COVID-19: Do the vaccines stop transmission? How can I volunteer to help? Your questions answered

Saturday 9th January 2021 19:45 GMT

As more people receive the vaccine, including the Queen, more questions are being raised.

Sky News gathered the most Googled vaccine queries - and came up with some of our own questions - to put to Professor Stephen Evans, professor of pharmacoepidemiology at the London School of Hygiene & Tropical Medicine.

1. Does the vaccine stop transmission?

Prof Evans, a clinical trials and drug and vaccine safety expert, said: "We aren't absolutely sure of that and we will need to follow up the use of the vaccines in practice to be more sure.

"The Oxford vaccine took samples from people so they've been able to look at asymptomatic cases, so we are fairly confident that they will at least reduce transmission once they are effective.

"They will start to have some efficacy 14 days after the first jab so will probably reduce transmission, but not totally prevent it before you have your second jab.

"Pfizer didn't do any tests but you can be fairly sure they will prevent asymptomatic cases and transmission."

2. Will we have to have the vaccine every year?

"I don't know, and nobody knows, as we don't know the full protection of it yet," Prof Evans said.

"The way the data looks, you probably won't need a new vaccine every year because of declining efficacy.

"We may, and that's a big 'may', have to if we get new variants that aren't amenable to the vaccine.

"But the indications are it will last at least a year and possibly longer."

3. When will I get the vaccine?

The government has set out a plan to vaccinate the over-70s, healthcare workers, and those required to shield by mid-February - including care home residents and workers.

By spring, it wants millions more vulnerable people to be vaccinated, including: people aged 65-69, then those aged 16-64 with underlying health conditions, followed by 60-64-year-olds, those aged 55-59, and then 50-54-year-olds.

The next phase of the roll-out has not yet been announced.

4. Can the vaccines be mixed?

Prof Evans said: "We don't have the data on mixing them so it's certainly not ideal.

"No one would give one of the vaccines then another if we had an option so if you can avoid it you will.

"But, if somebody has had one of the vaccines and there is none of it at the centre and they are getting towards the end of the 12-week period and they won't be able to get that vaccine, then the consensus of opinion is it's better to give them another vaccine then to leave them unprotected.

"There is going to be a trial of this in the UK and there are theoretical grounds for thinking it could be even more effective doing it that way, but we don't know yet and we wouldn't do it routinely until we knew that.

"There are no grounds for thinking it would be less effective."

5. Which vaccine is the best?

"The problem is we haven't done trials comparing one with another and the evidence is that the mRNA vaccines (Pfizer and Moderna) are not different to one another in efficacy," Prof Evans said.

"They may be more efficacious than the Oxford vaccine but the trials were done in different situations.

"They're not doing trials at the moment, but they will be doing that when they look at the heterologous prime boost trials to see if they can mix them.

"The mRNA vaccines (Pfizer and Moderna) seem to be better but that's much more uncertain.

"We'll fairly soon have a Johnson and Johnson vaccine as well - none have been trialled against each other.

"What is likely to happen is that going forward into 2021 it becomes quite difficult, ethically, to introduce a new vaccine with placebo controls because you would normally only do that when there is no vaccine available.

"In some areas in the world there may be no vaccine available, so some people may want to go for the 50% chance there, but it's unlikely in the UK.

"Going forward, new vaccines will most likely have to be looked at against an approved one, which makes it easier in some respects."

6. Are there adverse effects?

Prof Evans said: "There are undoubtedly the usual short-term effects of vaccines - sore arm, feeling nauseous, getting a temperature or rash. Those can happen quite readily.

"There are no - as far as I know, there's no evidence - there are no serious adverse effects to the vaccines.

"Moderna, there is a very clear directive on the EU website about the sort of things that happen there.

"With any vaccine, you can have a serious allergic reaction, like anaphylaxis, so you have to monitor everyone for 15 minutes and put adrenaline into anyone who gets those.

"Those are quite rare but they can happen, even if you've never had anaphylaxis, but I don't want to scare anyone as it's unlikely.

"You can get minor blood clotting, bruising - you can get that from any vaccine, or lymph nodes slightly raised. The duration is usually pretty short. Most people will get over it within 24 hours.

"I'm part of the Oxford vaccine trial. With the first dose I had a sore arm, but it was so transient I thought I might have been given the meningitis vaccine instead.

"But it turns out older people have the sore arm less than others.

"When I got my second dose I didn't really have a sore arm at all. If you didn't get something like that in the trial then you'd be concerned."

7. Is the vaccine safe if you are pregnant/breastfeeding?

"They weren't tested on pregnant women," Prof Evans explained.

"We have no evidence from those animal studies completed that we see any effects of any of the vaccines on pregnancy outcomes.

"For humans, we haven't had the opportunity to see that yet.

"There's no doubt, pregnant women, if they get COVID they are at slightly higher risk of getting it more severely.

"But these are relative risks. Women of childbearing age are at very low risk of getting COVID and getting it severely.

"I would personally be a bit cautious before advocating pregnant women get the vaccine. But if they have it [and] then find out they're pregnant, I wouldn't say it's bad.

"So many healthcare workers are getting the vaccine and some may be pregnant so we will see that.

"My judgment is unless someone is of very high risk of COVID, I would be very cautious indeed so I would not give it as a blanket policy.

"If it were my granddaughter who was pregnant I would say no, avoid the vaccine, because they're not in grave danger of the disease.

"But I can envisage somebody who is in great danger of the disease, it would be a difficult decision and has to be a difficult decision.

"I'm passionate about women's health and I want women to be protected but you're very unlikely for a new vaccine to include pregnant women in trials until you've got the data.

"I'd be quite cautious, but if there's a situation where getting the disease would be devastating for you, then you'd have to make that decision. It is difficult."

8. Does the vaccine cause infertility?

"No, not a shred of evidence to say that," Prof Evans said.

"There's no obvious mechanism for it having adverse effects on the foetus or mother, or fertility."

9. Is the vaccine live?

Prof Evans said: "They're not what you would call live vaccines, live virus, in the same way as a measles vaccine.

"With the Oxford vaccine, where the carrying element is technically live, it has been modified so it cannot be replicated.

"So no, they're not live in the usual way.

"With a live vaccine, like yellow fever, it is possible to get yellow from the vaccine - although it happens very rarely.

"With these, there's no way you'll get COVID from the vaccines."

10. How many people have had the COVID vaccine?

On 7 January, Boris Johnson said nearly 1.5 million people had had the first dose of the vaccine.

The NHS is aiming to ramp up vaccinations by giving up to two million a week to ensure all people over 70-years-old, the most clinically vulnerable, and frontline health and care workers are immunised by mid-February.

11. How do you volunteer to help administer the COVID vaccine?

St John Ambulance is signing up volunteers who are part of its network already to carry out clinical roles.

They have now opened this up to members of the public who have not previously volunteered with the charity.

NHS Volunteer Respond, set up by NHS England and the Royal Voluntary Service, is recruiting volunteers for a variety of roles that do not need medical training.

The public can sign up to become stewards at vaccination centres, as well as helping with food or medication deliveries, transporting people to medical appointments, or "check-in and chat" phone calls.

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For both options you will need a smartphone, as tasks are sent through an app, and you will need to pass identity checks.

Retired clinicians who did not apply to help the NHS last year can apply to administer the vaccine and/or lead a vaccination team by going to the NHS Professionals website.

They will have to go through vaccine training and the prime minister has now dropped the need for training on issues such as conflict resolution, human rights and counter-radicalisation before they can start.

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