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

Four Covid-19 vaccines – Pfizer/BioNTech, Oxford/AstraZeneca, Moderna and Johnson and Johnson – have been approved in the UK. Read on to learn more about the vaccines and understand who is eligible and when.

We’re updating this article regularly with new information, so you can keep up to date.

UPDATED: 13/12/2021

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, with 17 million doses pre-ordered. The first doses were administered to patients in Wales and Scotland on 7th April 2021 and England administered the first doses on 13th April 2021. Northern Ireland began giving out this jab in July 2021.

The Johnson and Johnson vaccine, made by the pharmaceutical company Janssen, was approved for use in the UK by the MHRA on Friday 28th May 2021. It is expected to be available to patients later this year.

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

• Pfizer/BioNTech Covid-19 vaccine
• Oxford/AstraZeneca Covid-19 vaccine
• Moderna Covid-19 vaccine
• Johnson and Johnson Covid-19 vaccine
• Covid-19 vaccine ingredients
• Covid-19 vaccines effectiveness and doses
• Will the Covid-19 vaccines have side effects?
• Covid-19 vaccine hospital hubs and vaccination centres
• When will the Covid-19 vaccine be available and who is eligible?
• When will PAs and unpaid carers get the vaccine?
• Covid-19 booster jab
• How to get the vaccine for under 18s
• Who can’t have a Covid-19 vaccine?
• Will I need a Covid-19 vaccine to travel?
• Other Covid-19 vaccines in development
• The new variants of Covid-19

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 ordered a total of 30 million doses of the Pfizer/BioNTech vaccine for 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 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 ordered a lot more of this vaccine – 100 million doses.

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.

This jab is more affordable and can be stored in a refrigerator between 2C and 8. Two jabs are also needed for this vaccine.

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 ordered 17 million doses.

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.

Johnson and Johnson Covid-19 vaccine

The Johnson and Johnson is a single-dose vaccine made by the pharmaceutical company Janssen. It is the fourth jab to be authorised by the MHRA for use in the UK on Friday 28th May 2021.

The UK Government initially ordered 30 million doses but following the success of the vaccination rollout across the country, it cut the order to 20 million doses.

How the Johnson and Johnson Covid-19 vaccine works

The Johnson and Johnson vaccine is a monovalent vaccine composed of a recombinant, replication-incompetent human adenovirus type 26 vector that encodes a SARS-CoV-2 full-length spike (S) glycoprotein in a stabilised conformation.

Once the jab is given, the S glycoprotein of SARS-CoV-2 is transiently expressed, stimulating both neutralising and other functional S-specific antibodies, as well as cellular immune responses directed against the S antigen, which may contribute to protection against Covid-19.

The Johnson and Johnson vaccine can be stored at refrigerated temperatures of 2C to 8C for a single period of up to three months.

Have you been fully vaccinated? Buy our vaccine card to show you are protected.

Covid-19 vaccine ingredients

Here is a full list of the ingredients that make up the Pfizer/BioNTech, Oxford/AstraZeneca and Moderna 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 (alcohol)
• sucrose
• sodium chloride
• disodium edetate dihydrate
• water for injections.

Moderna Covid-19 vaccine ingredients

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

This is a multidose vial that 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.

Johnson and Johnson Covid-19 vaccine ingredients

The active substance is Adenovirus type 26 encoding the SARS-CoV-2 spike glycoprotein**(Ad26.COV2-S) not less than 8.92 log10 infectious units (Inf.U) in each 0.5 mL dose.

Produced in the PER.C6 TetR Cell Line and by recombinant DNA technology.

This product contains genetically modified organisms (GMOs).

The other ingredients are:

• 2-hydroxypropyl-β-cyclodextrin (HBCD)
• citric acid monohydrate
• ethanol
• hydrochloric acid
• polysorbate 80
• sodium chloride
• sodium hydroxide
• trisodium citrate dihydrate
• 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.

Covid-19 vaccines effectiveness and doses

With different variants of Covid-19 emerging and spreading, the effectiveness of the vaccines can differ depending on the type and dosage. Overall, each vaccine is said to be highly effective against coronavirus.

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.

• Two doses of Pfizer/BioNTech were 80% effective against infection with Delta (78% with Alpha).
• Two doses of the Pfizer/BioNTech vaccine are estimated to be 96% effective against hospitalisation with the Delta variant (94% after one dose) compared with 95% with the Alpha variant.

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

• Two doses of the Oxford/AstraZeneca were 67% effective against infection with the Delta variant (79% with Alpha).
• Two doses of the Oxford/AstraZeneca vaccine are estimated to be 92% effective against hospitalisation with the Delta variant (71% after one dose) compared with 86% with the Alpha variant.

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.

Early indications have shown that the vaccine may be less effective after six months and therefore the UK has begun giving out booster jabs to people most at risk.

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.

On Wednesday 14th April it was announced the trial will be extended to include two more vaccines – Moderna and Novavax. People over 50 who have already had the first dose of either the Pfizer or AstraZeneca jab can apply for the Com-Cov trial.

Since then, an Oxford University study, published in June 2021, showed that people who received the first jab of AstraZeneca followed by a second of Pfizer experienced a nine-fold increase in antibody levels compared with those who had two doses of AstraZeneca.

These results meant that there is more flexibility if there are shortages of certain vaccines and help the autumn booster programme, which has started on 20th September 2021.

Will the Covid-19 vaccines have side effects?

So far the majority of people have experienced 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 – we’ve listed these side effects below.

In March 2021, there have been reports of the Oxford AstraZeneca vaccine may be causing rare blood clots in a very small minority of patients – more on this below.

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.

Local vaccination services

These utilise general practices, working together in groups of primary care networks, along with 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.

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

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

Covid-19 vaccine priority groups

This priority list is as follows:

1. 1. 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.

In February 2021, following a plea by BBC broadcaster Jo Whiley who’s sister has a learning disability, all adults registered with a learning disability were also prioritised for a Covid-19 vaccine along with people who have underlying health conditions.

Covid-19 vaccine rollout

Across the UK, the top nine priority groups were fully vaccinated by summer 2021. After this, the second phase of vaccination began, following age groups from 18 to 49 as the order of priority.

At present, people age 18 and over can also receive their vaccines. Appointments can be booked at vaccination centres, a pharmacy, or they can wait to be invited by their local NHS service.

People age 16 and 17 are also getting their vaccine too. Read on below for information on children under 16.

The booster programme is also now in full swing, so many of the top priority groups have received three jabs.

At the start of the Covid-19 vaccine programme, all health and social care workers were prioritised for the jab. This was followed by PA’s employed by Direct Payments and unpaid carers.

If you are a PA/carer or a care service user and have still not been vaccinated/not had your care team vaccinated, contact your local council or have your PA/carers contact their GP surgeries.

Mandatory vaccines for care home workers and NHS staff

From 11th November 2021, anyone working or volunteering in a CQC registered care home in England or for the NHS needed to be fully vaccinated against coronavirus, unless medically exempt.

This applies to all health and social care workers who have direct, face-to-face contact with people while providing care, for example, doctors, nurses, dentists and domiciliary care workers, as well as ancillary staff, such as porters or receptionists.

It will also include other people who enter a care home such as healthcare workers, CQC inspectors, trade workers, hair dressers and beauticians.

The deadline for first doses was the 16th September 2021 and therefore any care workers who are not vaccinated by this date will lose their job.

All care home and health workers will need to provide proof of their vaccine status using the NHS Covid Pass.

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 the 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.

For individuals who are fully vaccinated, you can buy our new I’ve been vaccinated Covid-19 card, lanyard or badge on the Disability Horizons Shop.

Covid-19 vaccine booster jabs

On 13th September 2021, health minister Sajid Javid announced that older people and those with health conditions will begin to get booster shots to protect against Covid as early as next week (20/09/2021).

Now, with the new Omicron variant of Covid in the UK, the Government is speeding up the booster jab program.

From today, 13th December 2021, everyone over the age of 18 can get a booster vaccine.

The JCVI has also said it will half the gap between second and third doses from six months to three months to get more jabs in arms.

For most people, the booster shots will be administered by the same places as before, such as GP surgeries and vaccination centres.

How to book your booster?

You can book your Covid-19 booster dose online if it’s been two months (61 days) since you had your second dose.

Alternatively, you can go to a walk-in vaccination centre or wait to be invited for your booster via letter, email, phone or text.

Regardless of what vaccine you had for your first and second, JCVI is recommending that people have a full dose of the Pfizer/BioNTech vaccine or a half dose of the Moderna as these show a strong booster response.

Where someone is unable to have one of these vaccines, for example because they are allergic to the ingredients, they will be offered the Oxford/AstraZeneca jab.

JCVI has also suggested that people get their flu and Covid jab at the same time, but exact details of this are to be decided by the NHS. It has also been stressed that anyone who would normally get a flu jab, do so this year.

How to get the vaccine for under 18s

On Monday 13th September 2021, it was announced that people aged 12 to 17 in England will be offered one dose of the Pfizer/BioNTech vaccine from 20th September 2021.

The Pfizer/BioNTech vaccine was approved for use in this age group on 4th June 2021, but no plan for rollout had been put in place until now.

The vaccination programme for these age groups will be delivered through schools. Other provisions will be made for anyone in social services, a mental health setting or home schooled.

Prior to the vaccination, a parent, guardian or carer will need to give consent for the child to have the vaccine.

Previously, it was only ‘vulnerable’ 12 to 15 years olds, or living with someone immunosuppressed, who were advised to have one dose of the vaccine.

On 30th November 2021, after discovering the new Omicron variant, the JCVI advised all 12 to 17-year-olds get a second dose of the Pfizer vaccine no sooner than 12 weeks after the first.

Who can’t have the Covid-19 vaccine?

Covid-19 vaccine and pregnancy

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

However, from Saturday 17th April, the JCVI advised pregnant women to take up the offer of the Pfizer or Moderna jab when their age group is invited for the vaccine.

This follows data of 90,000 pregnant women in the US found no safety concerns and adverse effects when getting the vaccine.

Covid-19 vaccine and breastfeeding

If you are breastfeeding, you will also 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.

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. 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.

People who cannot have the vaccine for medical reasons and need to show their Covid status at events or venues can use our Covid-19 Pass exemption card, which is available on the Disability Horizons Shop.

Will I need a Covid-19 vaccine to travel?

From 17th May 2021, international travel resumed for UK residents. The Government began with a traffic light system that indicated which countries are safe to travel to.

However, from 4th October 2021, a new travel system was put in place. It is now simply red list countries and the rest of the world.

Red list countries are those you should not visit unless absolutely vital. On your return to the UK, you will have to quartile in hotel for 10 days at a cost of up to £1,700.

It is not mandatory to get a vaccine to travel to non-red list countries but Covid-19 testing regulations will differ depending if you’re fully vaccinated or not.

• Fully vaccinated travellers – able to replace day 2 PCR tests with cheaper lateral flow tests – from the end of October – and no longer need to take pre-departure tests (PDTs)
• Unvaccinated travellers – will include pre-departure tests, day 2 and day 8 PCR tests.

From November 30th 2021, due to the new Omicron variant, all international travellers – vaccinated or not – need to take PCR tests on their return. This is a temporary measure that will be reviewed in three weeks. 

To see a full list of the red list countries and the other travel rules, visit the government website. The rules do differ in Scotland, Wales and Northern Ireland.

It is also believed that some countries have begun only excepting tourists who have been fully vaccinated. You will need to check on the foreign office website to see each country’s and territory’s requirements on Covid-19 vaccinations.