Frequently asked questions

What is the link between the AZ COVID-19 vaccination and blood clots?

There appears to be an as yet unexplained very small risk of blood clots associated with the AstraZenaca COVID-19 vaccine. This vaccine is effective at preventing hospitalisations, intensive care unit (ICU) admissions and deaths due to COVID-19. The side effects are usually mild or moderate and get better within a few days. The most serious side effects are very rare cases of unusual blood clots with low blood platelets, which are estimated to occur in 1 in 100,000 vaccinated people.

Although the risk is tiny compared to the risk of blood clots associated with smoking, or actually COVID-19 infection, the amount of media speculation and concern this has caused has been huge. When assessing the risk to an individual it is important to look at the risk of blood clots and compare this with the risk of COVID-19 infection. There is a clear benefit from having the AZ vaccine for those at greatest risk of infection, but for those at lowest risk of COVID-19 infection the risk:benefit ratio is reduced. For this reason all eligible patients under the age of 30 are now offered an alternative to the AZ vaccine for their first dose.

The new advice regarding the AZ vaccine only applies to first dose. If you are aged under 30 and have already received the AZ vaccine as your first dose you should have the second dose as planned, at the correct time interval, using the same vaccines as your first dose. This currently includes people aged 18 to 29 years who are health and social care workers, unpaid carers and family members of those who are immunosuppressed. Whilst it is expected that the first dose of the vaccine will have given you some protection, particularly against severe disease, having the second dose will give you higher and longer lasting protection against catching COVID-19infection or developing complications.

Unless you have an imminent appointment for your first vaccine we request that rather than contact the practice for advice you access the latest online information COVID-19 vaccination and blood clotting where you can find comprehensive information about the relative risks of COVID-19 infection and vaccination. The practice recommends that all patients follow the recommedations issued by the Medicines and Health Regulatory Agency (MHRA) and the Joint Committee on Vaccinations and Immunisations (JCVI). A statement issued by the JCVI can be accessed by following the link JCVI statement on the AZ COVID-19 vaccine


Do I need a second vaccine dose?

If you have already received the first dose of the vaccine without suffering any serious side effects you should complete the course. The current guidance is that the second dose should be the same type of vaccine as the first dose. Whenever possible patients should attend the same vaccination venue for both doses to ensure that the same vaccine is available and the second dose is administered at the correct time. This includes people aged under 30 years old. Although the first dose of the vaccine will have given you some protection, particularly against severe disease, having the second dose will give you higher and longer lasting protection against catching COVID-19infection or developing complications.

The new advice regarding the AZ vaccine only applies to the first dose. If you are aged under 30 and have already received the AZ vaccine as your first dose you should have the second dose as planned, at the correct time interval, using the same vaccines as your first dose. This currently includes people aged 18 to 29 years who are health and social care workers, unpaid carers and family members of those who are immunosuppressed. 

There are some circumstances where it clearly may not be possible for the patient to attend the same site (e.g. they have moved home or, in between the first and second dose, they have moved to a new GP practice which is not part of the PCN grouping that administered the first dose.) In these circumstances, it would be appropriate for the new provider to administer the second dose. 

Trials are underway to assess if flexibility, i.e. providing the AZ vaccine to those who had the Pfizer vaccine initially and vice versa, offers the same, or even enhanced, protection but it will be some time until results are available and until further information is available the advice is clear - the second dose should be the same vaccine as the first. 

Details of how to book a vaccination appointment are contained in the text message, or will be explained in phone calls or letters to patients. When booking through the  National Booking Service you will be given appointments for both your first and second vaccine doses. You will be asked your 10 digit NHS number, contained in your invitation letter if you have received one, but you can still book an appointment if you do not know your NHS number.  

Link to news

Link to latest COVID-19 update


When I’ve have the vaccine can I stop taking precautions?

No. The vaccines provide a high degree of protection, between 70-94% after the second dose. This means that although you can still catch COVID-19, if you do, the illness should be less severe and the likelihood of you needing hospital treatment should be less. Because of this, and because you may still be able to pass on the infection to others even if you have had the vaccine, it is very important that you continue with all the usual precautions to prevent infection - social distance, face mask and hand


What protection does the first dose of vaccine provide?

On December 31, the Joint Committee on Vaccination and Immunisation decided that vaccinating a greater number of people with a single dose would prevent more deaths and hospitalisations than vaccinating a smaller number of people with two doses. It states the efficacy for the Pfizer/BioNTech vaccine against symptomatic COVID-19 following the first dose is 89% from day 14 after the vaccination is administered.

It also found that the level of protection after a single dose of the AstraZeneca/Oxford vaccine is 73% after 22 days following the first dose.


When is the second dose of vaccine?

Second doses should be offered within 12 weeks of the first, but because of concerns about the Indian variant people over 50 and those with severe underlying health conditions which put them at high risk will now receive their second dose eight weeks later. 

The trials for the Pfizer vaccine recommended an initial interval of 3 weeks between doses. For most vaccines the interval between doses is longer, as this has been shown to achieve the maximum and more prolonged immune response. The short interval for the COVID-19 vaccine may be the result of the speed required to develop and test an effective vaccine. We know the first dose provides high levels of protection after 3 weeks, and that this protection is boosted and prolonged by having a second dose, but the timing of the second dose is still being debated. After reviewing the available evidence, the Joint Committee for Vaccination and Immunisation have concluded that given the high level of protection afforded by the first dose the benefits of vaccinating as many people as possible with a single dose is greater than vaccinating few people with two doses within a three weeks. Prolonging the interval means there is more vaccine available, enabling more people to receive the vaccine as quickly as possible and therefore help prevent more deaths and hospitalisations. The guidance is that the second dose of all the available vaccines should be given between 11 and 12 weeks.

The current guidance is that the second dose should be the same type of vaccine as the first dose. If you have already received the first dose of the vaccine without suffering any serious side effects you should complete the course. This includes people aged under 30 years old.


If I have had COVID-19 am I now protected from catching it again?

A study led by Public Health England shows that most people who have had COVID-19 are protected from catching it again for at least five months. However, although the risk of getting the infection again is lower, compared with those who have never had COVID-19, but some people do catch Covid-19 again, and there is evidence they can still infect others.For this reason it is important that everyone should follow the stay-at-home rules regardless of whether they have had the infection.

Pharmacies and COVID-19 vaccines

Some High Street pharmacies in England are now able to offer vaccinations to people from priority groups. The closest pharmacies offering this service are in Macclesfield, Alsager and Crewe, but more pharmacies will start providing this service, in addition to the larger vaccination centres an PCN run clinics. Only pharmacies that are able to administer a large number of vaccines every week whilst allowing space for social distancing will offer this service, so it is unlikely that more local pharmacies will be able to provide this service at this stage. If you have received an invitation letter from NHS England you can book an online appointment at one of the large vaccination centres or designated pharmacies by clicking here.


Use in Pregnancy and Fertility fears

The Joint Committee on Vaccination and Immunisation has advised that pregnant women should be offered the Pfizer-BioNTech or Moderna vaccines where available, as they become eligible based on their age. Although it is suggested they discuss the risks and benefits of the vaccines with their doctor before making an appointment, this is not a requirement.

This change to advice is based on safety data from the USA where the Pfizer-BioNTech and Moderna vaccines have been used more extensively than in the UK.  There is no evidence to suggest that other vaccines, including the AstraZeneca vaccine, are unsafe in pregnancy but because pregnant women have not been included in trials the data to support their use is not available at this stage.  It is expected more evidence will be available in the future.

There is no evidence that any of the COVID-19 vaccines currently available cause any problems with fertility. The COVID-19 vaccines, though still relatively new, are based on well tested techniques for developing vaccines which have been shown to be safe in pregnancy and have no adverse effects on fertility. They do not contain live, replicating vaccine and in common with other vaccines of this type they are felt to be safe.

No medication taken during pregnancy can be guaranteed to be without risk, but with regard to the vaccine, any risk should be balanced against the risks of COVID-19 infection, particularly if people are highly vulnerable. 


Can vitamin D help fight coronavirus?

The Scientific Advisory Commission on Nutrition and the health watchdog, NICE, have done a review of the evidence. Vitamin D, the 'sunshine vitamin' is produced in the skin when exposed to sunlight, and normally most people spend enough time outdoors to keep their vitamin D levels topped up. During the pandemic more have been staying indoors resulting in a reduction in vitamin D levels. Before the pandemic, people in the UK were already advised to consider taking supplements from October to March, but this should be extended to all year round if sun exposure is reduce, either by staying indoors, or covering up the skin with clothes, or possibly in people with darker skin as the amount of vitamin D the body makes may also be reduced. 

Vitamin D is important for healthy bones, teeth and muscles but there is also the suggestion it may boost the immune system and helps fight off infections. Although the evidence from research is inconsistent the government has decided to make vitamin D supplements free to vulnerable people at greatest risk from COVID-19 infection. Four months supply can be obtained free (visit https://www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/get-vitamin-d-supplements/) but applications have to be made by 21/2/21. Fortunately vitamin D is cheap to buy over the counter and is readily available from pharmacies, supermarkets and health food shops. The recommended dose of vitamin D is 10 microgram (400 international unit) daily.

Face covering guidance

Government advice on the use of face coverings can be found here http://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers#face-coverings This guidance states that people who are deemed clinically extremely vulnerable, including those with health, age or equality reasons, don’t have to wear a face covering. There is no requirement to produce evidence for exemption. Therefore Holmes Chapel Health Centre WILL NOT provide exemption letters. We would strongly encourage all people to wear a face covering/mask in enclosed public places. Keep safe and well. 

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