You may have clicked this page because you’re keen to find out about the COVID-19 Vaccination.

Perhaps you’re wanting to know how you or your loved ones can get access to it.

You won’t need to contact us just yet and in fact, we will be contacting you as soon as the roll out begins.

At the moment, the vaccines are in short supply, therefore we have to prioritise those who older adults in a care home setting first.

 

COVID-19 Vaccine Information Menu

Joint Community on Vaccination and Immunisation (JVCI) Priority Groups

The government rollout plan is intended to cover those at highest risk first. Please see the list below.

As soon as vaccines for your priority group is available, we will contact you.

Please ensure your contact details are up to date.

Priority Group Risk Group
1

Resident in a care home for older adults and their carers

All those 80 years of age and over

(12/01/2021 Update: This is currently underway and those in this risk group are being contacted
19/01/21: Care Home and Housebound visits already underway. The first Saturday Clinic for Covid-Vaccine for over 80s took place last Saturday and we will be doing more)
2 Frontline Health and Social Care Workers
3

All those age 75 years and over

All those age 70 years and over

4 Clinically extremely vulnerable individuals (not including pregnant women and those under 16 years of age)
5 All those 65 years of age and over
6 Adults aged 16 to 65 years in an at-risk group
7 All those 60 years of age and over
8 All those 55 years of age and over
9 All those 50 years of age and over

Table 1 Priority groups for vaccination advised by the JCVI on 2nd December 2020

Priority 1

Residents in a Care Home for Older Adults

There is clear evidence that older adults resident in care homes have been disproportionately affected by the COVID-19 pandemic. Those living in care homes have a high risk of exposure to infection due to their close contact with staff (including bank staff) and other residents including those residents returning to the care home from hospital.

The closed setting of the care home also increases the risk of outbreaks occurring as any asymptomatic residents and staff could be potential reservoirs for on-going transmission.

Given the increased risk of outbreaks, morbidity and mortality in these closed settings, older adults in care homes are considered to be at very high risk. The JCVI have advised that vaccination of residents and staff should be the highest priority for vaccination.

Studies carried out during the ongoing pandemic showed that infection rates are higher in residential care home staff than in those providing domiciliary care or in healthcare workers.

Older Adults:

Older adults are considered to be at very high risk if they develop COVID-19 infection as they are at higher clinical risk of developing severe disease and have a higher risk of death. Current evidence strongly indicates that the single greatest risk of mortality from COVID-19 is increasing age and that the risk increases exponentially with age.

Disease severity, risk of hospitalisation and mortality increase from age 50 years upwards, with the highest risk in those aged 80 years and above; 80% of deaths have been in those aged 70 years and over, and most of the excess all-cause mortality consisted of older age groups with more than 90% of excess deaths in those aged over 75 years.

Data indicate that the absolute risk of mortality is higher in those over 65 years than that seen in the majority of younger adults with an underlying health condition.

Vaccination of this group would not only directly protect them but could also indirectly protect the NHS by preventing admissions.

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Clinical at risk Groups

 

As well as age, other risk factors have been identified that place individuals at risk of serious disease or death from COVID-19. These include groups with certain underlying health conditions and may include people who have:

  • Chronic (long-term) respiratory disease
  • Chronic heart disease
  • Chronic kidney disease
  • Chronic liver disease
  • Chronic neurological disease
  • Diabetes
  • A weakened immune system due to disease or treatment
  • Asplenia or dysfunction of the spleen
  • Morbid obesity (defined as BMI of 40 and above)
  • Severe mental illness

There are two ways an individual may be identified as clinically extremely vulnerable:

  1. They have one or more of the conditions listed on the GOV.UK website, or
  2. A hospital clinician or GP has added them to the shielded patients list because, based on their clinical judgement, they consider them to be at higher risk of serious illness from COVID-19

Castle Surgery will identify those who are clinically extremely vulnerable and contact you when vaccines are available.

Clinical Risk Groups in detail:

  • Chronic (long-term) respiratory disease
    • Individuals with a severe lung condition, including those with asthma thatrequires continuous or repeated use of systemic steroids or with previous

      exacerbations requiring hospital admission, and chronic obstructive

      pulmonary disease (COPD) including chronic bronchitis and emphysema;

      bronchiectasis, cystic fibrosis, interstitial lung fibrosis, pneumoconiosis and

      bronchopulmonary dysplasia (BPD).

  • Chronic heart disease
    • Congenital heart disease, hypertension with cardiac complications, chronicheart failure, individuals requiring regular medication and/or follow-up for

      ischaemic heart disease. This includes individuals with atrial fibrillation,

      peripheral vascular disease or a history of venous thromboembolism.

  • Chronic kidney disease
    • Chronic kidney disease at stage 3, 4 or 5, chronic kidney failure, nephroticsyndrome, kidney transplantation
  • Chronic liver disease
    • Cirrhosis, biliary atresia, chronic hepatitis
  • Chronic neurological disease
    • Stroke, transient ischaemic attack (TIA). Conditions in which respiratoryfunction may be compromised due to neurological disease (e.g. polio

      syndrome sufferers). This includes individuals with cerebral palsy, severe or

      profound learning disabilities, Down’s Syndrome, multiple sclerosis,

      epilepsy, dementia, Parkinson’s disease, motor neurone disease and related

      or similar conditions; or hereditary and degenerative disease of the

      nervous system or muscles; or severe neurological disability.

  • Diabetes
    • Any diabetes mellitus, including diet controlled
  • A weakened immune system due to disease or treatment
    • Immunosuppression due to disease or treatment, including patientsundergoing chemotherapy leading to immunosuppression, patients

      undergoing radical radiotherapy, solid organ transplant recipients, bone

      marrow or stem cell transplant recipients, HIV infection at all stages,

      multiple myeloma or genetic disorders affecting the immune system (e.g.

      IRAK-4, NEMO, complement disorder, SCID).

      Individuals who are receiving immunosuppressive or immunomodulating

      biological therapy including, but not limited to, anti-TNF, alemtuzumab,

      ofatumumab, rituximab, patients receiving protein kinase inhibitors or

      PARP inhibitors, and individuals treated with steroid sparing agents such as

      cyclophosphamide and mycophenolate mofetil.

      Individuals treated with or likely to be treated with systemic steroids for

      more than a month at a dose equivalent to prednisolone at 20mg or more

      per day (any age).

      Anyone with a history of haematological malignancy, including leukaemia,

      lymphoma, and myeloma and those with systemic lupus erythematosus

      and rheumatoid arthritis, and psoriasis who may require long term

      immunosuppressive treatments.

      Some immunosuppressed patients may have a suboptimal immunological

      response to the vaccine

  • Asplenia or dysfunction of the spleen
    • This also includes conditions that may lead to splenic dysfunction, such ashomozygous sickle cell disease, thalassemia major and coeliac syndrome.
  • Morbid obesity (defined as BMI of 40 and above)
  • Severe mental illness
    • Individuals with schizophrenia or bipolar disorder, or any mental illness thatcauses severe functional impairment
  • Adult Carers:
    • Those who are in receipt of a carer’s allowance, or those who are the maincarer of an elderly or disabled person whose welfare may be at risk if the

      carer falls ill.

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Ensuring you get accurate information 

We will do our best to provide you with accurate information to help you make an informed decision about your care.

Getting Consent

Before we can give you or your loved one the covid-19 vaccine, we will need to obtain voluntary, informed consent.

If it is not possible to obtain informed consent due to not having the capacity, a best interest decision can be made. This is not the same as consenting on behalf of another adult so a GP cannot consent on behalf of their patient, a husband or wife cannot consent on behalf of their spouse and a family member cannot consent to a relative’s treatment if they lack capacity.

The offer of vaccination should be discussed with those close to the patient such as their carer, relatives or anyone appointed as a Lasting Power of Attorney (LPA) for Health and Welfare, or those named by the person to be consulted on vaccination if practical. Note Cover Letter

Explanation of the vaccine’s risk and benefits will be shared in the form of a leaflet. You can download this here.

Receiving the vaccine

Your clinician will have undertaken additional training, statuatory and mandatory training, vaccine specific training and competency assessment.

 

Q&A about the Oxford Vaccine

What is the ‘Oxford Vaccine’?

COVID-19 Vaccine AstraZeneca is a non-replicating viral vector vaccine. It uses part of a weakened adenovirus to deliver information about SARS-CoV-2 virus into cells. This stimulates the body to produce antigen. The presence of antigen stimulates the immune system to produce antibodies and activate T-cells.

How effective is the ‘Oxford Vaccine?’

In clinical trials of over 11,000 patients, overall vaccine efficacy against symptomatic disease was 70.4%.

Is the ‘Oxford Vaccine’ Safe?

The side-effects seen in clinical trial recipients following vaccination with COVID-19 Vaccine AstraZeneca were mild to moderate and usually self-resolving within a few days of vaccination.

Can I have the ‘Oxford Vaccine’?

At the moment, the vaccines are in short supply, therefore the government have advised prioritising those older adults in a care home setting first.

Can I choose a different vaccine?

Currently, we cannot yet offer alternative COVID-19 vaccines. You can decline when offered and choose to wait, should an alternative manufacturer become available.

Who shouldn’t have the vaccine?

If you’ve had a previous severe reaction to a previous dose of the same vaccine or any severe reactions to any components of the vaccine (see list next page).

You are advised to delay vaccination if you have had any recent acute infections

Individuals currently experiencing symptoms of COVID-19 disease should not attend for vaccination until they have recovered. This is to avoid wrongly attributing any new symptom or the progression of symptoms to the vaccine.

Vaccination should ideally be deferred until around 4 weeks after onset of symptoms, or from the first positive test in those who are asymptomatic.

Can I have the vaccine if I’m pregnant?

There is insufficient evidence to recommend the routine use of COVID-19 vaccine during pregnancy.

If a woman finds out she is pregnant after she has started a course of COVID-19 vaccine, she should complete her pregnancy before finishing the recommended schedule. Women should be offered vaccine as soon as possible after pregnancy.

JCVI has advised that, for women who are offered COVID-19 vaccine, vaccination in pregnancy should be considered where the risk of exposure to SARS-CoV-2 infection is high and cannot be avoided, or where the woman has underlying conditions that put them at very high risk of serious complications of COVID-19. In these circumstances, clinicians should discuss the risks and benefits of vaccination with the woman, who should be told about the absence of safety data for the vaccine in pregnancy.

What is the guidance on the ‘Oxford Vaccine’ if breastfeeding?

There is no known risk associated with giving non-live vaccines whilst breastfeeding. JCVI advises that breastfeeding women may be offered vaccination with the COVID-19 Vaccine AstraZeneca

What does the vaccine contain?

The COVID-19 Vaccine AstraZeneca contains recombinant, replication-deficient chimpanzee adenovirus vector encoding the SARS CoV 2 Spike (S) glycoprotein.

It also contains:

  • L-Histidine
  • L-Histidine hydrochloride monohydrate
  • Magnesium chloride hexahydrate
  • Polysorbate 80
  • Ethanol
  • Sucrose
  • Sodium chloride
  • Disodium edetate dihydrate
  • Water for injections

When will the second part of the vaccine be given?

There should be a minimum interval of 28 days between doses of AstraZeneca COVID-19 vaccine.

It is recommended that the second dose should be administered between 4 and 12 weeks after the first dose.

If an interval longer than the recommended interval is left between doses, the second dose should still be given (preferably using the same vaccine as was given for the first dose if possible). The course does not need to be restarted.

If the second dose is given less than 21 days after the first, it should be discounted and another dose (a third dose) should be given at least 28 days after the dose given too early.

 

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