Last week we entered a new lockdown to try and control the coronavirus epidemic. Stories about hospitals running out of capacity are supported by data that show the numbers of people in hospital with coronavirus in England are now higher than they were at the first peak of the coronavirus epidemic last spring.
There are also more people in the community with coronavirus than ever before, with the Office for National Statistics estimating that 1 in every 50 people in England now has the virus. How have we arrived at this situation, and what do we need to do next?
What more do we now know about the new variant?
It looks like the only important difference between the new UK variant of coronavirus and previous variants is that the new one is easier to catch. Scientists have found no evidence to suggest that the vaccines will work any less well with this variant, or that it makes people any more or less sick than other variants do. However, as the new variant is easier to catch it will infect more people, so even though it doesn’t make those people any more ill, as there are more of them it will cause more people to be very unwell or die.
One of the important consequences of this new variant being easier to catch is that we need to do more to slow the spread of it. However, although the new variant spreads more easily it doesn’t spread in a different way, and the things that reduced the spread of other variants before will also reduce the spread of this ‘new’ one. It is more important than ever we reduce close contact with others, keep the contacts we do have outdoors where possible, and open windows, socially distance and wear a mask when this isn’t possible.
Are there any other new variants?
As well as the new UK variant, a new coronavirus variant has emerged in South Africa. Although this has evolved independently of the UK variant, they have some similarities, and the South African variant is also easier to catch.
There have been questions about whether the South African variant differs in a way that means the coronavirus vaccines won’t work as well – such changes to a virus which mean that vaccines don’t work are called ‘escape mutations’ – but early evidence suggests this isn’t the case. If, however, a variant of coronavirus were to arise that the vaccine didn’t work for, the vaccines can be modified so they still provide protection.
What’s happening with vaccinations?
The Joint Council on Vaccination and Immunisation (JCVI) has recommended that people who are most vulnerable to severe illness from coronavirus be vaccinated first. Older people are top of the priority list and will be contacted by the NHS or a local pharmacy to be invited for a coronavirus vaccination, free of charge. More than 650,000 people aged 80+ in England have been vaccinated so far, and the Government has committed to offering a vaccine to everyone aged 70 and over, as well as people with health conditions that make them vulnerable, plus health and care workers, by mid-February
There are now 3 vaccines licenced for use in the UK – produced by BioNTech/Pfizer, Oxford University/AstraZeneca and, more recently, Moderna. The vaccines are safe and highly effective in reducing the chances of becoming unwell with coronavirus, including for older people. The vaccines provide a high level of protection from a couple of weeks after the first dose and should have a second booster dose to maximise long-term protection.
Why is the first dose of the vaccine being prioritised?
As the circumstances with the coronavirus epidemic in the UK are so challenging, the scientific experts who form the JCVI have recommended that the NHS prioritise giving the first dose of the vaccine to as many older and vulnerable people as possible. This means that more of the people who are at risk of the worst effects of coronavirus can be protected sooner.
To enable more people to get their first dose, the JCVI have recommended that the gap between the first and second doses of both the vaccines currently in use – BioNTech/Pfizer, Oxford University/AstraZeneca – be up to 12 weeks. Although 12 weeks is the recommended gap for the Oxford University/AstraZeneca vaccine, the manufacturer of the BioNTech/Pfizer vaccine recommend a shorter gap between doses.
Should we be worried about waiting longer for a second dose?
The JCVI recommendation that the second dose of the BioNTech/Pfizer vaccine be delayed has raised concerns that people will not be properly protected, however trials showed that from a fortnight after the first dose people had 90% protection. Although shorter gaps between doses were used in the trial a high level of protection is likely to be maintained until a second dose boosts immunity 12 weeks later.
A gap of around 12 weeks between the two doses of the Oxford University/AstraZeneca vaccine seems to provide better immunity against coronavirus in the long run than a shorter gap between doses. This is also how it works for many other vaccines – longer gaps between doses improve long-lasting immunity. It is likely that this is will also be the case for the for BioNTech/Pfizer vaccine, although this was not tested in the vaccine trials.
More articles by Dr Webb
Dr Elizabeth Webb is Head of Research at Age UK. She has an MSc in Epidemiology from the London School of Hygiene and Tropical Medicine and a PhD in Social Epidemiology from University College London.