Last updated – 17 June 2021 (Guidance may be subject to future updates)
HOW YOU CAN HELP THE NHS – Key Messages
- Please don’t contact your GP practice or Community Pharmacy to seek a vaccine, the NHS will contact you
- When you are invited, please be sure to attend your booked appointments.
- Please attend your appointment on your own. If you need assistance, please bring only one person with you. If we have more people attending, it is difficult to maintain social distancing.
- Even after having a Covid-19 vaccination, please continue to follow all the guidance to control the virus and save lives – that means staying at home as much as possible and following the ‘hands, face, space’ guidance when you are out.
- For people who have the NHS app, their vaccine status will show when they have been vaccinated. If people cannot access online services, and they are due to travel abroad in the near future, they can call 119 (COVID-19 vaccination service status) to request a letter that will provide evidence of their vaccination status. People are being urged NOT to call their GP as they will be unable to help.
We have outlined answers to some frequently asked questions below:
What is COVID-19 or Coronavirus?
COVID-19 is caused by a new coronavirus, known as SARS-CoV-2. It was first identified in late 2019. It is very infectious and can lead to severe respiratory disease.
Many people who are infected may not have any symptoms or only have mild symptoms. These commonly start with cough, fever, headache and loss of taste or smell.
Some people will feel very tired, have aching muscles, diarrhoea and vomiting, fever and confusion. A small number of people then go on to have severe disease which may require hospitalisation or admission to intensive care.
Overall fewer than 1 in 100 people who are infected will die from COVID-19, but in those over 75 years of age this rises to 1 in 10.
There is no cure for COVID-19 although some newly tested treatments do help to reduce the risk of complications.
GETTING THE VACCINE
How will people be invited for a vaccination?
When it is the right time people will receive an invitation to come forward. For most people this will be a letter or phone call, either from their GP or the national NHS. This letter will include all the information a person will need to book appointments. Some services are currently also phoning and texting patients to invite them in.
We know lots of people are eager to get protected but we would ask people not to contact the NHS to get an appointment until they are contacted. The NHS is working hard to make sure those at greatest risk are offered the vaccine first.
Some people who have been vaccinated by their GP may still get an invitation to a mass vaccination centre or a community pharmacy. This letter can be disregarded if you have already had your vaccine from your GP.
You can wait for an invitation from your GP if you would prefer to be vaccinated at a local designated hub rather than at a mass vaccination centre.
Why has the NHS vaccinated some groups before others?
Getting our most vulnerable people vaccinated as quickly as we can, while transmission rates are high, has undoubtedly save lives. Everyone in the first phase of the vaccination programme including: care home residents, frontline health and care staff, clinically extremely vulnerable people, those with underlying health conditions and people over the age of 50 have now been offered a vaccination.
Who is now eligible for the vaccination?
The vaccine is now being offered to people at lower risk from the complications of COVID-19. You are still at risk of catching the infection and passing it on to others.
For most younger people COVID-19 is usually a milder illness that rarely leads to complications. For a few people the symptoms may last for longer than the usual two to three weeks. The vaccination will help to protect you against COVID-19.
In the second phase of the programme the vaccine will be offered to those under 50 years old in the following order:
The risk remains higher in older ages. For example the risk of dying from COVID-19 in someone aged 40 – 49 is 3 times higher than someone in the 30 to 39 year age group and 12 times higher than someone in the 20 to 29 year age group.
Why have I been invited to a vaccination centre outside my area?
The NHS has opened a number of large-scale vaccination centres and community pharmacies across the region. Invitations to book an appointment are being sent to people in the relevant priority groups who have not yet been vaccinated and live up to 45 minutes’ drive from a centre.
You are free to choose to accept this invitation, by following the instructions on the letter, or wait to be contacted by your local GP services for an invitation to a locally designated site.
Why do I have to wait for my vaccination?
The NHS is offering vaccinations to those at greatest risk from Covid-19 first, in line with recommendations from the Joint Committee for Vaccinations & Immunisations (JCVI).
As more vaccine becomes available, appointments will be offered to a wider group of people in second phase priority groups.
Can I get one privately?
No. Vaccinations will only be available through the NHS for the moment. Anyone who claims to be able to provide you with a vaccine for a fee is likely to be committing a crime and should be reported to the Police 101 service and/or Local Trading Standards.
I have been told to pay for a vaccine
The vaccine is only available on the NHS for free to people in priority groups, and the NHS will contact you when it is your turn. Anyone offering a paid-for vaccine is committing a crime.
The NHS will never ask you to press a button on your keypad or send a text to confirm you want the vaccine, and never ask for payment or for your bank details.
If you receive a call you believe to be fraudulent, hang up. If you believe you have been the victim of fraud or identity theft you should report this directly to Action Fraud on 0300 123 2040. Where the victim is vulnerable, and particularly if you are worried that someone has or might come to your house, report it to the Police online or by calling 101.
Can I have the vaccine during Ramadan/does the vaccine invalidate fasting?
The British Islamic Medical Association have issued specific advice urging Muslims observing Ramadan not to delay getting the vaccine, drawing on analysis from Islamic scholars which says that injections for non-nutritional purposes do not invalidate the fast.
ABOUT THE VACCINES
What vaccines for Covid-19 are currently available?
The Pfizer/BioNTech, Oxford/AstraZeneca COVID-19 and the COVID-19 Vaccine Moderna vaccines are now available. All vaccines have been shown to be safe and offer high levels of protection, and have been given regulatory approval by the Medicines and Healthcare Products Regulatory Agency (MHRA).
About the types of vaccine
In the UK several different types of COVID-19 vaccines will be used during 2021. The vaccines will only be approved on the basis of large studies of safety and effectiveness.
Over 30 million people in the UK have been vaccinated against COVID-19 and the vaccine has already prevented many cases and more than 6 thousand deaths from COVID-19.
Recently there have been reports of an extremely rare condition involving blood clots and unusual bleeding after vaccination with AstraZeneca (AZ). This is being carefully reviewed but the risk factors for this condition are not yet clear. Because of the high risk of complications and death from COVID-19, the MHRA, the World Health Organisation and the European Medicines Agency have concluded that the balance is very much in favour of vaccination.
Can people pick which vaccine they want?
Any vaccines that the NHS provides will have been approved because they pass the MHRA’s tests on safety and efficacy. People should be assured that whatever Covid-19 vaccine they get will be effective.
A specific vaccine will only be selected where there is a clinical reason to do so related to severe allergic reaction (anaphylaxis) and based upon age recommendations made by the JCVI as below.
As the programme progresses, the JCVI will advise on the appropriate vaccine for each age group. The vaccine offered will depend on your age. Currently the JCVI has advised it is preferable for healthy people under 30 to have a vaccine other than AstraZeneca (AZ). The time when it will be offered will be based on the availability of those vaccines. Anybody who was previously eligible for vaccination remains so and should come forward to start or complete their recommended course.
The MHRA and the JCVI advises that all adults in this age group (including health and social care workers) should still receive any of the available COVID-19 vaccines. The benefits of vaccination in protecting you against the serious consequences of COVID-19 outweigh any risk of this rare condition. You should also complete your course with the same vaccine you had for the first dose.
If you choose to have another COVID-19 vaccine you may have to wait to be protected. You may wish to go ahead with the AZ vaccination after you have considered all the risks and benefits for you.
The MHRA and the JCVI continue to monitor the benefits and safety of the AZ vaccine in younger people. You should carefully consider the risk to both you and your family and friends of COVID-19 before making a decision.
JCVI are advising a preference for a vaccine other than AstraZeneca to be offered to healthy people under 40 years of age, including health and social care workers, unpaid carers and household contacts of immunosuppressed individuals.
Is the vaccine safe?
Yes. The NHS would not offer any Covid-19 vaccinations to the public until independent experts have signed off that it was safe to do so.
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 all other licensed medicines go through. The MHRA follows international standards of safety.
Millions of people have been given a Covid-19 vaccine and reports of serious side effects, such as allergic reactions, have been very rare. No long-term complications have been reported.
A very small number of individuals have experienced a severe allergic reaction (anaphylaxis) when vaccinated with Covid-19 vaccine. Following close surveillance of the vaccine roll-out, the MHRA has advised that individuals with a history of allergic reactions to food, an identified drug or vaccine, or an insect sting can receive any Covid-19 vaccine, as long as they are not known to be allergic to any ingredients of the vaccine.
I’ve heard through the media that the Oxford AstraZeneca vaccine causes blood clots.
The Joint Committee on Vaccination and Immunisation (JCVI) has issued advice to the government on the use of the AstraZeneca vaccine, following reports of extremely rare blood clots in a very small number of people
This condition is known to occur naturally although the underlying risk factors have not yet been fully established. A detailed review of suspected cases of this condition following COVID vaccination is ongoing by the Medicines Healthcare products Regulatory Agency (MHRA), supported by PHE and other professional groups.
This will help us to understand the risk factors for developing this condition. The current data suggests that the overall incidence is around 4 per million first doses of the AZ vaccine administered. Although cases have been reported in all ages and genders, there appears to be a trend for increasing incidence with decreasing age amongst adults, with the highest incidence reported in the younger adult age groups.
The MHRA’s advice remains that the benefits of being vaccinated with the available vaccines continue to outweigh any risks and that the public should continue to get their vaccine when invited to do so.
- For anyone over 40 who has not received their first Astra Zeneca vaccine dose, the advice is to get your vaccine as planned and keep your appointment if you have been given one.
- Anyone under 40 – without an underlying health condition – who has not been vaccinated yet – will be offered an alternative vaccine via PCN sites.
- People may make an informed choice to receive the AstraZeneca COVID-19 vaccine to receive earlier protection – this may be appropriate for people such as carers, health and social workers and other front line staff who are at an increased risk of exposure and/or to reduce the risk of passing the virus on to vulnerable individuals.
- For anyone under 40 – with an underlying health condition – who has not yet had a first vaccine will be offered an alternative vaccine.
A range of resources have been developed and updated to support this decision making and are available at www.gov.uk/government/collections/covid-19-vaccination-and-blood-clotting.
Is this condition only associated with the AZ vaccine?
Recently there have been reports of an extremely rare but serious condition involving blood clots and unusual bleeding after AstraZeneca (AZ) vaccination. Some people with this condition have suffered life changing effects and some have died. These cases are being carefully reviewed but the risk factors for this condition are not yet clear.
Although this condition remains extremely rare there is a higher risk in people after the first dose of the AZ vaccine. To date and overall, just over 10 people develop this condition for every million doses of AZ vaccine given. This is seen more often in younger people and tends to occur between 4 days and 4 weeks following vaccination.
Similar conditions can also occur naturally, and clotting problems are a common complication of coronavirus (COVID-19) infection. An increased risk has not yet been seen after other COVID-19 vaccines in the UK.
The link attached gives further information to support your understanding to help you make an informed choice about vaccination.
Will the vaccines work with the new strains?
There is currently no evidence that the new strains will be resistant to the vaccines 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 vaccines. Viruses, such as the winter flu virus, often branch into different strains but these small variations rarely render vaccines ineffective.
Do the vaccines include any parts from foetal or animal origin?
There is no material of foetal or animal origin in either vaccine currently in use. All ingredients are published in the healthcare information on the MHRA’s website.
For the Pfizer/BioNTech vaccine information is available here: https://www.gov.uk/government/publications/regulatory-approval-of-pfizer-biontechvaccine-for-covid-19
For the Oxford/AstraZeneca vaccine information is available here: https://www.gov.uk/government/publications/regulatory-approval-of-covid-19-vaccineastrazeneca
Should people who have already had Covid get vaccinated?
Yes – The MHRA have advised that getting vaccinated is just as important for those who have already had Covid-19. It is advised that if you have had Covid you need to wait four weeks before you can be vaccinated.
Will the Covid-19 vaccine protect me from flu?
No, the COVID-19 vaccine will not protect you against the flu.
Are there any people who shouldn’t have the vaccine?
People with history of a severe allergy to the ingredients of the vaccines should not be vaccinated.
If you have a history of anaphylaxis (severe allergy) with an unknown cause, you should discuss this when attending your vaccination.
What about pregnancy and breastfeeding?
The MHRA has updated its guidance to say that pregnant women and those who are breastfeeding can have the vaccine, with no known risk from the vaccine ingredients and no risk of infection to mum or unborn baby from the vaccine. Pregnant women can discuss it with a clinician to ensure that the benefits outweigh any potential risks should they wish. Similarly, advice for women planning a pregnancy has also been updated and there is no need for women to delay pregnancy after having the vaccination.
Although clinical trials on the use of COVID-19 vaccines during pregnancy are not advanced, the available data does not indicate any harm to pregnancy. JCVI has therefore advised that women who are pregnant should be offered vaccination at the same time as non-pregnant women, based on their age and clinical risk group.
Pregnant women in eligible groups Pfizer and Moderna vaccines are the preferred vaccines for eligible pregnant women of any age, because of more extensive experience of their use in pregnancy. Pregnant women who commenced vaccination with AstraZeneca, however, are advised to complete with the same vaccine
If a woman finds out she is pregnant after she has started a course of vaccine, she may complete vaccination during pregnancy using the same vaccine product (unless contraindicated).
I’m currently ill with Covid-19, can I get the vaccine?
People currently unwell and experiencing COVID-19 symptoms should not receive the vaccine until they have recovered. The guidance says this should be at least four weeks after the start of symptoms or from the date of a positive Covid-19 test.
AFTER HAVING YOUR VACCINE
What do I do next?
If this is your first dose, you should have a record card with your next appointment in between 3- and 12-weeks’ time. It is important to have both doses of the same vaccine to give you the best protection.
Keep your card safe. If this is your first dose, don’t forget to keep your next appointment.
Will there be any side effects?
Very common side effects in the first day or two include:
- having a painful, heavy feeling and tenderness in the arm where you had your injection
- feeling tired
- headache, aches and chills
You may also have flu like symptoms with episodes of shivering and shaking for a day or two. However, a high temperature could also indicate that you have COVID-19 or another infection. You can rest and take a normal dose of paracetamol (follow the advice in the packaging) to help make you feel better.
An uncommon side effect is swollen glands in the armpit or neck on the same side as the arm where you had the vaccine. This can last for around 10 days, but if it lasts longer see your doctor. If you are due for a mammogram in the few weeks after the vaccine, then you should mention that when you attend.
What should I do if I am worried about symptoms following my vaccination?
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.
If you experience any of the following from around 4 days to four weeks after vaccination you should seek medical advice urgently.
- a new, severe headache which is not helped by usual painkillers or is getting worse
- an unusual headache which seems worse when lying down or bending over or may be accompanied by– blurred vision, nausea and vomiting– difficulty with your speech, – weakness, drowsiness or seizures
- new, unexplained pinprick bruising or bleeding
- shortness of breath, chest pain, leg swelling or persistent abdominal pain
What should I do if I am not well before my next appointment?
If you are unwell, it is better to wait until you have recovered to have your vaccine. You should not attend a vaccine appointment if you are self-isolating, waiting for a COVID-19 test or within 4 weeks of having a positive COVID-19 test.
Will the vaccine protect me?
The COVID-19 vaccine that you have had has been shown to reduce the chance of you suffering from COVID-19 disease. Each vaccine has been tested in more than 20,000 people and many have also been used in many different countries.
It may take few weeks for your body to build up some protection from the vaccine. Like all medicines, no vaccine is completely effective, so you should continue to take recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but this should be less severe.
What should I do after I have had the vaccine?
The vaccine cannot give you COVID-19 infection, and a full course will reduce your chance of becoming seriously ill. We don’t know how much it will reduce the risk of you passing on the virus. So, it is important to continue to follow current national guidance.
To protect yourself and your family, friends and colleagues you MUST still:
- practise social distancing
- wear a face mask
- wash your hands carefully and frequently
- open windows to let fresh air in
- follow the current guidance at www.gov.uk/coronavirus
GETTING THE SECOND DOSE
Why were second doses of the vaccine rescheduled?
The UK Chief Medical Officers 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.
The latest evidence suggests the first dose of the Covid-19 vaccine provides protection for most people for up to three months.
Getting both doses remains important so we would urge people to return for it at the right time which will be between 10 and 12 weeks from the first dose.
Will I be at greater risk if I don’t get a second dose after three weeks?
The science suggests that protection comes 10-14 days after the first dose. Trials show that at three weeks, the Pfizer vaccine is 89% effective and the Astra Zeneca vaccine is 73% effective.
In the Astra Zeneca vaccine trial, second doses were given after varying time periods, with no suggestion that a delayed second dose gave inferior protection. There is no immunological reason why protection should wane between 3 and 12 weeks. Scientists are watching very carefully for any evidence that protection reduces between 3 and 12 weeks, and none has been found.
Will I have less long-term protection if I receive the second dose at 12 weeks?
There is no reason to think that a second dose at 12 weeks will give inferior long term protection, and lots of science to suggest this may actually give better long term protection.
For most vaccines, the best time for a booster dose is well beyond three weeks after the primary dose. In fact, a second dose too close to the first dose often means there is a lesser immune response in the long run.
Why have some second doses been brought forward to 8 weeks?
Following guidance from government and JCVI regarding the Delta variant first detected in India circulating in some parts of the country, the NHS is contacting people in the highest priority groups (cohorts 1-9), so they can receive their second dose earlier – at around 8 weeks. This means people at greater risk of getting seriously ill due to coronavirus can get maximum protection sooner. If you already have an appointment over the coming weeks, whether for your first or second dose, this remains in place and it’s really important that you attend as planned.
The dose interval for cohorts 10-12 (younger healthy adults ) is to remain at 12 weeks at the current time.
I’m in a vulnerable group. Can I get a second dose after three weeks?
There is no evidence that people in clinically vulnerable groups get any lesser protection from the first dose of vaccine than the general population. Giving people in these groups a second vaccine would delay the first dose for other vulnerable people. We do not have the option of making exceptions.
Does the second dose of vaccination need to happen at the same place as the first dose?
People using the National Booking Service (booking into a vaccination centre or designated community pharmacy) are given their closest available appointment locations. While most people will book both appointments at the same location, there is an option for the second dose appointment to be booked at a different location. This applies to the COVID-19 AstraZeneca vaccine only.
People who had their first dose through a GP service should be invited for their second dose through the same GP service.
People who had their first dose at a Hospital Hub site should be invited or be able to book their second dose at the same location.
There are other circumstances in which it may be appropriate for a patient to receive their second dose in a different location to their first dose, for example, discharged outpatients, students, doctors in training on rotation to hospitals, people who have become housebound or moved into a care home since their first dose, or patients who have moved to a new house to somewhere a long way away from where they had their first dose.
Can different vaccines be used for first and second doses?
The NHS has said that the same vaccine used for the first dose must be used for the second, except in very exceptional circumstances. These exceptional circumstances are:
If the first product received is unknown or if they received a brand that is not available in the UK. In these circumstances every effort should be made to determine which vaccine the individual received for their first dose and to complete the two-dose course with the same vaccine.
If the patient initially had the Pfizer Vaccine and has since become housebound. In these circumstances as the COVID-19 vaccine AstraZeneca can be transported, a second dose with this vaccine can be given.
People who experienced anaphylaxis reactions with the first dose of one brand of vaccine may be offered another vaccine if advised by an allergy specialist.
How will any surplus vaccine doses be used?
If there is surplus vaccine, following second dose clinics, this will be used for first doses in the priority cohorts, for those patients who have been vaccinated prior to starting immunosuppression and who need a shorter interval between doses.
Where can I find out more?