January 24 2021

There is a great deal of anxiety being expressed about the safety of the two vaccines available. Initially almost everyone was excited and happy to be immunised but in the last few weeks there is growing concern, largely because of misinformation, or the giving outdated advice by health care professionals about the risks with allergies. The Medicines and Healthcare Products Agency (MHRA) reacted to two early reports of 2 health care workers experiencing unexpected anaphylactoid reactions to the Pfizer BioNTech vaccine back in early December. They stated “Any person with a history of anaphylaxis to a vaccine, medicine, or food should not receive the Pfizer BioNTech vaccine.”

However, after careful consideration and surveillance of over a million more doses in both the UK and the USA, including areas where those with severe allergies were still being given the vaccine, on 30th December that early advice was rescinded. The MHRA concluded that it found NO increased risk of Anaphylaxis to the Pfizer BioNTech vaccine amongst people with serious but unrelated allergic histories and advised that only people who had an allergic reaction to the first dose or a reaction to any of the vaccine components should not receive it. We also know that this Pfizer vaccine does not contain egg, pork or any other animal material, neither does the Oxford Vaccine.

This is very welcome news for everyone with severe allergies. I am concerned that the successful roll out of the vaccine is being impaired by false or outdated advice given to those already anxious about allergies. I urge everyone who is involved in giving vaccines to be clear what the MHRA guidance is and to challenge any local guidelines based on the outdated early guidance.

It is all still about communication. The best approach to vaccine hesitancy includes “science, education, access, civil discourse and debate,” never coercion or censorship. Vaccinators must be prepared to provide information, and explain the difference between mild, moderate and severe allergies and to clarify the MHRA advice. Anyone who declines a vaccine can be told they can ask to be restored to the list in the future. All vaccination centres have some staff with the skills and equipment to deal with unexpected reactions and people are observed for 15-30 minutes to ensure they are safe to go home. The headline today in Microsoft News is “ Immunity from first vaccine dose could be less than 33% a Health Chief warns”. When I read this I read on to find this is about the small study in Israel I have already discussed. Prof. Anthony Harnden, the Deputy Chair of the JVCI (Joint Committee on Vaccine and Immunisation), says his committee is reviewing the data from that study and it APPEARS to show that two doses of the vaccine are needed before high levels of immunity are developed. He points out the study only lasted 3 weeks and the statistical methods were unclear. Prof Harnden concludes ‘we are looking at this in detail, but at the moment our clear steer is that the delayed second dose will save many more lives nationally.’

Please do not forget the confusion around immunisation strategy is whether you are aiming to protect a whole community or just one individual. In the whole community as we are now trying to achieve, we always do the greatest good for the greatest number. That’s what public Health Medicine is all about.

Matt Hancock has confirmed that 77 cases of the South African variant have now been identified in the UK. All seem to be clearly linked with travel from South Africa. There has not been any spread within the UK yet. This is why urgent steps were taken to stop travel to and from South Africa, with negative tests and quarantine required before entry. Quarantine hotels are being considered to make it harder to ignore quarantine laws.

It is great progress that 3 quarters of all over 80s and 3 quarters of all Care Home residents and staff are now vaccinated at least once.

A big illegal rave has been closed down in East London again. 78 people were issued with a £200 fine.

Even worse. in a Dutch Fishing Village, a crowd of rioters have burnt down a Covid testing centre on the first night of their national curfew. Police officers and their vehicles were also attacked. 3,600 fines were imposed for breaking the curfew.

A collective has come forward with an offer to vaccinate all teachers and education support workers In England during the coming half term holiday.

Up to 8 different Covid passport plans are under consideration.

Watch out for and look at critically the adverts for a new nasal spray, as yet still unnamed, being developed particularly for children, to prevent them catching covid19. It is made with pre-existing known ingredients and so passes safety approval. The idea is that the spray will coat the inside of the nose and so capture the virus in the nose so that it cannot escape . This it claims means it is safe to breath out as no viruses will escape. It makes no mention of virus excretion via the mouth when talking or singing. It is initially recommended to be used in each nostril 4 times a day but up to every 20 minutes in high density schools. I would think that a bunch of kids in school squirting up their own noses every 20 minutes is a recipe for chaos.

Here are the statistics for tonight, bear in mind the Sunday effect we see each weekend.

666,330 tests were done on 21st January with 30,004 being positive in the last 24 hours. This is down by 22.3% in the 7 day rolling average and the rate has dropped to 406.2 per 100k.There are no new figures for the health data. Almost 38, 000 are in hospital and 4,000 are on a ventilator. I am optimistic that these figures are stabilising but at a very high level. We will have a better idea by the middle of next week.

Tragically, the death figure of 610 is very high for a Sunday. There has been a 10.8% rise in the 7 day rolling average, and the rate per 100k has risen to 12. The absolute top priority for all of us is to get this figure going down again.

We do that in the ways we have done but getting many more to do the same. Whether or not you have had your first vaccine remember Hands, Face and Space. Plenty of space, as much as possible but always at least 2 metres apart. Stay at home whenever possible in well ventilated rooms. Go out for exercise if you must, socialise across the fence or on the telephone or Zoom.

With tensions and stress high, stay kind, stay encouraging because overall we are getting there. We want to finish the job with the minimal number of casualties.

Do not be afraid of the vaccines, virtually everyone is safe to have one.

Please stay safe.

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