Guidance from Bedfordshire, Luton and Milton Keynes (BLMK) Clinical Commissioning Group (CCG)

We do not have a lot of notice as to when vaccinations will be delivered to practices and so appointments are only being offered when we have absolute clarity that the vaccine is in supply. This is to avoid disappointment and concern over cancelled appointments.

Our teams are monitoring the number of delayed appointments daily, working with practices to support them, and no one will be lost or missed.

In terms of residents who have gone over the 12 weeks since their first vaccination, we are advising residents that they will get a second vaccine.

The JCVI guidance, which was updated on 16 April, and shared with our Chief Pharmacist, highlights that the optimal time for a second dose is between day 77-84, which is week 12. However, it does say that the second dose should be administered around this time. There is no evidence that indicates that immunity is lost after week 12.

The guidance also outlines that if doses are interrupted or delayed, then a second dose should be given as soon as possible, the course does not need to be restarted. This is outlined on Page 9/10 of the guidance.

Mixed doses

In terms of mixed doses, our Chief Pharmacist has said that providing a mixed dose is in line with the JCVI guidance (Page 16 of the guidance). The preference is that residents receive two doses of the same vaccine. However, the guidance outlines that clinicians can provide mixed doses if a course is incomplete or delayed and the first vaccine is unavailable. The mixed dose should only be provided if a patient is considered to be ‘at risk’, clinically vulnerable or there is a concern that the patient would not return for their second dose again.