COVID vaccine side-effects, fertility and jab shortages - Van-Tam answers your questions

·6-min read

England's deputy chief medical officer Professor Jonathan Van-Tam has appeared on Sky News to answer some questions from the public on the coronavirus crisis.

He shared his perspective on the public's queries and concerns on topics including the vaccine rollout, vaccine hesitancy and lifting the lockdown.

Below are some of the key things from the Q&A, followed by a short analysis from science correspondent Thomas Moore, who offers his insight on each answer.

1. Since we hit the first 15 million jabs target there has been a drop-off in the daily vaccination numbers. Why?

"That's really very simple to explain. There are always going to be supply fluctuations. These are new vaccines and by and large the manufacturers have never made them or anything like them before," Professor Van-Tam said.

Using one of his now-famous analogies Prof Van-Tam compared the manufacture of vaccines to beer-making. He said you set the equipment up and let it do its thing. He said the end product is not always the same and that the yield might be different each time.

"You do get batch size variations and that's natural." He says it's going to take few months for manufacturers to get a confident and steady routine.

He said there are global supply restraints but that the UK is in an "amazing place in the world". He says he thinks the numbers will pick up again.

Thomas Moore says: Supply is the big uncertainly in the vaccine rollout timetable. Both AstraZeneca and Pfizer have had problems in scaling up production to meet delivery targets. The analogy with beer-making is good - but vaccines have to meet the strictest tests on quality, sterility and stability and that's a high bar.

2. How concerned are you about vaccine hesitancy in ethnic and working class communities?

"I am concerned about this," he said, and says the NHS is set to reveal data on this issue.

Prof Van-Tam pointed out that this has been an issue with any vaccines for "decades" - particularly in areas of high deprivation.

"We need very high uptake" to give us the best chance of going "where we really want to be" with the roadmap, he said.

Professor Van-Tam added there is no "magic number" of uptake required, and the aim isn't herd immunity - and adds that he's been pleasantly surprised by uptake.

Thomas Moore says: There are complex reasons why some communities may not respond as well to health information - not just on vaccination, but screening tests and advice on healthy eating. The government will have to tailor its pitch to address the reasons why any one group may be reluctant to come forward. A high uptake, even if it doesn't achieve herd immunity, is the only way to reduce the virus to low levels in the population. These vaccines are not 100% effective, so there will always be some elderly people still vulnerable to the disease.

3. How do you know the vaccine will not affect my chances of infertility?

"First of all it is just not biologically logical that they would. Secondly, no vaccine has ever done this," Professor Van-Tam said.

"Getting COVID does affect your long-term chances of life and that's a pretty important counter-balance."

Thomas Moore says: Good myth-busting from JVT. There is some rubbish being spread on social media and he is right to dismiss it.

4. With schools heading back on 8 March why are we not vaccinating teachers as a priority?

Prof Van-Tam said the UK is vaccinating as a priority the people who have the highest risk of dying from COVID-19.

He says once that is done, the country will vaccinate those at the highest risk of being hospitalised with COVID.

He said data shows for teachers of both sexes the rate of death between 9 March and 28 December 2020 has been 18.4/100,000 for men and 9.8/100,000 for women.

If you compare that with the same age and sex population, the figures are lower than those - 31.4/100,000 for men and 16.8/100,000 for women.

"It is clear there is no excess mortality overall in teachers," he said, adding that any teachers who are at risk will be "picked up" by the JCVI (Joint Committee on Vaccination and Immunisation) and vaccinated faster.

Thomas Moore says: Actually some data shows that male teachers in secondary schools are at higher risk than other professions. But generally teachers are at no more risk and squeezing them in between the current priority groups risks slowing the rollout to people more likely to end up in hospital. Once all over-50s have had the jab there would be a good case to put teachers, and other professions with high public contact, front of the queue. But the NHS records birth date not occupation - so, again, age is judged the fastest way of protecting all adults.

5. Why does COVID impact some people more than others?

Prof Van-Tam said risk factors for how seriously ill people get with COVID is down to "age, age, and age - it's the absolute driver and the biggest factor".

He said other factors include underlying health conditions, and men are more badly affected - consistently across the ages, as well as the obese.

"We know why it's more likely to be serious for some than it is for others," he said.

He added: "If you take two 50-year-old males, why does one have milder symptoms and one ends up in ICU? That's because the body's immune response is different in people in relation to COVID infection, and we don't know all the answers to that yet."

Thomas Moore says: This virus is a puzzle. How can it kill some but not even cause symptoms in others. After more than a year of study we still don't know the underlying immunological effect of the virus. And without knowing the root cause it's hard to develop effective treatments

6. How and when will we know if we will need a booster shot in winter?

Prof Van-Tam said we need further data on how immunity protection lasts after people have had the current vaccines.

He said the emergence of new variants also needs to be watched carefully as they do have the potential to "outwit" the current vaccines.

He said we could end up revaccinating if immunity does not last in some parts of the population or because of the development of new variants.

But he added that all of the vaccine data has shown that they are "absolutely working against the so-called Kent variant".

Thomas Moore says: The expectation of most scientists is that we will have to give a booster, at least to the most vulnerable, and probably this autumn. The variants won't just be brought back from abroad as people start to travel again, they can be homegrown. Both the original UK virus and the Kent variant have mutated to evade the immune system. And as more people develop antibodies through infection or vaccination around the world the virus is put under increasing evolutionary pressure to mutate to survive.

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