Covid-19 staff vaccination

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Information for patient facing staff Information for Leaders

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Should I be worried by the media reports about nasty side effects from the AstraZeneca jab?

Update 15 March 2021

In short, no.

You may have seen media coverage of reports of blood clots and, most recently, decisions in some European countries to temporarily suspend the AstraZeneca Covid-19 vaccine. The MHRA remains clear that there is no evidence to support this and everyone should still go and get their Covid-19 vaccine when asked to do so. We are working with vaccine centre staff and clinical spokespeople in order to reassure local people.

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Should I get the vaccine if I have allergies?

 can I have the vaccine if I have allergies
You should not have the vaccine if you've ever had a serious allergic reaction to:

  • Any of the ingredients in the Covid-19 vaccine
  • A previous dose of the same Covid-19 vaccine

The MHRA (Medicines and Healthcare products Regulatory Authority) has advised that individuals with a history of anaphylaxis 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 ingredient in the vaccine.


Whilst serious allergic reactions are rare, staff giving the vaccine are trained to deal with allergic reactions and treat them immediately.

References: Greenbook

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What’s in the Covid-19 vaccines? Is the vaccine compatible with my religion?

religion
None
of the approved vaccines contain any product derived from pigs, cows or any other animals.

The Oxford/AstraZeneca vaccine uses a harmless, weakened form of an adenovirus (a different virus that also has the spike protein on its surface).  The virus was grown in human embryonic stem cells, but these stem cells weren’t taken directly from a human embryo – they are copies of stem cells which originally date from the 1970’s.  The vaccine itself does not contain any embryonic cells.

The British Islamic Medical Association has considered all varieties of the vaccine and recommends Muslims have the vaccine.  The Muslim Council of Britain is also recommending the vaccine, and Imams across the UK have confirmed that all varieties of the vaccine are halal.

The British Sikh community has also supported the vaccine, as have Hindu leaders.

The Church of England says that all clinically recommended vaccinations can be used with a clear conscience.  The Catholic Church has said that the vaccine, including the Oxford/AstraZeneca vaccine, is acceptable and can be morally justified.

More than 80 Jewish doctors in the UK have signed a letter to confirm that the Pfizer vaccine does not contain any products that are not kosher, and the Pfizer, Oxford and Moderrna vaccines have been purchased by the Israeli government.

References: https://britishima.org/covid19-vaccine-az/

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I've had my Covid-19 vaccination - can I return to leading a 'normal life' now?

> Does having the vaccine mean I can return to living a ‘normal’ life?
The first dose of the Covid-19 vaccine should give you good protection from coronavirus. But you need to have the 2 doses of the vaccine to give you longer lasting protection.  There is a chance you might still get or spread coronavirus even if you have the vaccine.

This means it is important to:

> Can I travel, visit my friends and family?
We must continue to follow government measures and guidelines around coronavirus until otherwise instructed.  There is a chance you might still get or spread coronavirus even if you have had the Covid-19 vaccine.

> How long do I need to take precautions after vaccination?  WHO’s Dr Kate O’Brien answers this and other queries in Science in 5.

 

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Who can get a Covid-19 vaccination?

> Why are healthcare workers amongst the first groups to receive the vaccine?

The JCVI have put patient-facing health and social care staff into a priority group because of their heightened risk of exposure to the virus.  The NHS is experienced in vaccinating hundreds of thousands of staff quickly and safely – we do it every year for the flu vaccine – and all local NHS employers will be responsible for ensuring that 100% of eligible staff have the opportunity to take it up over the coming weeks and months.

> How do DCHS staff get the Covid-19 vaccine?
DCHS staff are being offered vaccinations at a number of centres across the county. Priority has been given to Extremely Clinically Vulnerable (ECV) and patient-facing staff, which includes all staff who may have contact with patients not just clinicians. 

Vaccination appointments are available at the Arena in Derby (DE24 8JB) – you can book yours here. Getting vaccinated is the best way we can all protect ourselves. If you have not yet had your vaccination please consider doing so if you fall into any of these priority groups (as defined by the Green Book guidance).

  • Clinically vulnerable staff
  • Patient-facing staff
  • Support staff who would come into contact with patients and/or patient areas e.g. IFM, estates
  • Volunteers/redeployed/bank staff working in vaccination centres.

Getting vaccinated is the best way we can all protect ourselves from the virus, so we can be there for our patients and our loved ones.

> Which healthcare workers are being prioritised?
Nationally frontline health and social care workers at high risk of acquiring infection, at high individual risk of developing serious disease, or at risk of transmitting infection to multiple vulnerable persons or other staff in a healthcare environment, are considered of higher priority for vaccination than those at lower risk. Healthcare providers have been undertaking staff risk assessments throughout the pandemic to identify such individuals and have used these as the basis for prioritising access to vaccines.

DCHS is inviting staff to get their vaccinations at a number of centres across the county. Priority has been given to Extremely Clinically Vulnerable (ECV) and patient-facing staff, which includes all staff who may have contact with patients not just clinicians. 

> Protect yourself – complete your ALAMA self-assessment (2/2/21)
Looking after ourselves and each other has been a top priority throughout the pandemic, and we continue to learn about Covid-19 and how it impacts us all individually. The ALAMA Covid-age self-assessment helps us assess our level of risk based on individual factors such as age, ethnicity, gender and other health conditions. Importantly, it means we are able to ensure that we provide the right level of support. 

  • Please could ALL colleagues complete the ALAMA Covid-age self-assessment as soon as possible
  • Email the OH team: DCHST.occupationalhealth@nhs.net, copying your line manager. The subject header must contain: name, date of birth and your Covid-age score
  • Leaders should then review completed risk assessments, add the Covid-age score, and consider any necessary adjustments. For more information, click here.  
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Queries about the vaccination

> Are there any known or anticipated side effects?
These are important details which the MHRA always consider when assessing candidate vaccines for use.   For these vaccines, like lots of others, they have identified that some people might feel slightly unwell, but they report that no significant side effects have been observed in the tens of thousands of people involved in trials.  

Very common side effects 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 2 to 3 days, a high temperature is unusual and may indicate you have COVID-19 or another infection.
  • You can take the normal dose of paracetamol (follow the advice in the packaging) and rest to help you feel better. Do not exceed the normal dose.

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.

You can also report suspected side effects of vaccines and medicines online through the Yellow Card scheme or by downloading the Yellow Card app.

All patients will be provided with information on the vaccine they have received, how to look out for any side effects, and what to do if they do occur, including reporting them to the MHRA. 

More information on possible side effects can be found at https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/ 

> Can I go back to work after having my vaccine?
Yes, you should be able to work as long as you feel well. If your arm is particularly sore, you may find heavy lifting difficult. If you feel unwell or very tired you should rest and avoid operating machinery or driving.

The vaccine cannot give you Covid-19 infection, and two doses will reduce your chance of becoming seriously ill. Please remember you may still be able to transmit the virus and you should follow the DCHS PPE guidelines when in a clinical setting, and government guidelines around social distancing and the wearing of face coverings when outside of work.

> How many doses of the vaccine will be required and when?
You are required to have two doses of the Covid-19 vaccine, up to 12 weeks apart. You will get a good level of protection from the first dose but will not get maximum protection until at least 7 to 14 days after your second dose of vaccine.

> I have had my flu vaccine, do I need the Covid-19 vaccine as well?
The flu vaccine does not protect you from Covid-19. As you are eligible for both vaccines you should have them both, but normally separated by at least a week.

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Can women who are pregnant or breastfeeding have the vaccine?

pregnant

There's no evidence the Covid-19 vaccine is unsafe if you're pregnant. But more evidence is needed before pregnant women can be routinely offered the vaccine.

The JCVI has updated its advice to recommend women may be able to have the vaccine if they're pregnant and:

  • at high risk of getting coronavirus because of where they work
  • have a health condition that means they're at high risk of serious complications of coronavirus.

Breastfeeding women can have the Covid-19 vaccine.

Pregnant women should speak to their healthcare professional to discuss the benefits and risks of the Covid-19 vaccine, before having the vaccination. Women do not need to avoid pregnancy after vaccination. The vaccine cannot give women or their babies Covid-19.

 

References:
https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/

https://www.gov.uk/government/publications/covid-19-vaccination-women-of-childbearing-age-currently-pregnant-planning-a-pregnancy-or-breastfeeding/

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I'm worried about having the Covid-19 vaccination and my fertility. How do I know it is safe?

Updated 19/3/2021

Fertility and Covid-19 vaccines - webinar with the experts
Experts from NHS England & NHS Improvement and Birmingham Women’s Hospital are hosting a free webinar (Wednesday 24 March from 2-3pm), which will answer questions around pregnancy and fertility in relation to the Covid-19 vaccine. Head here for more details.  
 
You can also find a range of information here from the Royal College of Obstetricians and Gynaecologists (RCOG), including FAQs, an information leaflet/decision aid tool and more. Professor Jonathan Van-Tam, England’s deputy chief medical officer, has said there is no risk to fertility from the Covid vaccines. “It is just not biologically logical that they would, no vaccine has ever done this.”


One of the rumours surrounding Covid vaccines are their supposed links to infertility. WHO's Dr Katherine O'Brien explains the science and facts related to Covid vaccines and fertility. She says the vaccines cannot cause infertility. [Credit: World Health Organisation]

 

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Our BAME community and Covid-19 vaccination

> What is the evidence to show the vaccine is safe for BAME communities?
The Public Assessment Reports contain all the scientific information about the trials and information on trial participants.
For the Pfizer trial, participants included 9.6% black/African, 26.1% Hispanic/Latino and 3.4% Asian.  
For the Oxford/AstraZeneca vaccine 10.1% of trial recipients were Black and 3.5% Asian.
There is no evidence either of the vaccines will work differently in different ethnic groups. 

> Why are BAME groups not being prioritised?
There is clear evidence that certain Black, Asian and minority ethnic (BAME) groups have higher rates of infection, and higher rates of serious disease and mortality. The reasons are multiple and complex.  

There is no strong evidence that ethnicity by itself (or genetics) is the sole explanation for observed differences in rates of severe illness and deaths. What is clear is that certain health conditions are associated with increased risk of serious disease, and these health conditions are often overrepresented in certain Black, Asian and minority ethnic groups.  

Prioritisation of people with underlying health conditions will also provide for greater vaccination of BAME communities who are disproportionately affected by such health conditions.  Tailored local implementation to promote good vaccine coverage in Black, Asian and minority ethnic groups will be the most important factor within a vaccine programme in reducing health inequalities in these groups. 

Healthcare providers have been undertaking staff risk assessments throughout the pandemic to identify individuals at higher risk of contracting the virus and/or experiencing serious illness if they do. These risk assessments include factors such as ethnic background, and are being used as the basis for prioritising access to vaccines for staff over the coming weeks.

> Dispelling some of the myths 

> Covid-19 vaccine and the Black Community: A Tyler Perry special  

Our chief nurse Michelle Bateman highly recommends watching this! 

'American actor, director, producer and screenwriter,  Tyler Perry sits down with top medical experts Carlos del Rio, MD Executive Associate Dean, Emory School of Medicine at Grady Health System, and Kimberly Dyan Manning, MD Professor of Medicine at Grady Health System to address the public's concerns and fears about the Covid-19 vaccine. This half-hour special provides helpful and factual information for viewers looking to protect themselves and their families from this virus. Tackling issues head-on, Perry asks the hard-hitting questions to help the BAME community gain insight into this new vaccine.'

> JUCD (Joined Up Care Derbyshire) community representatives' communication toolkit
JUCD has developed some useful toolkits and resources to support staff engaging with members of our community regarding the Covid-19 pandemic, in particular the following communities: African, Caribbean, Bangladeshi & Pakistani community. The information will equally be of interest to our staff from these communities.

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How has a vaccine been developed so quickly? Is the vaccine safe?

safe

Covid-19 was declared a global pandemic in March 2020.  Scientists, drug companies and governments collaborated and prioritised developing a vaccine in order to keep populations safe. The vaccines that have been developed have all been through the same amount of testing and safety processes as other vaccines, including rigorous testing on tens of thousands of people.

Even before this pandemic began scientists had already been planning for an outbreak of a new disease and thinking about how a new vaccine could be developed as quickly as possible.  It helped that Covid-19 is caused by a coronavirus (like SARS) so scientists already had a good understanding of how coronaviruses work, including the ‘spikes’ on the surface which can be used to trigger a reaction from the immune system. 

Some of the processes that are usually involved in scientific research – eg recruitment of trial participants, gaps between trial phases and drug companies producing vaccines at scale before approval so they are ready to be distributed more quickly once approved – have been speeded up.

The approval by the MHRA (Medicines and Healthcare products Regulatory Authority) has also been quicker than usual with staff working around the clock looking carefully at all of the evidence about each vaccine and making sure it meets strict standards of safety, quality and effectiveness.  

References:

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Do I need to get vaccinated?

do I need to have the vaccination
I’ve already had Covid-19 - do I need to get vaccinated?

Yes, it’s really important you get the vaccine even if you’ve already had Covid-19 or have detectable Covid-19 antibodies .  You may have some level of immunity if you’ve had the disease, but this varies and may not last long. 

You should leave at least 4 weeks after you have recovered from your last symptom before getting your Covid-19 vaccination. If your symptoms carry on for a long time, or your suspect you have 'long-Covid', please seek advice from your GP about when or whether to have a Covid-19 vaccination.

I’m fit, young and healthy – do I need to get vaccinated?
Having the vaccine means you are less likely to become ill from Covid-19, which can cause serious illness and death.  Having the vaccine could also benefit those around you.  Although it doesn’t mean you can’t spread the virus, it may make it less likely.  And if more people are vaccinated, this also reduces the potential for new variants developing that might stop a vaccine from working in future.

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How does the vaccine work? Will it protect me against new strains of the virus?  

how does the vaccine work
Most of the vaccines and potential vaccines are based on the fact that coronaviruses have club-shaped spikes on their outer coats, which form a corona (Latin for crown) on the virus surface.  Studies suggest that the immune system is good at recognising these if it has encountered them before, and therefore these are a good approach for a vaccine.  If a vaccine is able to produce a ‘spike’ inside the body, the immune system recognises the ‘spike’ and responds to it.  That means that if the body encounters the Covid-19 virus in future the body’s immune system will recognise it and act against the virus so it can’t develop into an illness.

You can’t get coronavirus from the vaccine.  A vaccine would not be approved for use if it could give you the disease it is supposed to protect you from.

The Pfizer/BioNtech vaccine is not a live vaccine, meaning it does not contain any live viruses, nor does the Moderna vaccine.  The Oxford vaccine contains a harmless form of a different virus that has been altered so that it cannot cause an illness.

It’s likely the approved vaccines will still protect against new strains of Covid-19 as they are all based on generating an immune response to the Covid-19 spike protein. The recent UK variant has nine mutations to the spike gene, but 99 per cent of the spike is still identical to the versions the vaccine was designed to target.

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Do the vaccines work when the virus has mutated? In particular against the South African variant.

It has been widely reporteed in the news that the Oxford-AstraZeneca (O-AZ) vaccine has only a limited effect against the South African variant of coronavirus.  It is understandable that this would casue concern, particularly as O-AZ is the vaccine many in the UK are being given.  But what actually is the significance of this?

1. Understanding how viruses behave
We know it is normal for viruses to mutate. We understand changing is their way of 'surviving'; they adapt so they can continue to escape some of the body's immune system defences. Scientists keep an eye on the mutations and check whether existing vaccines are still effective.  They work to update vaccines where necessary to ensure continued protection against severe illnesss.
 

The changes seen in South Africa are an example of this, and all vaccines produced so far are likely to work less effectively against this variant.  A small scale study has shown that the O-AZ vaccine in its current form appears to only offer limited protection against the South African variant of the virus, but scientists feel it will still be effective protecting from serious illness and hospital admissions.

2. Should I still have my vaccination?
Yes.  The most important thing to remember is the O-AZ vaccine remains highly effective against the type of virus dominant in the UK. And the same is true for the other vaccine being used in the UK, produced by Pfizer-BioNTech.

To date (10/2/21) there have been fewer than 150 cases of the South African variant detected in the UK  There are no signs it is widespread and extra testing has been ordered in the places where there are signs the variant may be spreading to try to contain it.

Scientists are already working on tweaks to the existing vaccines to see if they can improve the protection offered.