Frequently asked questions about the vaccine

The Joint Committee on Vaccination and Immunisation (JCVI) is an independent advisory body to the UK Government. The Isle of Man vaccination programme follows the JCVI’s evidence-based guidance and the JCVI is referred to in many of the answers below. 

Find out more about the JCVI and read its current guidance online

Last updated 25 January 2021

• Vaccination schedule and priority groups
• Your vaccination appointment
• The vaccination hubs
• About the vaccines
• Vaccination documentation
• Vaccination and travel
• Vaccination impact
• COVID-19 variants
• Translated information

Vaccination schedule and priority groups

How is prioritisation for the vaccination being decided?

See Vaccination schedule and priority groups.

How many vaccinations does the DHSC expect to do?

The most important thing here is that the IOM DHSC aims to vaccinate as many eligible people as safely and quickly as possible. 

We have plans to vaccinate health and care workers, care home residents and their carers, and the majority of residents aged over 80 by mid-March. It is important to understand that this projection is based on the current schedule of vaccine delivery to the Island.  

While the Isle of Man will receive its fair share of vaccines from the UK sufficient for the whole population, delivery dates are not guaranteed. Therefore, our projections as to the number of people to be vaccinated over a set period of time, may change. We can only go as fast as our supplies of vaccine allow. 

Looking at the bigger picture, we aim to have vaccinated everyone in the JCVI Phase 1 priority groups – that is, everyone aged 50 and over, health and care workers, care home residents and their carers and people who are extremely clinically vulnerable, by May 2021. 

If our current expected delivery schedules are met, we hope to have offered a vaccination to everyone who wishes to have one, by September 2021.

What are the priority groups for the vaccination?

See Vaccination Schedule and Priority Groups

What is the next phase?

Phase 2 will be designed to further reduce hospitalisation and to vaccinate those at high risk of exposure to coronavirus. It may also target those delivering key public services

The JCVI is currently of the view that the key focus for the second phase of vaccination could be on further preventing hospitalisation.

Vaccination of those at increased risk of exposure to COVID-19 due to their occupation could also be a priority in the next phase. This could include first responders, the military, those involved in the justice system, teachers, transport workers, and public servants essential to the pandemic response. Priority occupations for vaccination are considered an issue of policy, rather than for JCVI to advise on.

JCVI has asked that the [UK] Department of Health and Social Care consider occupational vaccination in collaboration with other government departments.

Wider use of COVID-19 vaccines will provide a better understanding of whether they can prevent infection and onward transmission in the population. Data on vaccine impact on transmission, along with data on vaccine safety and effectiveness, will potentially allow for consideration of vaccination across the rest of the population.

As trials in children and pregnant women are completed, we will also gain a better understanding of the safety and effectiveness of the vaccines in these persons.

When will extremely clinically vulnerable people be vaccinated?

Individuals who are considered extremely clinically vulnerable have been shielding for much of the pandemic. Many of those who are clinically extremely vulnerable are in the oldest age groups and will be among the first to receive vaccine.

Data from the first wave in the UK estimates that the overall risk of mortality for clinically extremely vulnerable younger adults is roughly the same as the risk to persons aged 70 to 74 years.

Current advice from the Joint Committee on Vaccination and Immunisation (JCVI) is that those under the age of 70 who are clinically extremely vulnerable should be offered vaccine alongside those aged 70 to 74.  Those 70 years of age and over and clinically extremely vulnerable individuals will be offered vaccination once the over-75s have had theirs.

There is separate advice for pregnant women with heart disease and children.

When will patients with long term conditions be vaccinated?

The Isle of Man is following the guidance on priority groups from the Joint Committee on Vaccination and Immunisation, JCVI. Current evidence strongly indicates that the single greatest risk of mortality from COVID-19 is increasing age and that the risk increases exponentially with age. 

This evidence indicates that the most effective strategy to minimise future deaths, serious illness and hospitalisation from COVID-19 is to offer vaccination to older age groups first. 

Studies have concluded that the absolute increased risk in those with a number of underlying health conditions is considered to be lower than the increased risk in persons over the age of 65 years.

Therefore vaccination is being offered to those aged 65 years and over followed by those with a number of underlying conditions. Read about vaccination for people with underlying conditions.

What about people who are immunocompromised?

The UK Government is exploring all available avenues, to ensure that a treatment for COVID-19 is found.  

Being immunocompromised isn’t a contraindication for the vaccine, and people in this group are recommended to have it, though it may not be as effective

Treatments containing COVID-19 neutralising antibodies have been secured from AstraZenaca to support immunocompromised people who will not be able to benefit from a COVID-19 vaccine. The treatment currently being developed by AstraZeneca is a combination of two monoclonal antibodies and has the potential to be given as a preventative option for people exposed to the virus, and to treat and prevent disease progression in patients already infected by the virus if successful. 

Will children be vaccinated?

Almost all children with COVID-19 have no symptoms or mild disease and the vaccines not yet been tested in younger children. The Joint Committee on Vaccination and Immunisation advises that only children at very high risk of catching the virus and serious illness, such as older children with severe neuro-disabilities in residential care, should be offered vaccination.

What other groups will be considered for the vaccine?

A number of vaccination booking slots will be ‘ring fenced’ each day for priority patient transfer patients travelling to the UK for treatment. Confirmation of suitability for the vaccination, taking into account the patient’s current health and underlying conditions will be required from a medical professional directly involved in the patient’s care.

This may be their consultant at Noble’s or in the UK or their GP. Vaccination will be organised by the Patient Transfer Office in liaison with 111 who will contact the patient to arrange a booking for the vaccination.

Vaccination is not being offered to patient transfer escorts at this time.

Your vaccination appointment

Is the vaccine compulsory?

There are no plans to make the COVID-19 vaccine compulsory. The Isle of Man operates a system of informed consent for this vaccination before it can be administered.

Should people who have already had COVID be vaccinated?

People who have already had COVID-19 should still get vaccinated if they are in one of the priority groups identified by JCVI. The MHRA have looked at this and decided that getting vaccinated is just as important for those who have already had Covid-19 as it is for those who haven't.

How will patients be invited for a vaccination?

See Your vaccination appointment

What happens at the appointment?

See Your vaccination appointment

Can I book an appointment and/or complete the consent form for the vaccination on behalf of a less able relative?

In the Isle of Man, the regulations around Power Of Attorney do not extend to an individual being able to provide consent for a relative. The consent must come from their GP so you can make an appointment or complete a consent form for a less able relative, but you must be aware that the form will not be accepted at the vaccination hub unless the individual who is to receive the vaccine can clearly demonstrate:

• they have read or can read the Patient Information Leaflet
• they fully understand the reasons for the vaccination and can provide answers to the consent questions
• they have signed the form themselves, you cannot sign on their behalf.

If your relative is unable to do this, you will need to contact their GP for a best interest decision to be made on their behalf.

Will my GP be able to give me my vaccination?

Every part of the health care system will need to be involved in the vaccination programme.  

Initially we are rolling out vaccinations in the community and at hubs, to ensure we reach priority groups swiftly. GPs will be involved in the rollout as it continues to expand.

I am not registered with a GP. Will I still receive a vaccination letter?

People living here temporarily who would like to have the vaccination must be registered with a GP in the Isle of Man.

The route for a vaccination is to be registered permanently with a GP in the Isle of Man.

Anyone who is on the Island and has either been here for more than 3 months or intends to stay for more than 3 months is entitled to register with a GP here. Anyone who is staying for less than 3 months is able to register as a temporary resident with a GP so they can receive any urgent or emergency care.   

In order to be part of the vaccination programme patients need to be registered as a permanent patient with a GP on the Island (i.e. not as a temporary resident).

Information on how to register and the implications of doing so is available from our Primary Care team. They can be contacted on either fps@gov.im or 642694.

About the vaccines

Which vaccine is better/more effective?

Both Pfizer/BioNTech and Oxford/AstraZeneca are very effective vaccines. Comparisons between the vaccine efficacies are unhelpful due to differences in their methodologies, put simply, the way they work.

It’s not as simple as saying one vaccine is better than the other. An effective vaccine will save lives and reduce hospitalisations.

Comparing vaccines on a simple percentage of effectiveness is a mistake. A vaccine with slightly lower headline efficacy than another may prove to be the one that offers more durable protection or a greater effect on transmission.

Both vaccines have been approved by the Medicines and Healthcare products Regulatory Agency, MHRA. They have passed the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from Coronavirus.

Which vaccines are being used in the Isle of Man?

The programme delivery teams are currently administering both the authorised vaccines (Pfizer/BioNTech and Astra Zeneca/Oxford).  Supplies of Moderna Vaccine are likely to be received late Spring.  

What are the side effects?

See What to expect after your vaccination

Do the vaccines prevent transmission?

Public Health England (UK) will be employing existing surveillance systems and enhanced follow-up of cases to monitor how effective the vaccine is at protecting against a range of outcomes including: infection, symptomatic disease, hospitalisations, mortality and onwards transmission.

It is likely to be some time until they have sufficient data to provide a clear picture of how vaccination impacts on onward transmission.

How long will the vaccines protect people?

Public Health England (UK) will be employing existing surveillance systems and enhanced follow-up of cases to monitor how effective the vaccine is at protecting against a range of outcomes including: infection, symptomatic disease, hospitalisations, mortality and onwards transmission.

It is likely to be some time until they have sufficient data to provide a clear picture of how long the protective effect of vaccination lasts.

Should both vaccines be given in two doses?

The MHRA authorisation includes conditions that both the Pfizer/BioNTech and Oxford/AstraZeneca vaccine should be administered in two doses, after receiving the first dose, the second dose will be delivered either 3 weeks (21 days) later for Pfizer/BioNTech or 8 to 10 weeks later for Oxford/AstraZeneca.

Those who received their first AstraZeneca vaccine before 1 March 2021 will still receive the second dose after 4 weeks (28 days).

For both vaccines the second dose completes the course and is likely to be important for longer term protection.

Does one dose of the vaccine offer protection?

In view of the current serious situation in the UK, the JCVI has recommended that as many people on the JCVI priority list as possible should be offered a first vaccine dose. This is because one dose of the vaccine offers important protection and it is vital that as many people in higher risk groups are offered protection until the second dose can be administered.

The Isle of Man will be giving the second dose of the Pfizer-BioNTech vaccine 21 days after the initial vaccine and the AstraZeneca (Oxford) vaccine 8 to 10 weeks after the initial vaccine. This is subject to consistent review in line with guidance from the UK and vaccination manufacturers.

Those who received their first AstraZeneca vaccine before 1 March 2021 will still receive the second dose after 4 weeks (28 days).

Why have you moved the dose interval for AstraZeneca/ Oxford vaccine?

The latest evidence arising from deployment of the Oxford / AstraZeneca vaccine in the UK has confirmed that the interval between the two doses may be extended beyond the original specification of 28 days, and that the vaccine has an average 76% effectiveness against symptomatic coronavirus infection for three months after the first dose. It has also been shown that extending the time period for the second dose does not affect the efficacy of the first After extensive review of the evidence by senior clinicians in the Department of Health and Social Care, the strategy to extend the gap between the two doses of the Oxford vaccine is now being adopted here in the Isle of Man.

The decision means more people will be vaccinated with one dose at an earlier stage than originally planned. Our team is now working hard to re-draw our vaccination schedule.

Can I choose my vaccine?

Any vaccines that are available will have been approved because they pass the MHRA’s tests on safety and efficacy, so people should be assured that whatever vaccine they get will be highly effective and protect them from coronavirus.

Both vaccines give very high protection against severe disease, which is the primary aim of the first phase of the programme, and both vaccines have good safety profiles.

The Joint Committee on Vaccination and Immunisation (JCVI) does not advise a preference for either vaccine in any specific population. For operational and programmatic reasons, such as to enable more extensive and timely vaccine coverage, one vaccine may be offered in certain settings in preference over another vaccine.

Unless there are clinical indications which prevent the giving of the vaccine (or a particular brand of vaccine) to a person, we can only offer what is available in accordance with the mandated programme. The DHSC has a mandated requirement to adhere to the terms of recommendations set out by JCVI, and to work to the Patient Group Directions, both which set out the priority of the administration of the vaccine.

Additionally, DHSC also has to work within the constraints of booking appointments, and the logistics in arranging the storage, retention and opening of vaccines for use. Vaccines must be used in order of receipt, and in accordance with that mandated programme, meaning that the choice of the vaccine is dictated by the vaccine available on the appointment date.

The Department is not able to deviate from those mandated requirements, as this might lead to invalidating the Patient Group Direction, through which the Isle of Man Government, together with those administering the vaccine are protected by indemnity arrangements made with the UK Government.

How can you be sure safety was not compromised due to the speed of development of a COVID-19 vaccine?

There are extensive checks and balances required at every stage of the development of a vaccine, and this is no different for a Covid-19 vaccine. No stages in the vaccine development process are bypassed. 

All vaccines are tested through three phases of clinical trials to ensure they meet the gold standard.

• Phase 1 trials are with a small group of people to make sure there are no safety concerns and determines the appropriate dosage for the best immune response.
• Phase 2 trials are conducted on a larger group of people to check the vaccine works consistently and that the immune response is sufficient.
• Phase 3 trials test the vaccines on thousands of people for scientists to assess if the vaccine is producing immunity that will prevent disease. 

Usually, these phases are run in sequence, but in an effort to find a safe and effective Covid-19 vaccine as quickly as possible, once safety has been ascertained through Phase 1, Phases 2 and 3 are being run in parallel. 

The data from each phase then goes to the regulator in a “rolling” review rather than once all the trials have completed, which means the regulator can start looking at the results at an earlier stage than normal.

Companies have made decisions to begin large scale production of vaccines which are still in trials. This means that if the vaccines are not shown to be safe and effective and are not approved for use, the companies will have to destroy what they have manufactured. If, however the vaccines are successful, that means the vaccines are ready to be distributed.

How have the Covid-19 vaccines been developed so fast?

Vaccine technology and the technological approaches to making vaccines are getting better and better. It couldn’t have been achieved in this timeframe until recently – and wasn’t possible in the 2009 pandemic when we had a new virus about which very little was known. We’re in a different place today because of the technology.

When it became clear that COVID-19 presented a global public health emergency, governments were prepared to put in lots of funding to manufacturers, without any guarantee of success, but hoping that they would find a solution

Manufacturers knew this had to be a straight run through, they didn't have time for investment decisions and pausing or thinking about a commercial market at the end of it. It had to happen with real urgency.

But the vaccine trials have been just the same as normal vaccine trials. Phase one, phase two and phase three. Where time has been saved is by recruiting participants in advance, so at the moment the study protocol is in place, the Ethics Committee is in place, so are the vaccine trial participants – which speeds up the process. And that happened at phase one, phase two and phase three and therefore things ran very fast.