How Much Time To Leave Between Your Two Pfizer Vaccine Doses

Leaving eight weeks between your first and second dose of the Pfizer Covid-19 vaccine is the optimum gap for immunity and protection, say scientists.

A new study, funded by the Department of Health and Social Care has found that a 10-week gap between doses produces higher antibody levels, as well as a higher proportion of infection-fighting T cells, compared to just four weeks.

However, scientists involved in the study have described an eight-week dosing interval as the “sweet spot” when it comes to generating a strong immune response while also protecting the UK population against the Delta variant of coronavirus – to which people can still be vulnerable after just one jab.

At the start of the second wave of the Covid-19 epidemic, the Joint Committee on Vaccination and Immunisation (JCVI) decided to recommend 12 weeks between two doses for the two vaccines that were available at the time: Pfizer and Oxford/AstraZeneca.

This was when vaccines were in short supply and early research suggested that widening the gap from the manufacturer-recommended four weeks to 12 ramped up the jabs’ immune response.

In May, the guidance was changed to eight weeks as cases associated with the Delta variant – which was first identified in India – continued to rise in the UK.

Professor Susanna Duanchie of the University of Oxford, joint chief investigator in the study, said: “The original recommendation from JCVI was 12 weeks and this was based on a lot of knowledge from other vaccines that often having a longer interval (between doses) gives your immune system a chance to make the highest response.

“The decision to put it to eight weeks is really balancing all the wider issues, the pros and cons – two doses is better than one overall. Also, other factors need to be balanced: vaccine supply, the desire to open up, and so on.”

She added: “I think that eight weeks is about the sweet spot for me, because people do want to get the two vaccine (doses) and there is a lot of Delta out there right now. Unfortunately, I can’t see this virus disappearing so you want to balance that against getting the best protection that you can.”

Researchers recruited 503 healthcare workers for the study, 44% (223) of whom previously had Covid-19, and studied the immune responses generated by the Pfizer jab. They found that both short (three to four-week) and long (10-week) gaps between the Pfizer vaccine doses generated strong antibody and T cell immune responses.

But the longer gap led to higher antibody levels and a higher proportion of helper T cells, which according to the researchers, supports immune memory.

After the second dose, a wider gap also resulted in higher neutralising antibody levels against the Delta variant and all other variants of concern, they found. But in this instance, antibody levels dropped off between first and second dose – leaving the recipients vulnerable against the Delta variant after one jab.

Dr Rebecca Payne, one of the study’s authors from Newcastle University, said the cellular response from infection-fighting T cells remained consistent across both long and short dosing gaps, suggesting they play an important role in protecting against Covid-19 between the first and second jab.

“After the second dose on the longer dosing schedule, antibody levels surpassed those seen at the same timepoint after a shorter dosing interval,” she added. “Although T cell levels were comparatively lower, the profile of T cells present suggested more support of immune memory and antibody generation.”

Researchers said there may be exceptions where the gap between doses may need to be shortened from eight weeks to four, such as before treatments that may affect the immune system, such as cancer or organ transplant.

Vaccines minister Nadhim Zahawi said the government took the JCVI’s advice to shorten the dosing interval from 12 to eight weeks to help protect more people against the Delta variant.

“This latest study provides further evidence that this interval results in a strong immune response and supports our decision,” he added.

“I urge every adult to get both doses of the vaccine to protect yourself and those around you and we are looking to offer millions of the most vulnerable a booster jab from September to ensure this protection is maintained.”

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Pfizer Jab’s ‘Off The Scale’ Antibodies Could Protect Against Brazil Variant

“The other potential is that you boost your antibody levels so high from whatever vaccine you have that there’s enough to go around and you cope with the variant.

“We’ve certainly seen in this paper that the antibody levels are so good, really after the first two weeks, that we are pretty confident that this should be very helpful against the Brazilian variant.”

Asked if he is surprised how well the vaccines have worked in older people, he said: “We were. When we sent these samples to Porton Down they said ‘we can’t give you results right now because we’ve got to dilute them because they’re so high, they’re off the scale’.

“The antibody levels were so high that they’d gone above the thresholds so they had to dilute them.”

But he added it will be crucial to see how long antibody levels are maintained after people have had a Covid-19 vaccine.

“It will be important to assess that and whether they wane at different rates in people of different ages,” he said.

“I think that’s something that we have to watch out for.”

Although the new study did not look at the Oxford University/AstraZeneca vaccine, Prof Moss said the evidence for the jab is that “it’s very, very effective”.

He added: “The UK has a strong portfolio of vaccines – Pfizer, AstraZeneca, we’ve got Moderna coming very soon, and Novavax as well.

“So yes, I think it’s possible that we can have very broad vaccine coverage across the UK very quickly.”

On T cell responses, Prof Moss said they are “better against variants overall” than antibodies, but he added the role of T cells in fighting coronavirus is still uncertain.

“I do think cellular immunity is very important,” he said, adding that a third of people in the study had no cellular responses detected.

“We know that, as people age, their cellular and immune responses are more difficult to elicit.

“Even influenza vaccines are much less effective in older people so that’s something that we will keep an eye on very closely.”

Prof Moss also said the UK’s plan to exit lockdown appears to be “on track”, with policies to control variants, the development of new vaccines and a strong immunisation programme.

“I think we can be confident about gaining control of variants with the current plans, and also leaving lockdown,” he said.

First author on the paper, Dr Helen Parry, a National Institute for Health Research academic clinical lecturer at the University of Birmingham, said: “Our research provides further evidence that the mRNA vaccine platform delivers a strong immune antibody response in people up to 96 years of age and retains broad efficacy against the P.1 (Brazilian) variant, which is a variant of concern.”

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Pregnant Women Are Getting Antibodies From Covid-19 Jabs

The Covid-19 vaccines by Pfizer and Moderna are “highly effective” in producing antibodies against the coronavirus in pregnant and breastfeeding individuals, according to new research.

In the largest study of its kind to date, researchers at Massachusetts General Hospital, Brigham and Women’s Hospital and the Ragon Institute demonstrated the vaccines are not just effective in protecting pregnant women, but they pass on protective immunity to newborn babies through breastmilk and the placenta.

In the UK, pregnant women aren’t able to have the Covid-19 vaccine unless they have an underlying health condition that puts them more at risk from the virus, or they work in a profession that increases their exposure.

This is because there’s a lack of safety data from trials of the jabs. The Joint Committee on Vaccination and Immunisation (JCVI), which is responsible for prioritising who gets the vaccine, says although available data doesn’t indicate safety concerns or harm to pregnancy, there’s insufficient evidence to recommend routine use of Covid-19 vaccines during pregnancy.

Women are, however, able to have the jab if they’re breastfeeding.

In the US, women can choose to have the vaccine. The study, published in the American Journal of Obstetrics and Gynaecology (AJOG), looked at 131 women of reproductive age – 84 were pregnant, 31 were lactating and 16 were not pregnant. All of the women received one of two new mRNA vaccines: Pfizer/BioNTech or Moderna.

Scientists discovered that in all three groups, antibody levels were present and similar – and, reassuringly, side effects after vaccination were rare and comparable across the study participants.

The news of “excellent vaccine efficacy” is “very encouraging” for pregnant and breastfeeding women, who were left out of the initial Covid-19 vaccine trials, said Dr Andrea Edlow, a maternal-foetal medicine specialist at Massachusetts General Hospital and co-senior author of the new study.

“Filling in the information gaps with real data is key,” she said, “especially for our pregnant patients who are at greater risk for complications from Covid-19.”

The study is important because we know individuals who are pregnant are more vulnerable to Covid-19. Research led by the University of Birmingham and the World Health Organisation (WHO) suggests the risk of pregnant women being admitted to intensive care or needing ventilation is higher than non-pregnant reproductive-aged women with the virus.

Pregnant women are also at increased risk of severe Covid-19 if they’re from ethnic minority backgrounds, or if they have pre-existing conditions like obesity, high blood pressure and diabetes.

For the latest study on antibodies in pregnant people, the team also compared vaccination-induced antibody levels to those induced by natural infection with Covid-19 in pregnancy, and found significantly higher levels of antibodies from vaccination.

Vaccine-generated antibodies were also present in all umbilical cord blood and breastmilk samples taken from the study, showing the transfer of antibodies from mothers to newborns.

In Florida recently, a new mother made headlines after her baby girl was born healthy and with Covid-19 antibodies – the frontline health care worker had received the Moderna jab three weeks before giving birth.

“We now have clear evidence the Covid vaccines can induce immunity that will protect infants,” said Galit Alter, of the Ragon Institute and co-senior author of the study.

A new study has found the vaccines are effective at producing antibodies in pregnant women – and these antibodies have been found to pass on to their newborns too.

A new study has found the vaccines are effective at producing antibodies in pregnant women – and these antibodies have been found to pass on to their newborns too.

The research was also able to provide an insight into potential differences between the immune response elicited by the Pfizer vaccine compared to the Moderna vaccine. Levels of mucosal (IgA) antibodies were higher after the second dose of Moderna compared to the second dose of Pfizer.

The finding is important for all individuals, since SARS-CoV-2 is acquired through mucosal surfaces like the nose, mouth and eyes, said Kathryn Gray, an obstetrician at Brigham and Women’s Hospital and another author of the study.

“It also holds special importance for pregnant and lactating women because IgA is a key antibody present in breastmilk,” she added.

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