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Supporting health and social care providers in Devon

Vaccination and care homes: Frequently Asked Questions

Vaccination and care homes: Frequently Asked Questions issued by NHS England on 31 December 2020.

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?
The MHRA have said these vaccines are highly effective, but to get full protection people need to come back for the second dose. This is really important.
To ensure as many people are vaccinated as quickly as possible, the Department for Health and Social Care now advise that the second dose of both the OxfordAstraZeneca and the Pfizer/BioNtech vaccine should be scheduled up to 12 weeks apart.
Full protection kicks in around a week or two after that second dose, which is why it’s also important that when you do get invited, you act on that and get yourself booked in as soon as possible. Even those who have received a vaccine still need to follow social distancing and other guidance.

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?
Yes. The NHS will not offer any COVI-19 vaccinations to the public until independent experts have signed off that it is safe to do so.
The MHRA, the official UK regulator, have said these vaccines offer a high level of protection and have good safety records, 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 it has been authorised and is being used in the wider population.
The MHRA recommend certain groups do not take the vaccine, including women who are pregnant or breastfeeding, and those with certain types of allergies.

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:

  • 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.

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 at Annex D of the Standard Operating Procedure for COVID-19 Deployment in Community Settings.

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.

Useful links

Resources to support care home staff
Information is available on the 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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