We’ve already seen some noise develop around the shift to vaccinate as many people with one dose initially and extend the gap to the vaccination schedule of two doses 28 days apart. Having read as much of the science as I can find I for one support this. And here’s why

The four chief medical officers of the U.K. have issued a statement here on this https://www.gov.uk/government/news/statement-from-the-uk-chief-medical-officers-on-the-prioritisation-of-first-doses-of-covid-19-vaccines

The statement makes clear we are in dangerous times with the pandemic and we need to act to prevent as much serious illness as we can as an initial goal on the way to building population immunity from two doses

One way of doing that is five lots of people a single dose. It can reduce severity of disease and could save lives as well as helping the system cope with the sheer volume of suffering going on right now.

The 2nd doses are delayed not cancelled. By up to twelve weeks. The ultimate strategy remains to achieve what the joint committee on immunisation and vaccination want, two doses for all who get it. This is just taking a detour to try and get an extra benefit out of the vaccine.

Will it work? Well, there’s no 100% guarantee but it’s worth a try because it will get a reasonable level of immunity out there and also reduce severe disease in those who get it

That will make the pandemic more manageable but also give us a foothold to ramp up other aspects of suppression.

But this will ONLY work if the rest of us rigorously adhere to distancing, hand hygiene, mask wearing and self isolation when symptomatic or asked to do so . So if we don’t do our bit, don’t expect this to be a magic bullet anymore than two doses vaccination is.

The more people infected the more we will have to put staff time into care not vaccinating people . I suspect one of the reasons we’re doing one dose now is because that is already happening and we can’t sustain it without people dying

Yes we need test and trace to ramp up. But we must pull together. If we don’t do our bit, we will be in restrictions for far longer. It is that simple

As the Irish proverb says - “we live in each other’s shelter” - what we do to exit this pandemic affects others directly. The current hospital crisis draws that picture as starkly as any I have seen.

A crucial factor in this vaccine being successful is people being willing to have it. I will definitely have it when offered. But the more noise the more difficult it is for people to make rational decisions

Opinion polls show a minority of people will refuse this vaccine. But many people have real questions - I try to regard every question asked of me about the vaccine as a real question not an anti-vaxxer.

The more noise and dissent we create - and frankly some of the unedifying noise about postpones second dose is about promised payments to bits of the system and not about the science - the more we create hesitancy and the fewer people get vaccinated

There’s enough noise and dissent and misinformation about the vaccine out there to confuse people no end. So I want to make a plea. Let’s pull together, get behind this and try to make it work

No it isn’t perfect. Yes, it raises new questions. But it’s a pragmatic and from what I can see safe and sensible approach. So I for one will support it. Science isn’t perfect, especially in the eye of a storm like this.

If it doesn’t work, we have a whole pile of people needing 2nd doses. If it does work, not only do we get immunity but we get reduction in severe disease and possible some viral suppression here. That could help us get out of this. A stratagem worth trying in these times, imho.

The worst that could happen is it doesn’t work as well as we thought and we need to ramp up the second dose quickly. The best that could happen is we begin to exit the worst of this.

@ADPHUK have a rule of thumb in this pandemic - we will be as constructive as we need to be and as challenging as we have to be. I’m hoping it’ll catch on. This is the time to be constructive

Its also worth saying that the evidence the MHRA considered with the oxford/AZ vaccine suggested some good evidence that one dose then delaying it by 12 weeks makes the second function as a booster. thats a good sign which supports the tactic announced by the four CMOs

I commend to you threads by folk way more expert than I will ever be on this. Sandy douglas a vaccinologist whose expertise and judgement i trust implicitly https://twitter.com/sandyddouglas/status/1344949258483621888?s=20

And peter openshaw https://twitter.com/p_openshaw/status/1344941849874731008?s=20

You can find more written detail about the rationale for the joint decision on vaccine rolled out of the four CMOS here https://www.cas.mhra.gov.uk/ViewandAcknowledgment/ViewAlert.aspx?AlertID=103132.

It is unfashionable to trust experts these days. Contrary to people who seem to think expertise doesn’t matter, it does. The expertise of folk like Adam Finn and others on JCVI is authoritative. I will heed it.

By way of update the Chair of the Royal College of GPS has written today supporting the views of the Four CMOS on vaccination strategy @rcgp https://rcgp-news.com/49LX-ZHC8-6EDA1D8373791E23UTSH309976D73E3646553/cr.aspx