Spacing between first and second dose of Comirnaty™
- To be fully immunised with Comirnaty requires two doses given at least 3 weeks apart (minimum of 21 days apart).
- The recommended spacing between doses is at least 3 weeks to provide a protective and durable immune response.
- Vaccinators are advised not to give the second dose earlier than 21 days.
- It is not yet known for how long the first dose provides protection. A longer gap between doses provides an even better response after the second dose, but leaving it too long can leave you vulnerable to infection, particularly, if you are at high risk of exposure to SARS-CoV-2.
- On the other hand, because you immune system is not yet ready, having a dose too soon after the first dose (ie less than 21 days) will not produce a good response to the second dose.
- During clinical trials, the vaccine efficacy against symptomatic COVID-19 between the first and second doses was around 50% compared with 90% within 2 days of the second dose increasing to 95% after a week. Recent real-world data has shown that protected against SARS-CoV-2 infection was around 62 to 91% from 14 days after dose one and 68 to 97 % from 14 days after dose two in frontline workers. Two doses are required to be best protected against the more transmissible variants, like Delta.
COVID-19 vaccination after COVID-19 infection
Vaccination is being offered regardless of a history of SARS-CoV-2 infection with or without symptoms.
Vaccination is recommended to be given from 4 weeks after recovery, or 4 weeks from the first confirmed positive PCR test if asymptomatic, and when cleared to leave isolation by a clinician.
Data from clinical trials and from countries with a lot of COVID-19 cases have shown the vaccines to be safe and effective in this group of people. It is expected that the vaccine will boost the immune response and provide good protection for those who have previously had SARS-CoV-2 infection.
Spacing with other vaccinations
Other vaccines on the National Immunisation Schedule
All the vaccines (except shingles vaccine) can now be given at the same time or immediately before or after the COVID-19 vaccine. These include measles-mumps-rubella (MMR), influenza, human papillomavirus (HPV, Gardasil 9), tetanus and whooping cough vaccine (Tdap, Boostrix) and meningococcal vaccines. Ask your health provider if there are any vaccines that you may have missed or are due to have while you get your COVID-19 vaccine.
Pregnant women are recommended influenza vaccine and COVID-19 vaccine at any stage of pregnancy and whooping cough vaccine from 16 weeks gestation. They can be given at the same time or separately.
Note that most of the dedicated COVID-19 vaccination centres (drive-through, mass vaccination sites or pop-up centres) do not have other vaccines available. Please ask your usual health provider (eg, GP, pharmacist, or midwife) if there are any other vaccines you need.
Shingles vaccine (Zostavax)
A gap of seven days is recommended between the COVID-19 vaccine and the shingles vaccine, Zostavax. This is to ensure a good immune response to each vaccine in older adults. Zostavax can be given from the age of 50 years and one dose is funded for adults at 65 years (with catch-up until 31 December 2021 for those aged 66-80 years, if not given previously).
- Note that there are no clinical safety concerns should the gap between vaccines be less than the recommendations above. Do not delay vaccination if such a gap is not possible.
- Allow six weeks between the first and second doses of the COVID-19 vaccine.
Assessing eligibility for COVID-19 vaccination at vaccine centres: Don't delay
As more people are coming through the doors of vaccine centres, so too are the range of individual circumstances and the queries we are seeing at the Immunisation Advisory Centre to confirm eligibility. The Immunisation Advisory Centre would like to take this opportunity to emphasise that in most cases, the vaccine is safe to deliver. Importantly, vaccination should not be delayed.
It is safe to vaccinate:
• Pregnant women in any stage of pregnancy
• People with any medical condition or receiving any type of medical treatment. There are no medical conditions, past or current, or medicines that prevent a person receiving a COVID-19 vaccination. The vaccine is safe for people with compromised immune systems, however they may not have an immune response as strong as a healthy person and it is therefore important for those around them to also have the vaccine.
• People with history of anaphylaxis as long as it was not caused by the vaccine or something in the vaccine. Vaccinators will discuss this in detail at time of vaccination.
• People aged 12 years or over but not for anyone under 12 at the moment.
• People who are not competent to give consent can be vaccinated if the treatment is seen as in the best interest of the person – see guidance set out in the Immunisation Handbook.
For more detailed information please refer to the Immunisation Handbook.