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The new strategy, announced Wednesday by the head of the UK’s medicines regulator MHRA, means that the interval between doses could be extended to up to 12 weeks, instead of the three weeks previously stipulated.

It has prompted a debate among experts, with the British Medical Association (BMA), a body representing UK doctors, criticizing the move to postpone appointments for the very vulnerable patients currently awaiting their second shots.

The Pfizer/BioNTech vaccine has been in use in the UK since early December, when the country became the first in the world to approve it, but supplies are limited.

The argument over the vaccination strategy comes as infection rates soar in much of the UK, thanks in part to a new, more infectious variant of the virus. Most of England is now under the toughest level of restrictions to try to limit the virus’ spread.

“This group of very elderly patients is at the highest risk of death if they contract Covid-19, which is why GPs are so concerned for them. It is grossly and patently unfair to tens of thousands of our most at-risk patients to now try to reschedule their appointments,” Dr. Richard Vautrey, chair of the BMA General Practitioners Committee, said in a statement Thursday.

The Doctors’ Association UK also raised “real and grave concerns” over the new vaccination strategy, warning Friday that it could undermine the National Health Service’s patient consent process, “as well as completely failing to follow the science.”

Meanwhile, Pfizer said it did not have data to demonstrate that just a single dose of its vaccine would provide protection against the disease after more than 21 days.

“Pfizer and BioNTech’s Phase 3 study for the Covid-19 vaccine was designed to evaluate the vaccine’s safety and efficacy following a 2-dose schedule, separated by 21 days,” Pfizer said in a statement on Thursday. “There are no data to demonstrate that protection after the first dose is sustained after 21 days.”

But the chief medical officers for England, Scotland, Wales and Northern Ireland defended the move in a letter to healthcare professionals published Thursday, saying it was based on the “balance of risks and benefits,” and that the “great majority” of initial protection came from the first jab.

“The second vaccine dose is likely to be very important for duration of protection, and at an appropriate dose interval may further increase vaccine efficacy,” they said.

“In the short term, the additional increase of vaccine efficacy from the second dose is likely to be modest; the great majority of the initial protection from clinical disease is after the first dose of vaccine.”

‘Terrible impact’ on emotional well-being

The BMA warned in its statement that the delay could have a “terrible impact on the emotional well-being” of vulnerable and at-risk patients.

“The BMA believes these are patients that have already been promised, by the NHS and local clinicians, that they will receive a second dose of Pfizer vaccination next week; they have given their consent to receive it and, quite rightly, are expecting to have it,” the BMA said.

Vautrey, the BMA chair, told CNN Friday that healthcare professionals were particularly concerned about the “practicality of doing this so quickly,” with little warning given to practitioners on the revised guidance.

“We were only told in the last day that we are expected, next Monday, to re-change all of the appointments that we made for next week… it was simply not practical for our practice staff to do that in such a short space of time,” Vautrey said.

“We wanted the commitments that we made to our elderly patients to give their vaccine to be honored, certainly in the next few days.”

Helen Salisbury, a general practitioner in the English city of Oxford, told the BBC’s Today program Friday that her practice had not as yet canceled existing second appointments next week. This was because, firstly, she had been unable to find any data on immunity after the first dose beyond the 21 days when the booster was given in trials, and secondly, because the practice wanted to protect its most vulnerable patients, the elderly, and maintain their trust in the vaccine.

“When you have started a patient on a course of treatment and you have said, this is what the plan is, here’s one jab, please come back in three weeks, it’s really important that you have the second jab to be fully protected — and then to turn round five minutes later and say no, don’t worry about that, you can have it in 12 weeks rather than three weeks — I don’t think that’s good enough, actually,” she said.

The latest on the coronavirus pandemic and vaccines

In their letter, the chief medical officers said they recognized the operational difficulties and potential distress involved in rescheduling second appointments at short notice.

“However, we are all conscious that for every 1,000 people boosted with a second dose of Covid-19 vaccine in January (who will as a result gain marginally on protection from severe disease), 1,000 new people can’t have substantial initial protection which is in most cases likely to raise them from 0% protected to at least 70% protected,” they said.

Pfizer said it had not evaluated different dosing schedules because “the majority of trial participants received the second dose within the window specified in the study design.”

In its open letter, the Doctors’ Association UK wrote: “Protection provided by the first dose of the Pfizer vaccine is considerably lower at 52.4% compared to 95% if two doses given three weeks apart.”

Vautrey told CNN that greater assurances would be needed from both the UK chief medical officers and Pfizer in order to give healthcare professionals and patients confidence in the government’s strategy.

“We need Pfizer themselves to be confident that this new dosage regime is going to deliver effective coverage and protection to our patients, particularly our most vulnerable patients,” Vautrey said.

UK regulators have also advised giving the second dose of the newly approved Oxford/AstraZeneca vaccine, which is due to be rolled out from Monday, four to 12 weeks later.

US also considering spacing out jabs

The strategy of extending the interval between first and second vaccine doses is also “under consideration” in the United States, National Institute of Allergy and Infectious Diseases Director Anthony Fauci said Thursday.

Two vaccines have so far been approved for use in the US, the Pfizer/BioNTech shot and another made by Moderna, which requires a second dose 28 days later.

US officials promised 20 million vaccinated against coronavirus by the end of the year. It's going slower than that

“I still think, if done properly, you can do a single dose, reserve doses for the second dose, and still get the job done,” Fauci said on NBC’s Today Show, “but there’s a lot of discussion about whether or not you want to spread out the initial vaccination by getting more people vaccinated on the first round.”

Fauci said it could be debated either way, but a potential problem would be if a person didn’t get the second dose in time and there was a lag period.

He said it was known from the clinical trials that “the optimal time is to give it on one day and then for Moderna 28 days later and for Pfizer 21 days later, that’s what the data tells us is the best way to do it.”

If you want to stick with the data, that’s how it should be done, he said, “but you can make an argument, and some people are, about stretching out the doses by giving a single dose across the board and hoping you’re going to get the second dose in time to give to individuals.”

UK Prime Minister Boris Johnson struck an optimistic note on vaccines in an address on New Year’s Eve.

“We have a hard struggle still ahead of us for weeks and months because we face a new variant of the disease that requires a new vigilance,” he said.

“But as the sun rises tomorrow on 2021, we have the certainty of those vaccines. I believe 2021 is, above all, the year when we will eventually do those everyday things that now seem lost in the past, bathed in a rosy glow of nostalgia — going to the pub, concerts, theaters, restaurants, or simply holding hands with our loved ones in the normal way.”

CNN’s Niamh Kennedy and Vasco Cotovio contributed to this report.

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Pelosi to move forward with impeachment if Pence doesn’t act to remove Trump

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“In protecting our Constitution and our Democracy, we will act with urgency, because this President represents an imminent threat to both,” Pelosi said in the letter to Democrats on Sunday night laying out next steps.

The House will try to pass a measure on Monday imploring Pence to invoke the 25th Amendment, through which he and the Cabinet declare Trump “incapable of executing the duties of his office, after which the Vice President would immediately exercise powers as acting president.” If Republicans object, as is virtually certain, Democrats will pass the bill via a roll call vote on Tuesday.

“We are calling on the Vice President to respond within 24 hours,” Pelosi wrote. “Next, we will proceed with bringing impeachment legislation to the Floor.”

But it’s not clear when exactly the Senate will take up the House’s measure. The Senate isn’t scheduled to return until Jan. 19, but will hold pro forma sessions on Tuesday and Friday. In theory, a senator could try to pass the House resolution by unanimous consent, but as of now it appears unlikely that it would pass.

On Monday, multiple House Democrats plan to introduce impeachment resolutions that would become the basis of any impeachment article considered by the House later this week.

Rep. David Cicilline (D-R.I.), who will introduce an article of impeachment against Trump on Monday, said on Sunday that roughly 200 Democrats have co-sponsored the measure.

Currently, 211 voting members (plus three nonvoting members) support Cicilline’s legislation, and they are hoping to reach 217 voting members by Monday morning, enough for the House to impeach Trump, one Democratic source familiar with the matter told POLITICO.

A small number of Democrats have opted not to co-sign the bill, but privately say they will vote to support the resolution on the floor, the source added.

The impeachment effort in the House is likely to be bipartisan, with Democrats expecting at least one GOP lawmaker — Rep. Adam Kinzinger of Illinois — to sign on. A handful of other House Republicans are seriously weighing it, according to several sources, though those lawmakers are waiting to see how Democrats proceed, and some are concerned about dividing the country even further.

Among the GOP members whom Democrats are keeping an eye on are Reps. John Katko of New York, Brian Fitzpatrick of Pennsylvania, Fred Upton of Michigan, Liz Cheney of Wyoming and Jaime Herrera Beutler of Washington.

Across the Capitol, at least two Republicans — Sens. Pat Toomey of Pennsylvania and Lisa Murkowski of Alaska — have called on Trump to resign. On Saturday, Toomey told Fox News, “I do think the president committed impeachable offenses,” but told CNN the next day that he does not believe there is enough time to impeach.

Sen. Ben Sasse (R-Neb.) has also said he would consider articles of impeachment.

Another option has emerged among some Republican and moderate Democratic circles — censuring Trump — though it remains highly unlikely to advance.

A censure resolution would gain far more support in the GOP than impeachment. Some Republicans have privately been pushing for that route and are trying to get Biden on board, according to GOP sources. That group of Republicans is also warning that impeachment could destroy Biden’s reputation with Republicans.

But censure is considered a nonstarter in an incensed House Democratic Caucus, where members see it as a slap on the wrist that gives Republicans an easy out.

The Democrats’ enormous step toward impeachment on Sunday comes after Pelosi and other top Democrats held a private call on Saturday night in which they discussed the potential ramifications that a lengthy impeachment trial could have on Biden’s presidency.

Democratic leaders discussed several options to limit the political effects on Biden’s first 100 days, with one option — floated by House Majority Whip Jim Clyburn (D-S.C.) — for the House to delay the start of an impeachment trial in the Senate by holding on to the article of impeachment.

Senate Majority Leader Mitch McConnell (R-Ky.) has sent out a memo to senators explaining that the Senate could not take up impeachment until Jan. 19 at the earliest, absent unanimous consent.

A final decision has not been made, and House Democrats will discuss the matter on a 2 p.m. caucus call on Monday.

Lawmakers are already privately expressing concerns about returning to the Capitol for multiple days this week, worried about both a potential coronavirus outbreak and whether the building is secure, given how easily an armed pro-Trump mob invaded on Wednesday.

The Capitol physician urged House lawmakers and staff to get tested in a memo Sunday, saying they might have been exposed to someone who had the virus while huddling for safety in a large committee room for hours on Wednesday. During the hourslong lockdown, several Republican members refused to wear masks despite being offered them by Democrats worried about the spread of the deadly virus.

Melanie Zanona, Olivia Beavers and Marianne LeVine contributed to this report.

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Matt Hancock Scraps “Unnecessary Training Modules” Blamed For Slowing Vaccine Rollout

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Matt Hancock has agreed to remove some of the training modules required for volunteers to sign up to deliver the Covid-19 vaccine (PA)


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Matt Hancock said people will no longer need to undertake training including an anti-terrorism course to give the coronavirus jab after MPs said “bureaucratic rubbish” was delaying mass vaccination.

It comes as MPs called for the government to produce targets for the number of people given immunity before lockdown can be lifted.

The health secretary said a series of “unnecessary training modules” are being scrapped to speed up the process of getting people qualified to deliver the jab.

Speaking in the Commons, Sir Edward Leigh said he was shown by his fellow the Tory MP, a qualified GP, the “ridiculous form” he had filled out to start delivering the vaccine.

“When he’s inoculating an old lady, he’s not going to ask her if she’s come into contact with Jihadis or whatever, so the Secretary has got to cut through all this bureaucratic rubbish,” he said.

In response Mr Hancock said: “I am a man after Sir Edward’s heart and I can tell the House that we have removed a series of the unnecessary training modules that had been put in place, including fire safety, terrorism and others.

“I’ll write to him with the full panoply of the training that is not required and we have been able to remove, and we made this change as of this morning and I am glad to say it is enforced.

“I am a fan of busting bureaucracy and in this case I agree with him that it is not necessary to undertake anti-terrorism training in order to inject vaccines.”

Dr Fox had earlier challenged Boris Johnson to drop the “bureaucracy” and “political correctness” of the forms vaccine volunteers must fill out.

He told MPs: “As a qualified but non-practising doctor, I volunteered to help with the scheme and would urge others to do the same. 

“But, can I ask the Prime Minister why I’ve been required to complete courses on conflict resolution, equality, diversity and human rights, moving and handling loads and preventing radicalisation in order to give a simple Covid jab?”

Mr Johnson said he had been “assured by the Health Secretary that all such obstacles, all such pointless pettifoggery has been removed”.

The government has been attempting to recruit thousands of volunteers to help with a mass vaccination programme, and with the recent approval of the more easily deliverable Oxford/AstraZeneca version has today revealed the location of seven mass vaccination centres set to open next week.

The Prime Minister’s official spokesman told journalists at a briefing they would be at Robertson House in Stevenage, the ExCel Centre in London, the Centre for Life in Newcastle, the Etihad Tennis Centre in Manchester, Epsom Downs Racecourse in Surrey, Ashton Gate Stadium in Bristol and Millennium Point in Birmingham, and it is expected they will be run with a combination of NHS staff and volunteers.

But so far the government has not said how many people need to be inoculated before it has an impact on the coronavirus restrictions.

Mr Hancock was asked by a number of MPs if the measures could be eased once the top few tiers in the vaccine priority list had been clear.

Former Conservative chief whip Mark Harper said once the top four groups, which includes care home residents and staff, frontline NHS workers, the clinically extremely vulnerable and everyone over 70 “we’ve taken care therefore of 80% of the risk of death”.

Adding: “What possible reason is there at that point for not rapidly relaxing the restrictions that are in place on the rest of our country?”

The health secretary replied: “We have to see the impact of that vaccination on the reduction in the number of deaths, which I very much hope that we will see at that point, and so that is why we will take this – an evidence-led move down through the tiers, when we’ve broken the link, I hope, between cases and hospitalisations and deaths.”

The ex-Tory minister and another doctor, Andrew Murrison, said: “The logic of anticipating what is going to happen in two or three or four weeks’ time from the number of cases we are getting at the moment is that we can do the same in reverse.

“That is to say, when we have a sufficient number of people vaccinated up we can anticipate in two or three or four weeks’ time how many deaths have been avoided. 

“That means, since it cuts both ways he will be able to make a decision on when we should end these restrictions.”

Mr Hancock replied: “The logic of the case that Dr Murrison makes is the right logic and we want to see that happen in empirical evidence on the ground.

“This hope for the weeks ahead doesn’t take away, though, from the serious and immediate threat posed now.”

The Cabinet minister said the challenge for the government is to increase the amount of doses available, claiming “the current rate-limiting factor on the vaccine rollout is the supply of approved, tested, safe vaccine”.

He added: ”We are working with both AstraZeneca and Pfizer to increase that supply as fast as possible and they’re doing a brilliant job.”

But Labour’s shadow health secretary Jonathan Ashworth called for the government to ramp up its vaccination programme to six million doses a week.

He told the Commons: “The Prime Minister has promised almost 14 million will be offered the vaccine by mid-Feb. That depends on around two million doses a week on average.

“Both [Mr Hancock] and the Prime Minister have reassured us in recent days that it’s doable based on orders.

“But in the past ministers have told us that they had agreements for 30 million AstraZeneca doses by September 2020 and 10 million of Pfizer doses by the end of 2020.

“So, I think people just want to understand the figures and want clarity. Can ministers tell us how many of the ordered doses have been manufactured?”

Mr Ashworth added: “Two million a week would be fantastic but it should be the limit of our ambitions, we should be aiming to scale up to three, then five, then six million jabs a week over the coming months.”

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How South African police are tackling pangolin smugglers

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Quiet, solitary and nocturnal, the pangolin has few natural enemies, but researchers believe it is the most trafficked mammal in the world. The tough scales covering its body are sought after for use in Chinese medicine, in the erroneous belief that they have healing properties.

The animal has also been of interest to researchers during the coronavirus pandemic. Related viruses have been found in trafficked pangolins, though there is continued uncertainty around early theories that pangolins were involved in the transmission of the virus from animals to humans.

After South African police seized a pangolin from suspected smugglers, BBC Africa correspondent Andrew Harding witnessed how vets tried to save the animal’s life.

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