COVID-19 Vaccination

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.

There are currently three vaccines authorised for supply in the UK. The Pfizer (BioNTech), AstraZeneca (Oxford) and Moderna Vaccine.

The Mass Vaccination Centres in Swansea Bay currently provide Pfizer (BioNTech). You can access the Pfizer/BioNTech COVID-19 vaccination. You can access the Pfizer/BioNTech COVID-19 vaccination Patient Information Leaflet here
The Information for Healthcare Professionals is available here

  • As a General Practice surgery, Castle Surgery provides AstraZeneca (Oxford). You can access the Vaccine AstraZeneca Patient Information Leaflet here
    The Information for Healthcare Professionals is available here
  • The Green Book has the latest information on vaccines and vaccination procedures, for vaccine preventable infectious diseases in the UK. The latest update on COVID-19 vaccinations was released on 12th February 2021 and can be found here.
  • For information about allergy and anaphylaxis relating to COVID-19 Vaccines, please click here.
  • Information from the Welsh Government about Covid Vaccines can be found https://gov.wales/vaccine-coronavirus
  • Regarding concerns raised about vaccine safety, ‘AstraZeneca: UK and EU clot reviews confirm safety of vaccine’. Source: BBC
  • If you are 80 or over or classed as Clinically Extremely Vulnerable (CEV or someone who has a shielding letter) we will contact you.
  • If you are between 70 and 79 email SBU.COVIDbookingteam@wales.nhs.uk or ring 01792 530606 between 10am and 3pm Monday to Saturday.
  • Frontline social care staff can email westglamsocialcarevaccinations@swansea.gov.uk
  • Frontline health board staff should contact their line manager

Updates

Source: SwanseaBay NHS, Correct as of 2nd March 2021

Unpaid carers. We now have confirmation of how unpaid carers will get their vaccinations as part of priority group 6.

How?

There are only two ways for unpaid carers to get the vaccination:

  1. Automatically because you are already on your GP practice’s carers’ register. (If you are not already on the register, DO NOT contact your GP now. Please go to point 2.)
  2. By filling in an online form and being accepted. (Note: This form will be available on our health board website from Monday, March 8th. Our website address is https://sbuhb.nhs.wales/  A direct link to our special website pages and the form will be published on our main health board social media feeds on Facebook and Twitter from Monday and included in next Tuesday’s newsletter. We are also hoping to have a telephone number via the carers’ centre.

When you open the form you will be asked to answer questions on the person you care for and the care you provide. You will also be asked to give your personal details. Upon completion of the form you will be told if you are eligible for prioritisation for vaccination under group 6.)

  • Eligibility for prioritisation as an unpaid carer in group 6 is not dependant on receipt of carer’s allowance, membership of a carers’ organisation or being known to social services.   
  • Young carers under 16 will not be offered the vaccination. No children under 16 are being vaccinated, unless in exceptional circumstances due to severe neuro disabilities.

Need to know if you’re eligible?

Go to this page on the Welsh Government website for the full guidance on which unpaid carers will be prioritised for vaccination under group 6.

Pages giving details on eligibility and a comprehensive list of frequently asked questions will also go live on our health board website soon.

When will I be vaccinated?

Vaccinations should start on Monday, March 8th and run until April 19th. However, this is dependent on vaccine supply.

Where will unpaid carers receive their vaccinations?

Most unpaid carers will be vaccinated by their GP practice.

But if you are registered with Abertawe Medical Practice, Brunswick, Nicholl Street, University, Dyfed Road, Uplands & Mumbles and Mount surgeries, you will be called to a Mass Vaccination Centre (MVC.)

Some patients registered with Fforestfach Medical Group, Victoria Gardens and Kingsway practices may also be called to an MVC.

Vaccination of those with learning disabilities and serious mental illness as part of priority group 6. The Welsh Government has made it clear that it’s approach is inclusive, which means no one who is vulnerable in these groups is missed or left behind.

If you or a loved one are already registered with your GP practice as having a learning disability or severe mental illness, you or they will automatically be called for vaccination under group 6.

Our community mental health and learning disability teams, partners in local councils and charities and, where appropriate, specialist services such as substance misuse services and families and carers will also be asked to identify whose with learning disabilities and mental illness who should be prioritised for vaccination under group 6.

If you or a loved one live in supported accommodation, you or they will also be contacted for vaccination.

Vaccinations should start on Monday, March 8th and run until April 19th. However, this is dependent on vaccine supply.

Most of the vaccinations will be done in GP surgeries. But if you are registered with Abertawe Medical Practice, Brunswick, Nicholl Street, University, Dyfed Road, Uplands & Mumbles and Mount surgeries, you will be called to a Mass Vaccination Centre (MVC.)

Some patients registered with Fforestfach Medical Group, Victoria Gardens and Kingsway practices may also be called to an MVC.

Go to this page on the Welsh Government website for the full guidance on vaccinations for individuals with a learning disability or severe mental illness.

Housebound patients waiting for vaccination. We know there are still some housebound patients waiting for their first vaccination. GP practices are aware and will arrange appointments as soon as possible. However, to ensure there is no vaccine wastage the practice must wait until they have a round of 9 or 11 vaccines to do, depending on the size of the vial. Covid vaccine vials contain either 9 or 11 doses.

Pregnant women. The pathway for pregnant women to receive the Covid vaccination is almost ready. We hope to bring you the details in next week’s newsletter.

Covid vaccination timetable – first doses. Here’s an updated timetable for first dose vaccinations in Swansea and Neath Port Talbot. (Please note all dates are estimated based on current information on vaccine supply and are subject to change if supply quantities or delivery dates change.)

  • Group 5, ages 69 to 65 – You will be called to a Mass Vaccination Centre between February 15th and March 10th.
  • Group 6, people with underlying health conditions, unpaid carers, people with learning disabilities and severe mental illness – Most people in group 6 will be vaccinated by their GP practice. But if you are registered with Abertawe Medical Practice, Brunswick, Nicholl Street, University, Dyfed Road, Uplands & Mumbles and Mount surgeries, you will be called to a Mass Vaccination Centre (MVC.)

Some patients registered with Fforestfach Medical Group, Victoria Gardens and Kingsway practices may also be called to an MVC. Vaccinations will take place between March 8th and April 19th.

  • Group 7, ages 64 to 60 – You will be called to an MVC between March 22nd and March 29th.
  • Group 8, ages 59 to 55 – You will be called to an MVC between March 29th and April 8th.
  • Group 9, ages 54 to 50 – You will be called to an MVC between April 9th and April 19th.

Covid vaccination timetable – second doses. Here’s an updated timetable for second dose vaccinations in Swansea and Neath Port Talbot. (Please note all dates are estimated based on current information on vaccine supply and are subject to change if supply quantities or delivery dates change.)

Pfzer-BioNTech

  • If you had your first dose week beginning January 18th, your second dose should take place week beginning March 1st or March 8th.
  • First dose week beginning January 25th, your second dose should take place week beginning March 8th or 15th.
  • First dose week beginning February 1st, your second dose should take place week beginning March 15th or March 22nd.
  • First dose week beginning February 8th, your second dose should take place week beginning March 22nd.

Oxford-AstraZeneca

  • The second doses for those living in care homes were due to start this week.
  • The second doses for everyone else will be 11 weeks from the first dose, beginning on March 22nd.

Immbulance. Sixty-six-year-old Linda Sanders became the first person to receive an injection in our new vaccination clinic on wheels on Thursday, February 25th.

The Primark worker from Clase in Swansea boarded the Immbulance, which had a two-day trial run at the city’s Guildhall.

The Immbulance is now operational and is vaccinating people in and around these locations this week:

  • Wednesday, March 3rd – Cwrt Herbert in Neath.
  • Thursday, March 4th – Croeserw Community Enterprise Centre car park.
  • Friday, March 5th – The library in Cwmafan.

Vaccinations on the Immbulance are by appointment only. The public are urged not to turn up unless they have been sent an invitation.

People on dialysis get Covid vaccine in record time. People on life-saving dialysis who had been living in fear since the start of the pandemic have now been vaccinated in record time.

Patients with kidney failure are extremely vulnerable to the virus yet are unable to shield because they need regular dialysis to stay alive.

Now hundreds of patients living across South West Wales have been given their first dose following a fast-moving operation coordinated by a specialist team based at Morriston Hospital.

They worked with renal staff across South West Wales to give the vaccine to patients who were attending their routine sessions in dialysis units ranging from Swansea to Aberystwyth.

Those first doses were delivered to around 400 patients within days, with a 99 per cent take-up and not a single dose wasted.

Go to this page on our website to read the full story of how patients on dialysis were vaccinated within days.

People living in Swansea and Neath Port Talbot can now go for a free Coronavirus test if they have a wider range of symptoms.

As well as the three classic signs: fever, a new continuous cough or a loss/change of taste and smell; people are now able to get a test if they have other symptoms too:

  • Flu-like symptoms including any or all of: myalgia (muscle ache or pain); excessive tiredness; persistent headache; runny nose or blocked nose; persistent sneezing; sore throat and/or hoarseness, shortness of breath or wheezing;
  • Generally feeling unwell and a history of being in contact with a known COVID-19 case
  • Any new or change in symptoms following a previous negative test.

If you have any of the new symptoms and want a test, ring 119 or book online: Go to this Welsh Government page for details on how to book a test online.

As these are national contacts, you may automatically be asked about the classic three symptoms.

However, simply choose either option: “you have been asked to take a test by your local council” or “you are part of a government pilot project” to book your test.

You can also ring our local number: 01639 862757 and speak to an operator who will book your test. (Local operators will be briefed about the new local testing regime.)

The change is happening to help find hidden COVID-19 cases in our communities, and drive down the numbers of onward transmissions

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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