Whilst the vaccine trials have not looked specifically at safety in patients with liver disease, there is no data to suggest harm for people with chronic liver disease. Vaccines are, in general, less effective in patients with chronic liver disease and those post-liver transplant. But, there is no data specifically with the COVID-19 vaccines.

The British Society of Gastroenterology and BASL have advised that they recommend that patients with chronic liver disease, autoimmune hepatitis and those post-liver transplant should strongly consider vaccination for COVID-19 with any of the available vaccines. However, although it is likely that the vaccine will offer some level of protection, they do not know whether the vaccines will be equally effective in transplant patients or those who are  immunosuppressed.

It is important that everyone who has the Covid vaccine, does not change their behaviours and continues to take precautions against catching Covid 19. No vaccine is 100% effective and the government  also does not know whether having the vaccine stops people passing coronavirus on to others. It is particularly important for those who are immunosuppressed  or who have had a transplant continue to continue to keep themselves safe after vaccination.

We will only get good information about the full safety and effectiveness in those who have been transplanted and are immunosuppressed once these vaccines start being used in clinical practice. The Government will be undertaking ongoing active surveillance on the effectiveness of the vaccine and will be gathering data as the vaccination programme is implemented. When enough of the UK population have been vaccinated, then the COVID-19 pandemic should start to ease. This is likely to be the most important way in which the vaccine helps those who are immunosuppressed.

Patients who have autoimmune hepatitis and are worried that being vaccinated may make their condition worse or cause a ‘flair up’ should have an individual conversation with their consultant clinician.

Please note that the nurses on the Helpline are only able to provide the general information outlined above and are not able to advise you on whether a particular vaccine would be safe or effective for you as an individual.

The only vaccines that are ‘live’ are Oxford Uni/Astra Zeneca and Janssen. DHSC have indicated to us verbally that they are not ‘live’ in the ‘conventional’ sense (they don’t replicate) and that “it is unlikely that anyone would be contra indicated for any of the live vaccines that are currently being developed unless they have a specific allergy to that vaccine.

Each of the vaccines are tested on tens of thousands of people across the world. They are tested on both men and women, on people from different ethnic backgrounds, representative of the UK population and of all ages between 18-84.

Pfizer/BioNTech trials took place in the US, Europe, Turkey, South Africa and South America. Approximately 42% of global participants and 30% of U.S. participants had racially and ethnically diverse backgrounds.

AstraZeneca also included a trial in South Africa of 2,130 participants, and another in the US including African American, Hispanic and Native American participants.

In the AstraZeneca trials, the non-white demographic in the UK trial was 8%. In the Brazil trial it was 34.2% and in South Africa it was 87.5%.

• The trials for both vaccines have involved people with chronic underlying conditions deliberately, and they have involved people from very broad age ranges and quite a lot of people in the elderly bracket. The JCVI have looked at this, there’s no indication that there should be any difficulty in giving it to people with chronic underlying conditions.
• The JCVI has picked out, not just by age, but people 18 to 65 with at-risk conditions. And, and the reason for that is that they are at extremely high risk from coronavirus compared with the general population.

The Joint Committee on Vaccination and Immunisation (JCVI) has advised the government to prioritise people for the coronavirus (COVID-19) vaccine who are over 16 and living with adults who have weakened immune systems, such as those with blood cancer, HIV or those on immunosuppressive treatment including chemotherapy.

There is growing evidence that the COVID-19 vaccines may reduce the chance of someone who has been vaccinated passing the virus on. Given this emerging evidence, the JCVI advises that those over 16 years of age who live with severely immunosuppressed adults are offered the COVID-19 vaccination alongside priority group 6. This will help limit the spread of the virus to immunosuppressed adults.

The NHS is now offering vaccines to people aged 50 and above and those who are at risk due to underlying health conditions (see PHE Green Book, p.10), which includes a wider group of people at higher clinical risk and young adults in residential settings. This also includes those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.

The JCVI defines clinically vulnerable people as those with:

• 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

If you are taking medication, please bring a list of these with you to the vaccination centre. Do not bring the medicines themselves.

If you are taking a blood thinner called 'warfarin' you will also be going for regular blood tests to monitor the thickness of your blood using a test called INR. The INR test result is a number (for example 2.5). Please make sure you know your latest INR reading and when that was last checked.

If you don't know this, you can get if from your GP surgery. If you are taking warfarin but we don't know your INR reading it can sometimes mean your vaccination cannot go ahead. The vaccination computers at the centre do not link back to your medical records so we can't look up your result on the day.

What to bring

You'll need to bring:

• a face covering, unless you cannot wear one for a health or disability reason.
• your booking reference numbers if your appointment is at a vaccination centre

If you need a carer, you can bring them with you on the day.

Protection from any vaccine takes time to build up. In general, the older you are the longer it takes. It will take at least two weeks in younger people and at least three weeks in older people before you can expect to have a good antibody response. Even then, you must return when called for your second dose. Vaccines offer important protection to reduce risk but they do not make you invincible. No vaccine offers 100% protection against any disease.

The Pfizer / BioNTech and Astra Zeneca (Oxford) vaccines have been shown to provide a high level of protection from symptomatic COVID-19.

New Public Health England data (01/03/2021) shows that both the Pfizer and Oxford-AstraZeneca vaccines are highly effective in reducing COVID-19 infections among older people aged 70 years and over. Since January, protection against symptomatic COVID, 4 weeks after the first dose, ranged between 57 and 61% for one dose of Pfizer and between 60 and 73% for the Oxford-AstraZeneca vaccine. In the over 80s, data suggest that a single dose of either vaccine is more than 80% effective at preventing hospitalisation, around 3 to 4 weeks after the jab. There is also evidence for the Pfizer vaccine, which suggests it leads to an 83% reduction in deaths from COVID-19. (Full statement and data here).

• Every single vaccine authorised for use in the UK has been authorised by the MHRA. The three components of authorisation are a safety assessment, an effectiveness assessment and a manufacturing quality assessment.
• Like all medicines, vaccines can cause side effects. Most of these are mild and short-term, and not everyone gets them.
• These are important details which the MHRA always consider when assessing candidate vaccines for use.
• For the Pfizer/BioNTech vaccine, 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 over 43,000 people involved in trials.
• 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.

Some side effects may include:

• a sore arm where the needle went in
• feeling tired
• a headache
• feeling achy
• feeling or being sick
• All patients are given 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 Medicines and Healthcare products Regulatory Agency (MHRA).

Healthcare professionals are asked to report any suspected side effects to COVID-19 vaccines. Report using the dedicated Coronavirus Yellow Card reporting site or the Yellow Card app.

More info here on patient information leaflets from PHE

https://www.gov.uk/government/publications/covid-19-vaccination-guide-for-older-adults

More information on the vaccination from NHS

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/coronavirus-vaccine/?priority-taxon=774cee22-d896-44c1-a611-e3109cce8eae

Every single vaccine authorised for use in the UK has been authorised by the MHRA and the three components of authorisation are a safety assessment, an effectiveness assessment and a manufacturing quality assessment.

• You cannot catch Covid from the vaccines. But it is possible to have caught Covid and not realise you have the symptoms until after your vaccination appointment.
• If you have any of the symptoms of Covid, stay at home and arrange to have a test.
• If you need more information on symptoms visit: nhs.uk/conditions/coronavirus-COVID-19/symptoms/

• Vaccination to at-risk groups till take place at the most appropriate settings to encourage uptake. This includes administering vaccination to at risk individuals in their usual place of residence. The three models of delivery are:
• Hospital Hubs - NHS providers vaccinating staff onsite.
• Local Vaccination Services – Community and primary care-led service based on local and logistical considerations but is likely to include GP practices, local authority sourced buildings or other local facilities, and potentially roving teams if vaccines are transportable in this way.
• Vaccination Centres - Large scale centres such as sports and conference venues set up for high volumes of people.

• Both Pfizer/BioNTech and Oxford/AstraZeneca are very effective vaccines. Comparisons between the vaccine efficacies are unhelpful due to the different methodologies used.
• Both vaccines have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from Coronavirus.

• Any vaccines that are available will have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from coronavirus.
• The Pfizer/BioNTech vaccine is being rolled out as fast as possible by the NHS across the UK. Now authorised, the AstraZeneca/Oxford vaccine will be deployed alongside the Pfizer/BioNTech vaccine to increase the pace and volume of the UK programme. There are no current plans to mix these vaccines.
• The vaccines people are offered will be appropriate for them. This decision is based on clinical judgement supported by the advice of Joint Committee on vaccination and immunisation. This will take into account individual vaccine characteristics, which may mean they are more suitable for some groups of people, and not others – for example, some may be less well tolerated or effective in certain age groups.

• The Pfizer/BioNTech vaccine is rapidly being rolled out across the UK, starting with the highest priority groups.
• The AstraZeneca/Oxford vaccine and other candidates will be deployed alongside the Pfizer/BioNTech vaccine to increase the pace and volume of the UK programme.
• More evidence is needed to understand whether a seasonal vaccination or booster dose might be needed.
• The vaccines people are offered will be appropriate for them. This decision is based on clinical judgement supported by the advice of Joint Committee on vaccination and immunisation. This will take into account individual vaccine characteristics, which may mean they are more suitable for some groups of people, and not others – for example, some may be less well tolerated or effective in certain age groups.

Vaccination numbers are published daily:

https://coronavirus.data.gov.uk/details/healthcar

• Full protection should begin 7-10 days after the second injection.

You can still carry the virus on your body and clothes if you come into contact with it. You will therefore still need to follow the guidance in your workplace, including wearing the correct personal protection equipment and taking part in any screening programmes.

To continue to protect yourself, your residents, your family, friends and colleagues you should follow the general advice at work, at home and when you are out and about:
practise:

• social distancing
• wear a face mask
• wash your hands carefully and frequently
• follow the current guidance
• Guidance is at gov.uk/coronavirus

• The MHRA will publish information on the ingredients in a summary of product characteristics (SpC) or equivalent. See here for more details.

Every single vaccine authorised for use in the UK has been authorised by the MHRA and the three components of authorisation are a safety assessment, an effectiveness assessment and a manufacturing quality assessment.

• The Medicines and Healthcare products Regulatory Agency (MHRA) is the UK’s independent regulator. Their role is to ensure medicines, devices and vaccines work effectively and are safe for use.
• Each COVID-19 vaccine candidate is assessed on a case by case basis and will only be authorised once it has met robust standards of effectiveness, safety and quality.
• Teams of scientists and clinicians carefully, methodically, scientifically rigorously review all data on safety, effectiveness and quality as soon as they become available, and have done so throughout all tests and trials
• The data looked at includes all the results from laboratory studies, clinical trials, manufacturing and quality controls and testing the product. The public on that basis should be very confident that all tests are done to the very highest standards, and only then will a COVID-19 vaccine be made available.

• Nurses, paramedics, pharmacists, GPs and other NHS staff are working hard to get the vaccine to those most vulnerable.
• Recruitment of workforce has focused on those who already have experience in handling vaccinations but may currently work outside of NHS settings, for example, independent nurses or allied health care professionals.
• Existing schemes such as NHS Bring Back scheme have also been utilised in order to fill roles.
• A comprehensive training package has been put together by NHS England and NHS Improvement (NHSE-I), with professional groups and Public Health England (PHE). New vaccinators will have undergone both a comprehensive training programme and competency assessment to ensure they can safely administer vaccines to patients under the clinical supervision of an experienced health care professional. This training will include how to deal with possible adverse reactions to a vaccine.

Yes, if they are in a priority group identified by JCVI. The MHRA have looked at this and decided that getting vaccinated is just as important for those who have already had Covid-19 as it is for those who haven’t.

There is no evidence that the vaccine affects fertility. The theory that immunity to the spike protein could lead to fertility problems is not supported by any evidence. Most people who contract COVID-19 will develop antibody to the spike and there is no evidence of fertility problems after Covid-19 disease.

Read the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives response to misinformation around Covid-19 vaccine and fertility.  

The MHRA has confirmed that the COVID-19 Vaccine AstraZeneca and Pfizer/BioNTech COVID-19 vaccine do not contain any components of animal origin.

There is a trace amount of ethanol in the vaccine, which is less than the quantity found in bread. We have worked closely with Imams who have reviewed the ingredients of the AstraZeneca vaccine and confirmed that it is Halal.

Pfizer/BioNTech: A full list of ingredients for the qualitative and quantitative composition of the Pfizer/BioNTech vaccine can be found here.

AstraZeneca/Oxford: A full list of ingredients for the qualitative and quantitative composition of the vaccine can be found here.

• To help NHS organisations and communications teams with rolling out a COVID-19 vaccine campaign, there is a range of free print, digital and social campaign materials available on PHE’s Campaign Resource Centre.
• Various versions of the leaflets and posters have been developed, with different call-to-actions to be used depending on vaccine availability. Large print, braille and Easy read versions and translated versions are also available for download. There will be BSL videos for the ‘adults’, ‘what to expect’ and ‘pregnancy’ leaflets shortly.
• The easiest way to book a vaccination appointment once you receive an invite to book is through the National Booking Service online. The 119 telephone service also has BSL and text relay facilities. The booking service is sending out letters to those who have yet to receive a vaccine, with letters, phone calls and text messages to follow up anyone who still doesn’t reply.
• GPs are using a range of methods to contact their patients and are responsible for ensuring that they do this in a way that is accessible – including providing translations and alternative formats.

You can also place orders for these resources via the health publications website

The BSL videos are also available to download or view on the Health Publications website: https://www.healthpublications.gov.uk/Home.html

For training advice and guidance please see the training resources section here: https://www.gov.uk/government/collections/covid-19-vaccination-programme

The Easy Read leaflet

https://www.gov.uk/government/publications/covid-19-vaccination-easy-read-resources

• COVID-19 vaccines have prevented 10,400 deaths in adults over the age of 60.
• From 8 December 2020 to the end of March 2021, over 15 million vaccine doses were given to adults aged 60 and over.
• PHE analysis compared the observed number of deaths with the number of deaths that would have been expected if the vaccine hadn’t been given during this time period.
• Using this method, PHE estimates that around 10,400 deaths were prevented to the end of March – 9,100 in those aged 80 and over, 1,200 in those aged 70 to 79 and 100 in those aged 60 to 69.
• Expected deaths with coronavirus (COVID-19) were estimated using real-world data on how effective the vaccines are at preventing death and vaccine uptake.
• Findings from the latest COVID-19 REACT-1 study show infections fell by approximately 60% from the last REACT study in February, with only 1 in 500 people infected.
• there were substantial falls in regional prevalence from February to March: in South East from 0.36% in February to 0.07% in March; London from 0.60% to 0.16%; East of England from 0.47% to 0.15%; East Midlands from 0.59% to 0.19%; and North West from 0.69% to 0.31%
• Data suggests infections have led to fewer deaths since December, which coincides with the vaccination rollout and ‘Stay at Home’ rules during this period
• Infections may have produced fewer hospitalisations and deaths since the start of widespread vaccination.

Over 140,000 volunteers were tested in England between 11 to 30 March 2021 as part of one of the largest and most significant COVID-19 studies in the world, conducted by Imperial College London and Ipsos MORI and published 8/4/2021.

Daily data summary

https://coronavirus.data.gov.uk/?_ga=2.218839707.329771229.1610380715-938063789.1606390656

Government vaccination programme information

https://www.gov.uk/government/collections/covid-19-vaccination-programme

All patient leaflets and translated leaflets can be viewed, downloaded or ordered as paper copies via the Health Publications order line website

https://www.healthpublications.gov.uk/Login.html

The Easy Read leaflet

https://www.gov.uk/government/publications/covid-19-vaccination-easy-read-resources

Vaccination deployment plan

https://www.gov.uk/government/publications/uk-covid-19-vaccines-delivery-plan

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/951284/UK_COVID-19_vaccines_delivery_plan.pdf

Vaccine uptake plan published 13 February 2021. Sets out the government's approach to making sure that as many people as possible take up the offer of vaccination.

https://www.gov.uk/government/publications/covid-19-vaccination-uptake-plan

NHS England vaccination sites

https://www.england.nhs.uk/coronavirus/hospital-hubs-and-local-vaccination-services/

Joint letter from four CMOs

https://www.gov.uk/government/publications/letter-to-the-profession-from-the-uk-chief-medical-officers-on-the-uk-covid-19-vaccination-programmes/letter-to-the-profession-from-the-uk-chief-medical-officers-regarding-the-uk-covid-19-vaccination-programmes

Green book - Coronavirus (COVID-19) vaccination information for public health professionals

Daily data summary

https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a

MHRA – latest monitoring data confirms safety of Vocid-19 vaccines

https://www.gov.uk/government/news/latest-monitoring-data-confirms-safety-of-covid-19-vaccines

• Vaccines are the best way to protect people from coronavirus and will save tens of thousands of lives.

• As more people are vaccinated, more people will be protected from the harmful effects of COVID-19.
• Vaccines work by tricking your body into thinking it has to fight the virus. It trains your immune system for this fight by stimulating you to create antibodies and stimulating T-cells.
• This means that when Covid-19 is encountered naturally, the body has already been prepared to protect against it.
• However, like any training, getting up to ‘match fitness’ takes time. Your body’s response, the immune response, is only trained up around 2 or 3 weeks after you have your first jab. If you are older it’s better to allow at least 3 weeks. You do not have the full protection from the first dose in this 2 or 3 weeks.
• Even better and longer lasting protection then comes from the second dose so it is really important that everyone gets the second jab. Again the effect from that jab will be weeks after it is given.

• Three vaccines have been authorised in the UK. Pfizer/BioNTech, AstraZeneca/Oxford and Moderna
• The University of Oxford/AstraZeneca vaccine and the BioNTech/Pfizer vaccine are now available across the UK. The Moderna vaccine will become available later in 2021.

• Vaccines are being distributed fairly across the UK to ensure the most vulnerable are immunised first and all GPs will continue to receive deliveries as planned. The NHS, government and armed forces are doing everything we can to vaccinate those most at risk as quickly as possible.
• Parts of the country have made very significant progress and gone faster than the average. We’re putting more supply into areas that have more to do, with the NHS doing brilliantly to deliver the amount of supply we have.

• Our supply and scheduled deliveries of the Oxford/AstraZeneca, Pfizer/BioNTech and Moderna vaccines will fully support vaccination of JCVI priority cohorts 1-9 by the end of April.
• The UK has secured access to seven different possible vaccines, across four different vaccine types, reflecting the government’s strategy to ensure the UK has a supply of vaccines should they prove safe and effective in clinical trials. These are at separate stages of development.

• The UK has secured early access to 457 million doses of eight of the most promising vaccine candidates.
• This includes agreements with:

• BioNTech/Pfizer for 40 million doses

• Valneva for 100 million doses

• Oxford/AstraZeneca who will work to supply 100 million doses of the vaccine being developed by Oxford University

• GlaxoSmithKline and Sanofi Pasteur to buy 60 million doses

• Novavax for 60 million doses

• Janssen for 30 million doses of their not-for-profit vaccine, alongside funding of their Phase 3 clinical trial​

• Moderna ​for 17 million doses

• CureVac ​for 50 million doses

• These vaccines have had three stages of clinical trials and have been tested on tens of thousands of people around the world.
• The trial phases were run in parallel, speeding up the overall time of vaccine production, but not the critical research time.
• Time has also been gained because:

• Vaccine trial volunteers were recruited at the start of the process, so they were ready to go once the vaccine was ready to trial
• The National Institute for Health Research (NIHR) made this their top priority
• Plans were made for the next phase of trials by the companies without having to wait for investor decisions.
• Companies made decisions to begin large scale production of vaccines which are still in trials. So, if vaccines were found to be safe and effective, they would be ready to be distributed.

• Three of the UK's eight COVID19 vaccines are being manufactured in the UK, this includes Valneva's whole inactivated virus vaccine, Novavax VLP protein adjuvant vaccine and Oxford/AstraZeneca's vaccine, which is delivered through a majority UK supply chain.​

• We have invested over £300m into manufacturing any successful vaccine and an enormous amount of planning and preparation has taken place across Government to be able to quickly roll out the vaccine, including ensuring we have adequate provision, transport, PPE and logistical expertise to do so.

• There will be further studies to look at how best to use the different vaccines, such as which vaccine is most effective in which individuals and what sized dose is most effective.
• A number of vaccines remain in development, and these may offer benefits over the first approved vaccine/s.

The NIHR holds a registry of vaccine trial participants, and welcomes people wanting to take part in health and social care research. https://www.nhs.uk/sign-up-to-be-contacted-for-research

• Each of the vaccines are tested on tens of thousands of people across the world. They are tested on both men and women, on people from different ethnic backgrounds, representative of the UK population and of all ages between 18-84.

• Pfizer/BioNTech trials took place in the US, Europe, Turkey, South Africa and South America. Approximately 42% of global participants and 30% of U.S. participants had racially and ethnically diverse backgrounds
• AstraZeneca trials took place in the UK, Brazil and South Africa. The non-white demographic in the UK trial was 7.1%. In the Brazil trial it was 31.4% and in South Africa it was 87%.

In line with the Government's wider priorities, the objective for the next phase of vaccine rollout is to bring down further the number of people dying, becoming seriously ill and being admitted to hospital. This will help to protect those more at risk, reduce pressure on the NHS, and support the reopening of the economy. We have asked the JCVI to advise on the best strategy for achieving this. They will publish their interim advice shortly.

In Phase 2 of the vaccine rollout we aim to offer every adult aged 18 and over a first dose of the vaccine by 31st July.

From Wednesday 17 March 2021, people aged 50 and over will start to receive their invites to book their vaccinations as part of cohort 9.

The latest batch of national invites follows a significant boost to bookings last week, with a major push by text message and letter prompting slots booked almost to double in 48 hours from 340,000 on March 7 to 609,000 on March 9 when texts were sent.

Healthcare teams continue to urge anyone yet to be vaccinated to take up the offer as around two million additional text messages go out from Wednesday 17 March 2021, with a link allowing people also to pick a convenient slot at an NHS vaccine centre, or pharmacy-led service through the national booking service website.

People who cannot go online can call the service on 119.

The text alerts will be followed up with 2.4 million letters landing on doorsteps later in the week.

• Nine out of 10 people aged 65 and over have now had their first COVID vaccine
• NHS staff continue to vaccinate people aged 60 to 63 and those who are clinically vulnerable against Covid who have not yet had their vaccination
• All those aged 50 and over, care workers and clinically vulnerable can book your vaccination appointment online via the national booking service.
• Anyone unable to book online can call 119 free of charge, anytime between 7am and 11pm seven days a week.
• Those who receive a letter can choose from more than 100 large scale vaccination centres or almost 200 pharmacy services.
• GP led vaccination sites will focus initially on the clinically vulnerable from cohort 6 because of the relationship between general practice and those with long term conditions, and continuity of care.
• Should somebody want to wait to be called by their local GP vaccination service or who have already received the jab they do not need to respond to their invitation.

• We are focused on saving lives and continue to follow the advice of the independent JCVI to vaccinate the most vulnerable people in society first. The priority order is primarily based on age, which is the biggest factor determining mortality, we expect this order to be followed.

• • Vaccines are being distributed fairly across the UK and we’re putting more supply into areas that have more to do. The rollout of vaccinations will continue to expand at pace as we work to offer a vaccine to all over-50s by mid-April.

• Local services should continue to vaccinate people in the priority groups, set out by the JCVI, which now includes the wider group of people who are clinically vulnerable and people aged 60 and over.

• The JCVI’s advice was developed with the aim of preventing as many deaths as possible. As the single greatest risk of death from COVID-19 is older age, prioritisation is primarily based on age.

• • The JCVI have considered evidence on the risk of exposure and risk of mortality by occupation. Under the priority groups advised, people of any occupation aged over 50 years of age or in a medical risk group are eligible for vaccination in phase of the vaccination programme.
  • For phase two, the JCVI have concluded that targeted vaccination to reduce transmission or give priority to occupational groups at higher risk of exposure would not be as effective or as fast in reducing deaths and hospitalisations as direct protection of those at higher risk of serious disease.
  • Delivery of a programme targeting occupations would be operationally very complex and therefore would risk slowing down the pace of the vaccination programme.

• An age-based programme will still protect individuals working in jobs with a potentially higher risk of exposure to the virus, with the most vulnerable in those occupations vaccinated first

• Yes. The MHRA have looked at this and decided that getting vaccinated is just as important for those who have already had Covid-19 as it is for those who haven’t.
• As with all new viruses, we won’t know how long those who have recovered from coronavirus or the level of their immunity. The most important thing is to vaccinate those who are most at risk from Covid, so we will continue to follow the science and advice from the JCVI and chief medical officers.

• The UK government has secured early access to 457 million vaccine doses through agreements with eight separate vaccine developers, giving the UK the best chance of securing safe and effective vaccines at the quickest speed.
• The vaccines are available from the NHS - for free – to everyone who would benefit, starting with those most at risk.

How did the AstraZeneca/Oxford vaccine become available so quickly?

• The UK was the first country in the world to procure and authorise the Oxford/AstraZeneca vaccine, and we were the first country in the world to start a vaccination programme with it w/c 4th January.
• The Oxford vaccine is a British success story – it has had UK government backing throughout.
• We have signed deals for substantial future supply of both vaccines to replenish our stocks and enable swift vaccination of first and second doses across the UK

Can the Oxford/AstraZeneca vaccine be used for all adults regardless of age?

• • The WHO’s Strategic Advisory Group of Experts on Immunisation has issued interim recommendations on the Oxford/AstraZeneca vaccine, saying that the jab could be given to people aged 18 and above “without an upper age limit”.

• Dr Alejandro Cravioto, chairman of the WHO's Strategic Advisory Group of Experts on Immunisation, said: "In the case of the data coming from clinical trials, we have seen that there was a small participation of people over 65 years of age.

Is the Oxford/AstraZeneca vaccine safe for people over 50?

• Yes, the vaccine has been thoroughly assessed by MHRA – the UK medicines regulator – for its safety and efficacy.
• Routine safety monitoring and analysis of the approved COVID-19 vaccines by the UK’s medicines regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), shows that the safety of these vaccines remains as high as expected from the clinical trial data that supported the approvals. (5 February)
• The benefits of the Oxford/AstraZeneca Covid vaccine outweigh any risks and the shot should be recommended for use, including in people aged 65 and older, a World Health Organization panel said on Wednesday 10 February.

• The UK was the first country in the world to start a vaccination programme using the Pfizer/BioNTech vaccine.
• We have signed deals for substantial future supply of both vaccines to replenish our stocks and enable swift vaccination of first and second doses across the UK in the weeks and months ahead.
• We have been monitoring the requirements across the supply chain from supplier through to patient for some time. There are clear supply chain plans in place for both the supply and onward deployment of all vaccine candidates. This includes materials, manufacturing, transport, storage and distribution.
• The Vaccines Taskforce has conducted supply chain risk assessment and is working with the vaccine suppliers to understand the optimal logistics and timings.

How effective is the Pfizer vaccine?

• Public Health England data (17/03/21) - Analysis of routine testing data continues to show a vaccine effect against symptomatic COVID19 from either vaccine in those aged 70 year and over, for whom the vaccine effectiveness (VE) of a single dose reaches ~ 60%. This analysis includes additional weeks' of data which gives us increased confidence in the levels of protection the vaccines are offering. (Read full study and results). High protection against any COVID-19 infection is shown in health care workers with no decline in protection after a single dose beyond 56 days (which is the length of time people have been studied). Among those who develop symptomatic infection, risk of hospitalisation is reduced by 35 to 45% after one dose of either vaccine. Combined with the reduced risk of becoming a case, this is consistent with a vaccine effectiveness against hospitalisation which is similar to previously reported value of 80%. Risk of death for cases over 80 is reduced by 54%. Combined with the reduced risk of becoming a case, this is consistent with a vaccine effectiveness against mortality which is similar to previously reported value of 85%.

How effective is the Moderna vaccine? 

• The Moderna vaccine has been shown to be 94% effective in its Phase Three clinical trials.

When will the first doses become available and how many doses will we have by 1 April?

• Moderna are currently scaling up their European supply chain. These doses would become available in the UK by Spring 2021 at the earliest.
• Moderna are currently scaling up their European supply chain, which means these doses would become available in spring 2021 in the UK at the earliest.
• We have now purchased 17 million doses of the Moderna vaccine

Is it true we’ve paid more for Moderna doses compared to EU countries?

• The financial information in our contracts is commercially sensitive, so we are unable to disclose this at the present time.
• The price of any vaccine is a commercial decision for the company developing it. We take this into account when deciding whether or not to procure any vaccine.

A press statement from Novavax on 11/03/2021 said they had confirmed high efficacy against both original and variant COVID-19 strains in United Kingdom and South Africa Trials. In it’s press statement, the company said:

“100% protection against severe disease

“Final analysis in U.K. trial confirms 96% efficacy against original strain of COVID-19

“Efficacy against variants confirmed in U.K. and South Africa”

Read full statement.

What’s the latest on the Novavax Phase Three safety and efficacy data (updated on 29/01/2021)

• The company is planning to submit its data to the MHRA. Once our medicines regulator receives the data, it will begin to carry out its crucial, independent work to assess whether the vaccine meets robust standards of safety, effectiveness and quality.
• We have procured 60 million doses of the Novavax vaccine that will be delivered during this year, if approved for use, boosting our vaccination programme and our efforts to tackle Covid-19.

How effective is the Novavax vaccine?

• The Novavax vaccine has been shown to be 89.3% effective in its Phase Three clinical trials.
• If approved by the medicines regulator, the MHRA, the Novavax vaccine will be a significant boost to our vaccination programme.
• Novavax’s candidate differs from those currently being used in the UK, combining an engineered protein from the virus that causes Covid-

What is the latest on the Janssen single-dose Phase Three safety and efficacy data (updated 01/03/2021)

• Janssen submitted data to MHRA on Friday 26 February 2021 for their single-dose vaccine.

• Trials for the two-dose vaccine are ongoing (including at 16 sites in the UK) - and they are just about to have recruited all 6,000 necessary UK participants for those trials.

• This is yet more promising news from Janssen. Once the full data has been submitted to the regulator they will consider the evidence to determine whether the vaccine meets robust standards of safety, effectiveness and quality.
• Thanks to the life-saving work of our Vaccine Taskforce, the UK moved quickly to secure 30 million doses of Janssen’s vaccine last summer. If this vaccine is authorised by our medicines regulator, we are set to receive the doses in the second half of this year.
• The Janssen vaccine works in the same way as vaccine developed by Oxford and AstraZeneca and is designed to prompt an immune response including neutralising antibodies against the spike protein to eliminate the virus. Again similarly to the Oxford / AstraZeneca vaccine it can be safely stored and transported at standard refrigeration temperatures.

How effective is the Janssen vaccine?

• The Janssen single-dose vaccine has been shown to be 66% overall effective in its Phase Three clinical trials.

• • Phase Three trials for the company’s two-dose regimen are ongoing worldwide. While a single dose of a safe and effective vaccine would offer a significant advantage during a global pandemic emergency, a two-dose schedule may have the potential to offer enhanced durability in some participants.

• The data did not report any significant safety concerns relating to the vaccine, with no serious adverse events in vaccine recipients.

Where is the latest on the Valneva vaccine and where is it being manufactured (updated 28/01/2021)

• Thanks to the UK Vaccine Taskforce, we have ordered up to 100 million jabs of Valneva’s promising vaccine if it proves to be safe, effective and suitable in its clinical trials this year.
• By starting manufacturing, we will have a running start at rolling these out as quickly as possible to protect the British public if it receives regulatory approval.
• This facility in Scotland, backed by millions from the Government, will help us beat coronavirus and boost our resilience against future pandemics.

Which vaccine is better/more effective?

• • All vaccines that are approved by the MHRA are very safe and effective vaccines. Comparisons between the vaccine efficacies are unhelpful due to the different methodologies used.
  • It’s not as simple as saying one vaccine is better than the other. An effective vaccine will save lives and reduce hospitalisations.

• Public Health England data (17/03/21) - Analysis of routine testing data continues to show a vaccine effect against symptomatic COVID19 from either vaccine in those aged 70 year and over, for whom the vaccine effectiveness (VE) of a single dose reaches ~ 60%. This analysis includes additional weeks' of data which gives us increased confidence in the levels of protection the vaccines are offering. (Read full study and results). High protection against any COVID-19 infection is shown in health care workers with no decline in protection after a single dose beyond 56 days (which is the length of time people have been studied). Among those who develop symptomatic infection, risk of hospitalisation is reduced by 35 to 45% after one dose of either vaccine. Combined with the reduced risk of becoming a case, this is consistent with a vaccine effectiveness against hospitalisation which is similar to previously reported value of 80%. Risk of death for cases over 80 is reduced by 54%. Combined with the reduced risk of becoming a case, this is consistent with a vaccine effectiveness against mortality which is similar to previously reported value of 85%.

• Public Health England data (01/03/2021) shows that both the Pfizer and Oxford-AstraZeneca vaccines are highly effective in reducing COVID-19 infections among older people aged 70 years and over. Since January, protection against symptomatic COVID, 4 weeks after the first dose, ranged between 57 and 61% for one dose of Pfizer and between 60 and 73% for the Oxford-AstraZeneca vaccine. In the over 80s, data suggest that a single dose of either vaccine is more than 80% effective at preventing hospitalisation, around 3 to 4 weeks after the jab. There is also evidence for the Pfizer vaccine, which suggests it leads to an 83% reduction in deaths from COVID-19. (Full statement and data here).

• • No vaccine has ever been 100% effective so no-one will have 100% protection from the virus. The way to reduce everyone’s risk is to break the chains of transmission and push down the number of cases.
  • Comparing vaccines on a simple percentage of effectiveness is a mistake. A vaccine with slightly lower headline efficacy than another may prove to be the one that offers more durable protection or a greater effect on transmission

• Vaccines have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from Coronavirus.

If you're given one type of vaccine does that mean you have to stick with that vaccine forever? 

• The Pfizer/BioNTech vaccine is rapidly being rolled out across the UK, starting with the highest priority groups.
• The AstraZeneca/Oxford vaccine and other candidates will be deployed alongside the Pfizer/BioNTech vaccine to increase the pace and volume of the UK programme.
• More evidence is needed to understand whether a seasonal vaccination or booster dose might be needed.
• The vaccines people are offered will be appropriate for them. This decision is based on clinical judgement supported by the advice of Joint Committee on vaccination and immunisation. This will take into account individual vaccine characteristics, which may mean they are more suitable for some groups of people, and not others – for example, some may be less well tolerated or effective in certain age groups.

Can people choose what vaccine they have? It has been suggested that vaccines could be mixed and matched?

• No. Any vaccines that are available will have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from coronavirus.
• The Pfizer/BioNTech vaccine is being rolled out as fast as possible by the NHS across the UK. Now authorised, the AstraZeneca/Oxford vaccine will be deployed alongside the Pfizer/BioNTech vaccine to increase the pace and volume of the UK programme. There are no current plans to mix these vaccines.

• The Government’s Vaccine Taskforce keeps its approach under review, ensuring the UK is in the strongest position to protect people. The science is uncertain about how mixing vaccines could produce a better immune response, so trials and testing will continue to assess and test vaccine responses.

Is a clinical trial being done to see whether vaccines could be mixed?

• A new clinical trial, backed by £7 million of government funding, is looking into alternating Covid-19 vaccine doses. The study, run by the National Immunisation Schedule Evaluation Consortium (NISEC) across eight National Institute for Health Research (NIHR) supported sites, will examine whether different vaccines can safely be used for two dose regimes in the future. The current programme of two doses of the same vaccine over twelve weeks remains unchanged
• The study will also gather immunological evidence on different intervals between the first and second dose for a mixed-vaccine regimen against control groups when the same vaccine is used for both doses.

In rare cases can the Pfizer/BioNTech and AstraZeneca/Oxford vaccine be mixed and matched?

• We do not recommend mixing the COVID-19 vaccines – if your first dose is the Pfizer vaccine you should not be given the AstraZeneca vaccine for your second dose and vice versa.
• However, there may be extremely rare occasions where the same vaccine is not available, or where it is not known what vaccine the patient received.
• Our guidance is very clear that every effort should be made in these instances to give the same vaccine to the patient, but where this is not possible it is better to give a second dose of another vaccine than not at all.
• This is a reasonable measure on a very exceptional basis, when the alternative is to leave someone with an incomplete course – which is the greater concern, especially if the individual is likely to be at immediate high risk or is considered unlikely to attend again.
• In these rare circumstances, as both vaccines are based on the spike protein, it is likely the second dose will help to boost the response to the first dose.
• While there is no evidence on the interchangeability of the COVID-19 vaccines at this time, this is a pragmatic and scientific approach agreed by many scientists and vaccine experts, including the UK’s Deputy Chief Medical Officer.

Will there be a sufficient numbers of vaccine doses?

• Everyone will receive their second dose and this will be within 12 weeks of their first.

• Both approved vaccines offer considerable protection after the first dose and the second dose is important for longer-term protection.
• We are in constant contact with the vaccine manufacturers and remain confident in the continued supply of vaccine for the UK.

How does the UK supply chain work?

• The UK Government has secured and purchased vaccines on behalf of the whole United Kingdom, and we are distributing them quickly, fairly and proportionately to all four nations.
• The UK Government has developed detailed plans for its supply chains with both AstraZeneca and Pfizer. We are not able to disclose details of these for security reasons.

What happens to the unused doses that may be left over at the end of the day? Can they be given to people outside cohorts 1-9 to avoid being wasted?

• No vaccines should be wasted.
• Local vaccination sites should be managing their appointment lists to ensure all appointments are filled and they have a back-up list of patients and staff, in the top six cohorts, who can receive the vaccine at short notice.
• The Joint Committee on Vaccination and Immunisation (JCVI) are the independent experts who advise Government on which vaccine/s the United Kingdom should use and provide advice on prioritisation at a population level.
• It is estimated that vaccinating everyone in the priority groups would prevent 99% of deaths, including those associated with occupational exposure to infection.
• Local services should continue to vaccinate people in the priority groups which now includes the wider group of people who are clinically vulnerable and people aged 56 and over. Our target remains to offer a vaccine to all priority groups (i.e. all over-50s) by 15 April, and all adults by the end of July.
• The NHS guidance to Primary Care Networks/GPs is that vaccines should not be given to people outside of the eligible cohorts. It is absolutely permissible, and indeed encouraged, to have reserve lists of recipients, who can come in at short notice if vaccine is still available. However, these lists should only be drawn from eligible recipients in these cohorts.

Will the reported supply issues impact (phase 2) roll out?

• Over 25 million people have now received their first vaccine dose, with 1.75 million already vaccinated with both jabs.
• Our supply and scheduled deliveries of the vaccines remain on-track to fully support vaccination of JCVI priority cohorts 1-9 by 15 April. There will be no cancelled appointments as a result of supply issues.

• There will be no weeks in April with no first doses. If you are eligible for a vaccination within priority cohorts 1-9, you will still be able to receive your first jab.
• Appointments are available now, but are filling up fast. All those aged over 50 years, people with a health condition that puts them at greater risk of COVID-19 and health and social care workers are encouraged to book their vaccination now. It’s quick and simple to book at nhs.uk/covid-vaccination or by phoning 119, with a choice between attending a vaccination centre or pharmacy service.

• People within cohorts 1-9 who are due to receive a second dose in April will still be able to have their jab as planned. These appointments are being prioritised by the NHS to ensure that those who are most vulnerable to COVID-19 are protected.
• If you already have an appointment over the coming weeks, whether for your first or second dose, this remains in place and it’s really important that you attend it as planned. The first dose of both the Pfizer/BioNTech and Oxford/AstraZeneca vaccine offer good levels of protection, but to get maximum protection everyone will need to get a second dose, so we are urging people to come back when they are contacted or if they have an appointment booked.
• We remain on course to start offering first doses to those over 40 from mid-April, although we will continue to prioritise second doses during this month. We are on track to offer a first vaccine to all adults by 31 July.
• If you are under 50, when it is the right time you will receive an invitation from the NHS to come forward for your vaccination. We know lots of people will be eager to get protected but we are asking people aged under 50 not to contact the NHS to get an appointment until they get their letter

Group 6 - Clinically Vulnerable groups
What is the advice to clinically extremely vulnerable people who can’t receive the vaccine for medical reasons?

• The clinically extremely vulnerable are advised to follow shielding guidance until 31 March. This includes staying at home as much as possible, except for exercise or to attend health appointments (including vaccination appointments).
• This guidance does not change regardless of whether someone shielding has been vaccinated or not.
• Once shielding is no longer advised, there will continue to be additional, precautionary advice in place for people who are CEV in order to help them keep themselves safe.

Why might the vaccination rollout not result in significant increased immunity for some vulnerable people? Why can some people not be vaccinated?

• As per JCVI advice, many immunosuppressed individuals qualify for vaccination in priority groups 4 or 6. For those whom vaccination is not advised, a GP or relevant clinician will host a consultation. It is important that clinically extremely vulnerable people should continue following government advice on reducing risk.
• The UK is leading the way on vaccine research. As soon as sufficient evidence becomes available, the JCVI will provide advice on strategies to protect immunosuppressed individuals and consider if certain vaccines are preferred for particular groups.

Why has the government not prioritised disabled people who are shielding?

• The Joint Committee on Vaccines and Immunisation’s (JCVI) advice of 30 December placed “the clinically extremely vulnerable” (which includes those on the Shielded Patient List) and “all individuals aged 16 years to 64 years with certain underlying health conditions which put them at higher risk of serious disease and mortality” at number 4 and 6 respectively on the priority list for phase 1 of the vaccination roll out.
• Those definitions will apply to many people who are disabled, which has given many welcome assurance that they are being given priority status befitting the higher risks they face.

What is ‘QCOVID’? What can it be used for?

• New technology has been introduced in England to help clinicians identify for the first time a new group of people who may be at high risk from COVID-19.
• The technology analyses a combination of risk factors based on medical records, to assess whether somebody may be more vulnerable than was previously understood, helping clinicians provide vaccination more quickly to them and ensuring patients can benefit from additional advice and support.
• The data-driven approach to medical risk assessment will help the NHS identify further individuals who may be at high risk from COVID-19 due to a combination of personal and health factors.
• This action ensures those most vulnerable to COVID-19 can benefit from both the protection that vaccines provide, and from enhanced advice, including shielding and support, if they choose it.

How many individuals are being added to the Shielded Patient List (SPL) as a result of the QCovid model? How many of those will already have had their vaccine?

• Around 1.7 million patients could be identified. Those within this group who are over 70 will have already been invited for vaccination and 820,000 adults between 19 and 69 years will now be prioritised for a vaccination.
• Vaccines are now being offered to people aged 56 and over and those who are clinically vulnerable, which includes a wider group of people at higher clinical risk (see PHE Green Book, p.10), including carers and young adults in residential settings.
• GPs and other primary care professionals have been asked to invite those eligible for vaccination within cohort 6 to attend an appointment for vaccination from Monday 15 February.  Information about whether your clinical condition is eligible within cohort 6 is found on your patient record, which your GP will review. It can also be found from carers allowance data and from information held within local authority systems and by local carers organisations. Guidance has been provided to the NHS on utilising this data and local intelligence in order to identify and offer a vaccine to those in this priority group as soon as possible.
• However, there will be individuals who have not been captured on such systems and therefore cannot be identified through such means. Therefore, the guidance places a strong emphasis on Local Authorities and NHS services working with voluntary sector groups to reach out and identify these individuals in order to offer them a vaccine.
• A hospital clinician or GP can also add a patient to the list, based on their clinical judgement, because they consider them to be at very high risk of serious illness from COVID-19.

People who are defined as clinically vulnerable are thought to be at high risk of serious illness from COVID-19. The PHE Green Book identifies the following conditions which are automatically deemed clinically vulnerable including chronic liver disease Cirrhosis, biliary atresia, chronic hepatitis.

• Effective vaccines will be the best way to protect the most vulnerable from coronavirus and the biggest breakthrough since the pandemic began. A huge step forward in our fight against coronavirus, potentially saving tens of thousands of lives.
• We will closely monitor the impact of vaccinations on individuals, on NHS pressures and on the spread of the virus.

• The Medicines and Healthcare products Regulatory Agency (MHRA) is the UK’s independent regulator. Their role is to ensure medicines, devices and vaccines work effectively and are safe for use.
• Each COVID-19 vaccine candidate is assessed on a case-by-case basis and will only be authorised once it has met robust standards of effectiveness, safety and quality.
• Teams of scientists and clinicians carefully, methodically, scientifically rigorously review all data on safety, effectiveness and quality as soon as they become available, and have done so throughout all tests and trials
• The data looked at includes all the results from laboratory studies, clinical trials, manufacturing and quality controls and testing the product. The public on that basis should be very confident that all tests are done to the very highest standards, and only then will a COVID-19 vaccine be made available

There are currently no plans in place to make the Covid-19 vaccine compulsory. The UK operates a system of informed consent for vaccinations.

The only vaccines that are ‘live’ are Oxford Uni/Astra Zeneca and Janssen. DHSC have indicated to us verbally that they are not ‘live’ in the ‘conventional’ sense (they don’t replicate) and that “it is unlikely that anyone would be contra indicated for any of the live vaccines that are currently being developed unless they have a specific allergy to that vaccine”.

• It can take 10-15 years to develop a vaccine, but scientists recognised years ago the threat of a pandemic such as Covid-19 so had already researched how the right vaccine could be used. Because the scientists knew how to make a vaccine that should work, they could begin trials to find a vaccine that would work and more quickly than usual.
• They have spent the last year working on what the right vaccines will be and trialling with human volunteers all over the world.
• This science has been backed by considerable resources including investment by the UK government and commercial partnerships to fast track production.
• The final step is for the independent regulator to confirm that the vaccines are safe as well as an effective way for people to protect themselves and their families.

• The Joint Committee on Vaccination and Immunisation (JCVI) are the independent experts who advise the Government on which vaccine/s the UK should use and provide advice on who should be offered the vaccination first.
• JCVI will consider each vaccine and provide their advice to the Government once detailed information on the characteristics and clinical properties of the approved vaccine becomes available.
• The current phase they recommend is a phase where the most vulnerable individuals in society are prioritised, particularly those who are most likely to die from severe Covid infection.
• The UK has focused on vaccines that are expected to generate an immune response among the over 65’s. Currently, over three-quarters of deaths caused by SARS-CoV-2 infection are in this older population, so it is essential that any vaccine is able to protect this group. The reason for this is because age is by far the strongest risk factor associated with severe Covid disease.
• The JCVI has advised that the vaccine first be given to care home residents and staff, followed by people over 80 and health and social workers, then to the rest of the population in order of age and risk. The prioritisation could change substantially if the first available vaccines were not considered suitable for, or effective in, older adults.

• The government has invested significantly to scale up manufacturing capabilities to ensure we are in a position to manufacture a successful vaccine in large quantities. The government has funded several UK vaccine manufacturing sites.
• The government is working closely with the devolved administrations to ensure successful delivery across the whole of the UK. We have also announced an additional £100 million investment to fund a state-of-the-art Manufacturing Innovation Centre in collaboration with the Cell and Gene Therapy Catapult, to accelerate the mass production of a successful COVID-19 vaccine in the UK.
• The government has invested £93 million additional funding to ensure the UK’s first dedicated Manufacturing and Innovation Centre will open 12 months earlier than planned, in summer 2021. While this centre is being built, the government has established a ‘rapid deployment facility’ thanks to a further investment of £38 million to begin manufacturing at scale from this summer.
• Collaboration between government, academia and industry is essential to manufacturing vaccine candidates at pace and scale. The UK’s leading life sciences industry knows how to develop, manufacture and distribute vaccines to global markets. The fact that the University of Oxford has signed a global licencing deal with UK-based AstraZeneca is testament to this.

The UK government will make vaccinations available for all of the UK, plus the Crown Dependencies and Overseas Territories.

Vaccination will be managed by the health services in each nation: NHS England and NHS Improvement, NHS Wales, NHS Scotland, and Health and Social Care Northern Ireland. The UK government is working closely with the Devolved Administrations to ensure an aligned approach to COVID-19 vaccine deployment across the UK.

The UK government has agreed to buy these vaccines on behalf of the Devolved Administrations, Crown Dependencies and Overseas Territories at no charge.

• False information about COVID-19 vaccines could cost lives.
• The government is working with health experts to provide information and advice at every possible opportunity.
• The Government’s Counter Disinformation Unit, led by DCMS works to tackle disinformation and misinformation relating to COVID-19.
• The Unit works closely with social media platforms to help them identify and take action to remove incorrect claims about coronavirus, and to promote authoritative advice and information.
• The Government published the Full Government Response to the Online Harms White Paper consultation in December 2020, which sets out new expectations on companies to keep their users safe online.
• The new laws will have robust and proportionate measures to deal with disinformation that could cause significant physical or psychological harm to an individual, such as false information about Covid-19 and COVID-19 vaccines.
• We have developed the SHARE checklist which aims to increase audience resilience by educating and empowering those who see, inadvertently share and are affected by false and misleading information. The checklist provides the public with five easy steps to identify false content, encouraging users to stop and think before they share content online.
• We have also partnered with the University of Cambridge to create a game called “Go Viral!”. Our aim is to build the public’s resilience to false information, mitigating the risk of undermining the uptake of Covid-19 vaccines, treatments and diagnostics.

• The encouraging news about vaccines is thanks to clinical study participants volunteering to take part and shows the importance of this vaccine research.
• Clinical trials into the vaccines against COVID continue at pace, and it is essential that these do so. We will need data about a number of vaccines and their safety and effectiveness, in order to protect the population. No one vaccine is likely to be suitable for everyone, the first vaccine may not be the most effective and easiest to use, and we must make sure that the other studies continue to allow us to have a selection of vaccines to protect the whole population. We are likely to need several vaccines to provide enough doses for everyone at risk, as early as possible.
• Once a vaccine is available, there will be a process in place so people on vaccine studies are not disadvantaged. People taking part in the vaccine research will still be able to have an approved vaccine when this is available. Taking part in a study is the best way to help effective vaccines to be identified and made available to everyone earlier and may even give you early access to a vaccine later found to be effective.

• All the vaccines will be tested on between 15,000 to 50,000 people across the world. They are tested on both men and women, on people from different ethnic backgrounds, and of all ages between 18-84.
• The studies have also looked at if the vaccines work on people with certain medical conditions and in older people, as their immune responses can work less effectively and therefore give them less protection through vaccines. As a result of this testing on a representative sample of the population, we can be confident that an approved vaccine will be effective for the wider population in the UK.
• Research and vaccine development will not end with the first approved vaccine, there will be a process of continuous improvement.

Once a vaccine is available, we will have a process in place so people on vaccine studies are not disadvantaged. People taking part in the vaccine research will still be able to have an approved vaccine when this is available. Taking part in a study is the best way to help effective vaccines to be identified and made available to everyone earlier and may even give you early access to a vaccine later found to be effective.

There is currently no evidence to suggest that the Pfizer or Oxford/AstraZeneca vaccine would not protect people against the new strain. Further laboratory work is currently being undertaken to understand this.