Spacing between first and second dose of Comirnaty™
- To be fully immunised with Comirnaty requires two doses given at least 21 days apart.
- Vaccinators are advised not to give the second dose earlier than 21 days, and while longer spacing is acceptable, the recommended spacing is for the second dose to be given as close after 21 days as possible.
- A delay for longer than 21 days is not considered to be a problem in terms of how you will respond to the second dose.
- It is not yet known, for how long the first dose provides protection. If you are at risk of exposure to SARS-CoV-2, it is advisable to have the second dose when recommended.
- 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.
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 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
The COVID-19 mRNA vaccine two-dose schedule should take priority over influenza (flu) vaccine.
Ideally, the flu vaccine can be administered two weeks after the second dose of COVID-19 vaccine, which is given at least 21 days after the first dose.
Do not delay either vaccination if it is not practical to leave a space.
MMR and other live vaccines
By having a gap between the different types of vaccines and the COVID-19 vaccine makes it easier to judge which vaccine may be responsible for any side effects to fully understand what types of responses to expect. Adverse reactions to live vaccines, such as MMR, can take a week or two to occur.
- Currently, it is advised to leave a four-week gap after a live vaccine (MMR) before giving COVID-19 vaccination.
- Complete both doses of the COVID-19 vaccine, 21 days apart, before giving another vaccine.
- Please continue to allow a two-week gap after the second dose of COVID-19 vaccine and MMR.
- 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.
- The MMR and influenza vaccines can be given at the same time.
- The Ministry of Health has put together a flowchart for healthcare providers managing MMR and influenza vaccinations around COVID-19.
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 who have had a flu vaccine or a tetanus vaccine booster in the last 14 days, though the preferred gap is two weeks.
• People who have had MMR vaccine in the last 4 weeks, though the preferred gap is 4 weeks.
• 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 16 years or over but not for anyone under 16 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.