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: 11/01/2021

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 will be rolled out alongside from today (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 vaccine:

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 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 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 follows a new strain of coronavirus, 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 variant of Covid-19 below).

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.

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.

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. These 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

Although feeling feverish is not uncommon for two to three days, a high temperature is unusual and may indicate you have COVID-19 or another infection. You can rest and take the normal dose of paracetamol to help you feel better. If your symptoms seem to get worse or if you are concerned, call NHS 111.

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 Pfizer vaccine is already being given to care home residents and workers, frontline health and social care workers, inpatients over the age of 80, and outpatients over 80 with an appointment via one of 70 designated ‘hospital hubs’.

GP surgeries across England also started giving out the Pfizer vaccine to people over 80 the week commencing 14th December.

Today (4th January 2021) the Prime Minister announced that the Government aims to give the first jab to the top four priority groups by the middle of February.

The Oxford vaccine, which can be delivered and stored more easily, will now be administered alongside the Pfizer jab to the same list of priority groups. Which one you get will depend on the logistics of administering it where you are.

If you’re in one of these first two groups and haven’t yet been contacted about getting the vaccine, get in touch with your GP or health care provider.

Everyone else on the list who is eligible will be contacted by the NHS in due course – you do not need to get in touch with them.

The second phase of vaccination will probably focus on the rest of the population and may prioritise teachers, transport workers and the military.

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.

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 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

The new variant of Covid-19

Over the past three weeks, scientists have discovered a new variant of coronavirus in the UK. It has already spread to numerous countries globally, including France, Italy, Canada, USA, Japan and Australia.

It was first identified in south-east England and infected thousands of people across the region. The new strain is more easily transmittable, but there is currently no evidence to suggest this strain causes more severe disease or mortality.

In addition, there is no evidence to suggest that the Covid-19 vaccines cannot protect you from the new coronavirus variant.

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.

By Disability Horizons

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