Wellbeing & Fitness

Covid-19 vaccines: how they work and who is eligible if you have a disability or chronic illness

The first three Covid-19 vaccines – Pfizer/BioNTech, Oxford/AstraZeneca and Moderna – have been approved in the UK and it’s hoped that millions of doses will be given to people by Easter. Read on to learn more about the vaccines and understand who is eligible and when.

UPDATED: 25/02/2021

Which Covid-19 vaccines have been approved?

The Pfizer/BioNTech vaccine was approved in November 2020 in the UK and begun being administered on 8th December 2020. Millions of people have already received their first dose.

On 30th December 2020, the Oxford/AstraZeneca vaccine was approved for use in the UK. It was rolled out alongside the Pfizer/BioNTech vaccine from Monday 4th January 2021.

The Moderna vaccine was approved by the MHRA for use in the UK on 8th January 2021. 17 million doses have been pre-ordered but supplies are not expected to arrive until spring 2021.

Here at Disability Horizons, we take you through everything you need to know about the Covid-19 vaccines:

Pfizer/BioNTech Covid-19 vaccine

The Pfizer/BioNTech Covid-19 vaccine was the first jab to be approved in the UK by the Medicines and Healthcare Regulatory Authority (MHRA).

People begun receiving the injection at NHS hospitals across the country from 8th December.

Pfizer and BioNTech are not British companies. Pfizer is a pharmaceutical company based in America and BioNTech is a biotechnology company based in Germany. The drug is being made at a Pfizer manufacturing facility in Belgium.

The UK has ordered a total of 30 million doses of the Pfizer/BioNTech vaccine, which will protect 15 million people as two doses are needed.

How the Pfizer/BioNTech Covid-19 vaccine works

The Pfizer/BioNTech Covid-19 vaccine trains the immune system to fight coronavirus.

It is a new type of jab called a Ribonucleic acid (RNA) vaccine that uses a tiny fragment of the virus’s genetic code. This starts making part of the virus inside the body, which the immune system recognises as foreign and starts to attack.

The genetic material is encased in a tiny protective bubble of fat to get it into cells.

The exact ingredients of the vaccine have not been made public, but other vaccines can contain other ingredients to make them stable or more effective.

The jab has to be stored at -70C. It can then be in a refrigerator for up to five days before it starts to degrade.

Oxford/AstraZeneca Covid-19 vaccine

The Oxford/AstraZeneca Covid-19 vaccine, which was developed at Oxford University alongside pharmaceutical company AstraZeneca, was approved by the MHRA on Wednesday 30th December 2020.

The UK government has ordered a lot more of this vaccine – 100 million doses. This jab is more affordable and can be stored in a refrigerator between 2C and 8. Two jabs are also needed for this vaccine.

How the Oxford/AstraZeneca Covid-19 vaccine works

The Oxford vaccine is based on a harmless adenovirus from a chimpanzee, which has been engineered in the lab to include genes from Sars-Cov-2, the coronavirus that causes Covid-19.

When the genetically modified adenovirus is injected into human cells, they make coronavirus proteins that prime the immune system to respond to future infections with Sars-Cov-2.

Moderna Covid-19 vaccine

The third Covid-19 vaccine to be approved in the UK is the Moderna vaccine. It was authorised by the MHRA on Friday 8th January 2021.

The UK Government has ordered 17 million doses but is eager to increase this number so more people can be vaccinated. The jabs will be available in spring 2021.

How the Moderna Covid-19 vaccine works?

Like the Pfizer jab, the Moderna vaccine uses synthetic RNA messengers that use genetic code from the coronavirus to prompt human cells to generate a so-called “spike” protein found on the outside of the virus.

The process sets off an immune response from the body, which eventually blocks the actual coronavirus from latching onto cells.

Fortunately, the Moderna Covid-19 vaccine remains stable for six months at -20C and for 30 days in a standard medical refrigerator.

Covid-19 vaccine ingredients

Here is a full list of the ingredients that makes up the Pfizer/BioNTech and Oxford/AstraZeneca vaccines:

Pfizer/BioNTech Covid-19 vaccine ingredients

This vaccine contains polyethylene glycol/macrogol (PEG) as part of ALC-0159.

  • ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate)
  • ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide
  • 1,2-Distearoyl-sn-glycero-3-phosphocholine
  • cholesterol
  • potassium chloride
  • potassium dihydrogen phosphate
  • sodium chloride
  • disodium hydrogen phosphate dihydrate
  • sucrose
  • water for injections

Oxford/AstraZeneca Covid-19 vaccine ingredients

One dose (0.5 ml) contains: COVID 19 Vaccine (ChAdOx1-S* recombinant) 5 × 10^10 viral particles

*Recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS CoV 2 Spike glycoprotein. Produced in genetically modified human embryonic kidney (HEK) 293 cells.

This product contains genetically modified organisms (GMOs).

The other ingredients are:

  • L-histidine
  • L-histidine hydrochloride monohydrate
  • magnesium chloride hexahydrate
  • polysorbate 80
  • ethanol
  • sucrose
  • sodium chloride
  • disodium edetate dihydrate
  • water for injections

Moderna Covid-19 vaccine ingredients

This vaccine contains polyethylene glycol/macrogol (PEG) as part of PEG2000-DMG.

This is a multidose vial which contains 10 doses of 0.5 mL.

The active substance in each dose is 0.10 mg mRNA encoding the pre-fusion stabilized Spike glycoprotein of SARS-CoV-2 embedded in lipid nanoparticles.

The other ingredients are:

  • lipid SM-102, cholesterol
  • 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC)
  • 1,2-Dimyristoyl-rac-glycero-3-methoxypolyethylene glycol-2000 (PEG2000-DMG)
  • trometamol (tris)
  • trometamol hydrochloride (tris HCl)
  • acetic acid
  • sodium acetate trihydrate
  • sucrose
  • water for injections

Head to the Disability Horizons Shop to buy Covid essentials, including lip-reading face masks, face mask inserts to make breathing easier and extra-thick plastic aprons.

One images showing three products for the Disability Horizons Shop - a lip-reading face mask, face mask breathing insert to make it easier to breath and extra thick plastic apron

Covid-19 vaccines effectiveness and doses

Pfizer/BioNTech vaccine

The Pfizer/BioNTech vaccine is given in two doses and offers up to 95% protection against Covid-19 after the two doses have been given. You will not be fully protected from coronavirus until at least 7 days after the second dose.

Initially, the two doses of the Pfizer vaccine were to be given three weeks apart. However, at the end of December, the Department for Health and Social Care announced that it will prioritise administering the first dose to as many people as possible and delay the second dose to between three and 12 weeks. This is more in line with how the Oxford vaccine is given.

This also followed a new strain of coronavirus being found in the UK, which was discovered in London in mid-December and has gone on to spread to many European, Asian and North American countries (read more about the new variants of Covid-19 below).

On 23rd February 2021, Public Health England published data analysing the effectiveness of the Pfizer vaccine since the vaccination programme began.

Study shows that healthcare workers were 72% less likely to develop infection (with or without symptoms) after one dose of the vaccine, rising to 86% after the second dose.

Protection starts after two weeks. This protection will also help to reduce the spread of infection, thus protecting the whole population – as you cannot spread the virus if you don’t have infection.

Protection from any Covid-19 symptoms in over-80s is 57% from four weeks after vaccination. After the second dose, effectiveness rises to more than 85%.

Hospitalisation rates are falling in all age groups. However, people aged 75 and over, who were among the first to be offered vaccination, are seeing the fastest decline.

Those over 80 who develop the Covid-19 infection after vaccination are around 40% less likely to be hospitalised than someone with infection who has not been vaccinated.

However, people who are vaccinated are less likely to catch Covid-19 in the first place.

Death rates are also declining in all age groups. However, the rate of decline is slightly faster in the oldest age groups who have already been offered vaccination. This is in contrast to the first lockdown, when deaths in these age group stayed high for longer than younger age groups.

In older people (aged over 80) who develop Covid-19 infection, those who are vaccinated have a much lower chance of death (about 56% lower) than someone with infection who hasn’t been vaccinated.

Oxford/AstraZeneca vaccine

The Oxford/AstraZeneca vaccine is said to be 90% effective when given a half dose then a full dose.

The second dose will be given four to 12 weeks after the first, and, like with the Pfizer vaccine, you won’t be 90% protected until the second jab.

As well as being 90% effective against contracting Covid-19, scientists revealed on 3rd February 2021 that the Oxford/AstraZeneca vaccine can also cut transmission of the virus by almost 70% too.

On 23rd February 2021, data from Public Health Scotland show the Pfizer-BioNTech and AstraZeneca vaccines reduced the risk of hospitalisation from Covid-19 in up to 85% and 94%, respectively.

Moderna vaccine

Moderna’s vaccine is 94% effective and will require two injections, which need to be administered 28 days apart. This time scale may be extended due to the governments aim to administer as many first doses as possible.

The jabs won’t be available until spring 2021 because it is being manufactured in the US at first, and will take a few months before manufacturing facilities in Europe will be ready to distribute.

How long will a Covid-19 vaccine protect me?

Because the vaccines haven’t been available for long, at this stage, there is no evidence to show how long the Pfizer, Oxford or Moderna vaccines can protect you, so more research is needed.

This means the Covid-19 vaccine may need to be administered on an annual basis, similar to the flu jab.

Mixing Covid-19 vaccines to be trialled

On Thursday 4th February 2021, it was announced that a new trial would be starting to see if it’s safe and effective to have dosses from two different vaccines so that the vaccination programme can be sped up if supplies are low of one particular jab.

For instance, if you have the Pfizer vaccine as your first dose then the Oxford vaccine as your second dose, will it give you enough protection or even more protection than two of the same vaccine?

800 people over 50 will be taking part in this study and early results will be published in summer 2021.

Will the Covid-19 vaccines have side effects?

So far there are no severe side effects or reactions from any of the Covid-19 vaccines but there are some mild, short-term side effects, which can occur in most vaccines.

Pfizer/BioNTech side effects

Very common (may affect more than 1 in 10 people)

  • pain at the injection site
  • tiredness
  • headache
  • muscle pain
  • chills
  • joint pain
  • fever

Common (may affect up to 1 in 10 people)

  • injection site swelling
  • redness at the injection site
  • nausea (feeling sick)

Oxford/AstraZeneca side effects

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 feverish
  • headache
  • feeling sick (nausea)
  • joint pain or muscle ache

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.

If you do have side effects, please record them at the coronavirus yellow card government webpage. It will help to build a picture for the future & further developments.

Covid-19 vaccine hospital hubs and vaccination centres

The Government has a plan to deliver vaccines at several hospital hubs and vaccination sites across the UK. The number of vaccination sites across the country will match the expected vaccine supply.

The capacity and mix of sites must also ensure safe, convenient and equitable access to vaccination in the order of JCVI cohort prioritisation. This requires the right clinical protocols, invitation and booking systems and clear public communication. Vaccinations will be offered at:

Larger vaccination centres

A new approach in the NHS, these are large-scale, re-purposed venues, including sports stadiums, theatres, and hotels, located within communities enabling the NHS to vaccinate large numbers of people. People will be offered an invitation and can book a slot that suits them using the National Booking Service.

Hospital hubs

These are based at NHS trusts, including acute, community mental health and ambulance trusts. They are targeting the health and care workers and will work closely with local authorities, local resilience forums and providers to coordinate rapid vaccination of the workforce.

They are also excellent locations for initial deployment of new vaccines, so that all clinical safety issues can be identified and managed before a wider roll-out. This has been the approach taken with the launch of the Pfizer/BioNTech and the Oxford/AstraZeneca vaccines.

Local vaccination services

These mobilise general practice, working together in groups of primary care networks plus large and small community pharmacy sites. These services provide the largest number of locations and are well placed to support the highest risk individuals, many of whom already have a trusted relationship with their local health services.

They also coordinate and deliver vaccination to people who are unable to attend a vaccination site, including visiting care homes, the homes of housebound individuals and other settings, such as residential facilities for people with learning disabilities or autism, and to reach vulnerable groups, such as those who are experiencing homelessness.

To see a full list of local vaccination services and what happens at a vaccine appointment, visit the NHS website.

Woman i9n a black and white checked shirt about to be given a vaccine by a man in a white lab coat and blue plastic gloves

When will the Covid-19 vaccine be available and who is eligible?

The Joint Committee on Vaccination and Immunisation (JCVI) has put together a list of nine different groups who will be prioritised in getting a Covid-19 vaccine in phase one.

Covid-19 vaccine priority groups

This priority list is as follows:

      1. residents in a care home for older adults and their carers
      2. all those 80 years of age and over and frontline health and social care workers
      3. all those 75 years of age and over
      4. all those 70 years of age and over and ‘clinically extremely vulnerable‘ individuals
      5. all those 65 years of age and over
      6. all individuals aged 16 years to 64 years with underlying health conditions that put them at higher risk of serious disease and mortality
      7. all those 60 years of age and over
      8. all those 55 years of age and over
      9. all those 50 years of age and over.

Covid-19 vaccine rollout

The first dose of the Pfizer and Oxford vaccines have already been given to the majority of the first four priority groups.

If you’re in one of these groups and haven’t yet been contacted about getting the vaccine, get in touch with your GP or health care provider. You can also book one online at nhs.uk/coronavirusvaccine or call 119.

People aged 65 and over and with underlying health conditions should currently be receiving their invite to be vaccinated.

Following a plea by BBC broadcaster Jo Whiley who’s sister has aa learning disability, all adults registered with a learning disability will now be prioritised for a Covid-19 vaccine along with people who have underlying health conditions.

The Government plans to have given the first dose of a vaccine to those aged between 50 and 65 by the end of April.

The second phase of vaccination, which will start after the top nine groups have had their first dose, will focus on the rest of the population.

It won’t prioritise teachers, the police or any other groups, and will be done purely based on age. The Prime Minister aims to offer everyone over 18 their first injection by the end of July.

Everyone who has had their first dose of the vaccine should be invited for the second within eight or 12 weeks.

Buy hand sanitiserantibacterial face masksface mask extenders or tighteners to ensure your mask fits snuggly, face mask exemption cards and more Covid essentials from the Disability Horizons Shop.

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When will PAs and unpaid carers get the vaccine?

Up until now, if you use direct payments to hire your own PA/carers or use self-employed carers, when your PAs and carers can be vaccinated has been less clear.

Some people have received letters from their councils, some have contacted their GPs, and many others say they have no idea if and when their carers can be vaccinated.

On 30th December, the Government qualified that frontline health and social care workers should be prioritised within their group if they are:

  • at high risk of acquiring infection
  • at the high individual risk of developing a serious disease
  • at risk of transmitting the infection to multiple vulnerable persons or other staff in a healthcare environment.

In addition, there previously hasn’t been any clarity around whether the vaccine will be given to unpaid carers.

The Government has now said that it will be given to people “who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.”

Although this indicates that PAs and unpaid carers who look after someone who is either clinically vulnerable or at a higher risk will be vaccinated when those groups are, it appears it will be decided on a case-by-case basis.

If you’re unsure, contact your local council or have your PA/carers contact their GP surgeries.

Covid-19 clinically extremely vulnerable

People who are defined as ‘clinically extremely vulnerable’ are at very high risk of severe illness from coronavirus. This group is set to receive a Covid-19 vaccine along with the over 70s.

There are two ways you may be identified as ‘clinically extremely vulnerable’:

      1. You have one or more of conditions listed below, or
      2. Your clinician or GP has added you to the Shielded Patient List because, based on their clinical judgement, they deem to you be at higher risk of serious illness if you catch the virus.

People with the following conditions are automatically deemed clinically extremely vulnerable:

      • solid organ transplant recipients
      • people with specific cancers:
        • people with cancer who are undergoing active chemotherapy
        • people with lung cancer who are undergoing radical radiotherapy
        • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment
        • people having immunotherapy or other continuing antibody treatments for cancer
        • people having other targeted cancer treatments that can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
        • people who have had bone marrow or stem cell transplants in the last 6 months or who are still taking immunosuppression drugs
      • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)
      • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease)
      • people on immunosuppression therapies sufficient to significantly increase risk of infection
      • problems with your spleen, for example splenectomy (having your spleen removed)
      • adults with Down’s syndrome
      • adults on dialysis or with chronic kidney disease (stage 5)
      • women who are pregnant with significant heart disease, congenital or acquired
      • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions.

If you think there are good clinical reasons why you should be added to the Shielded Patient List, discuss your concerns with your GP or hospital clinician.

Underlying health conditions

The sixth priority group is all individuals aged 16 years to 64 years with underlying health conditions that put them at moderate risk of serious disease and mortality.

People at moderate risk from coronavirus include people who have:

  • chronic respiratory disease, including chronic obstructive pulmonary disease (COPD), cystic fibrosis and severe asthma
  • chronic heart disease (and vascular disease)
  • chronic kidney disease
  • chronic liver disease
  • chronic neurological disease including epilepsy
  • Down’s syndrome
  • severe and profound learning disability
  • diabetes
  • solid organ, bone marrow and stem cell transplant recipients
  • people with specific cancers
  • immunosuppression due to disease or treatment
  • asplenia and splenic dysfunction
  • morbid obesity
  • severe mental illness.

Vaccine being put into a syringe being held in someone's hand wearing blue gloves and a white lab coat in front of a Covid-19 sign

How to get the vaccine for under 16s

It is advised that only those children at very high risk of exposure and serious outcomes – such as older children with severe neuro-disabilities that require residential care – should be offered vaccination.

Clinicians should discuss the risks and benefits of vaccination with a parent or guardian, who should be made aware of the lack of safety data for the vaccine in children aged under 16 years. More detail on vaccination in children is set out in the Green Book – Immunisation Against Infectious Disease.

On Saturday 13th February 2021, it was announced that a new clinical trial will start to find out the effectiveness of the Oxford/AstraZeneca vaccine in children to see if they produce a strong immune response.

300 children aged between 6 to 17 will take part in this research, which should hopefully help find out if children need vaccinated but also will having them vaccinated to prevent transmission.

Who can’t have the Covid-19 vaccine?

Covid-19 vaccine and pregnancy

Women who are pregnant have been told not to have a Covid-19 vaccine. This is because there is no data on how the vaccine will affect pregnant women or their baby.

They are advised to get the vaccine after the birth or when they’ve finished breastfeeding.

However, if you are clinically vulnerable or at higher risk, or in a situation where there is an increased risk of you catching Covid-19 (for example because you’re a nurse), you should talk to your clinician about the pros and cons of having it.

Covid-19 vaccine and breastfeeding

If you are breastfeeding, you might now be offered the vaccine. This is a change from what was previously recommended as, like with pregnant women, there is no safety data for this specific situation. If you’re unsure, discuss it with your clinician.

For women who were involved in clinical trials or been given the vaccine without realising they were pregnant, both mothers and babies will be closely monitored, and the mothers will be given their second jab after the birth. This should, in due course, mean there is more data available.

People with allergies

People who have a history of “significant” allergic reactions (known as anaphylaxis) to the ingredients of the vaccine should not have it.

However, those with other allergies, such as to certain foods, can now have the vaccine.

People with weakened immune systems

For some people with weakened immune systems, a Covid-19 vaccine may not be effective for them. This will vary on a case-by-case basis.

People with a weakened immune system who do get the vaccine are still advised to take extra precautions until further analysis is released.

Those who cannot have the vaccine may be offered a new coronavirus antibody treatment, which can be injected or administered intravenously.

Clinical trials are beginning in the UK and initial results from the randomised control trial are expected to be published in the first half of 2021. However, the trial is expected to last for 12 months.

Will I need a Covid-19 vaccine to travel?

At the moment, a Covid-19 vaccine is not mandatory when travelling abroad. However, there is speculation that an immunity passport – or e-vaccination certificate – may be required in the future, to show that the holder has been vaccinated against coronavirus.

It’s an idea that the World Health Organisation is looking into in order to encourage safe travel between countries.

In November, the CEO of Australian carrier Qantas said that he expected such a measure to be essential for future travel, and the airline would only accept passengers who had taken a vaccine.

In addition, travelling abroad would depend on what precautions other countries are taking. For example, UK travellers may be unable to go to EU countries after 1st January 2021, under Covid-19 safety restrictions, if there is a no-deal Brexit.

Covid-19 vaccine and face mask lying on a map of the world

Other Covid-19 vaccines in development

As well as the three vaccines that have already been approved in the UK, the government has secured acess to four vaccines being developed and still in clinical trials. These include:

  • Janssen (Phase 3 trials) – 30 million doses ordered
  • GlaxoSmithKline/Sanofi Pasteur (Phase 1/2 trials) – 60 million doses ordered
  • Novavax (Phase 3 trials) – 60 million doses ordered
  • Valneva (Phase 1/2 trials) – 60 million doses ordered

The new variants of Covid-19

Over several months, scientists have discovered 4,000 coronavirus mutations worldwide, including in the UK, South Africa and Brazil.

As well as being more easily transmitted, it’s thought that some of the vaccines might be less effective against some of the variants – more on this below.

However, viruses commonly do mutate and vaccines are regularly adjusted to respond to this. In the case of Covid-19, scientists are already working on how this might apply to the new vaccines.

UK variant of Covid-19

The first was found in the UK and it has already spread to numerous countries globally, including France, Italy, Canada, USA, Japan and Australia.

Known as B117, the UK variant was first identified in Kent in September 2020 and infected thousands of people across the region. The new strain is more easily transmittable and in mid-January 2021, there was early evidence that it may be more deadly too.

South Africa variant of Covid-19

There has also been a new variant detected in South Africa, which is also more transmittable but not thought to cause more severe illness.

The B.1.351 variant was first discovered in Nelson Mandela Bay in October 2020 and has since spread to 90% of South Africans testing positive for coronavirus.

It has also spread across 30 other countries including the UK, in which mass testing is taking place in parts of Kent, Hampshire, Surrey, London, Hertfordshire, West Midlands, Walsall, Merseyside  and Middlesborough in order to control the spread.

Brazil variant of Covid-19

In spring 2020, coronavirus struck the city of Manauns near the Amazon in Brazil, infecting a majority of the 2 million population.

By the summer, it was hoped most infected people would have gained antibodies. However, in December 2020 and throughout January, a new Brazilian variant – known as P1 – had been discovered, which is believed to be able to re-infect people who suffered the first strain.

As a result, all travel from South America has been banned by numerous countries, including the UK, and so far there have been no identified cases in the UK.

Will vaccines protect people from new variants?

So far, research has found that the Oxford/AstraZeneca vaccine does not protect against the South African variant but can prevent serious illness and hospitalisation. However, this study only looked at 2,000 people with an average age of 31.

Therefore, more research is needed to find out if the Oxford jab can protect people from the South African variant in older and vulnerable people.

However, studies have shown that the Oxford vaccine is effective against the UK variant. Research has found it is 84% effective against the original strain and 74.6% against the UK variant.

Fortunately, early results have found that having two doses of the Pfizer/BioNtech vaccine will give people strong T-cell responses against the UK and South African variants of Covid, suggesting that the vaccine will continue to protect against serious disease in the coming months.

It’s not yet clear if the current vaccines can protect against the Brazilian variant, but the manufacturers are working to make changes to the vaccines for any new variants that occur over the coming months and years.

What are your initial thoughts on the Covid-19 vaccines? Are you eager to get vaccinated or do you still have doubts? Share your opinions on Facebook and Twitter @Dhorizons.

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