”

This definition makes no distinction on healthcare workers based on job role i.e. there is no distinction between frontline/patient facing and back office staff and includes laboratory staff, students, trainees and volunteers working in healthcare.
Regions and local systems should prioritise the vaccination of healthcare workers based on protecting individuals at highest risk of exposure, local expediencies of delivery and minimising wastage.


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