UK COVID-19 Update: Oxford Jab vs UK Variant, Side Effects Data

These are the UK coronavirus stories you need to know about today.

Oxford Jab vs UK Variant

The Oxford/AstraZeneca vaccine has similar efficacy against the UK virus variant to previously circulating variants, according to a preprint from the University.

The paper also describes how the jab reduces the duration of shedding and viral load, which the research team said could mean reduced disease transmission.

Chief Investigator, Professor Sarah Gilbert, commented: "We are working with AstraZeneca to optimise the pipeline required for a strain change should one become necessary. This is the same issue that is faced by all of the vaccine developers, and we will continue to monitor the emergence of new variants that arise in readiness for a future strain change."

Meanwhile, the Government announced a partnership with CureVac and an order for 50 million vaccine doses "if they are required".

The statement said: "The new agreement will utilise UK expertise on genomics and virus sequencing to allow new varieties of vaccines based on messenger RNA technology to be developed quickly against new strains of COVID-19 if they are needed."

A Cambridge-led team reported in Nature today how variants could arise from convalescent plasma treatment for chronic infection over an extended period of time.

Professor Ravi Gupta, who led the research, said: "What we were seeing was essentially a competition between different variants of the virus, and we think it was driven by the convalescent plasma therapy.

"The virus that eventually won out – which had the D796H mutation and ΔH69/ΔV70 deletions – initially gained the upper hand during convalescent plasma therapy before being overtaken by other strains, but re-emerged when the therapy was resumed. One of the mutations is in the new UK variant, though there is no suggestion that our patient was where they first arose."

Jab Side Effects Data

King's College London research from the ZOE COVID app found that having a first jab of the Pfizer/BioNTech vaccine caused at least one systemic side effect within 7 days for around 1 in 7 people who had previously had COVID-19.

Four in 10 participants had at least one after effect in their arm, most commonly pain and swelling 1 or 2 days after vaccination.

The study involved reports from nearly 40,000 people in December. Of these 23,308 had received one dose, and 12,444 had both.

Analysis found most symptoms happen in the first 2 days after first vaccination, and headache, fatigue and chills or shivers were most common.

Symptoms were more common for the second dose, with around 1 in 5 reporting at least one systemic effect. Around half experienced effects in the arm, such as pain and swelling.

Previous exposure to coronavirus made systemic effects after vaccination nearly twice as likely (33% vs 19%).

Lead scientist Professor Tim Spector commented: "It’s interesting to see that those with previous COVID are more likely to experience these mild after effects than naive subjects. This could be good news, as a larger response like this suggests that those getting a first dose after having had COVID are generating a stronger immune reaction and may get greater protection from just a single shot of the vaccine."

MHRA monitoring found a side effect reporting rate of 3 in 1000 for both current vaccines

For Pfizer/BioNTech, the most frequent adverse reactions were:

Pain at the injection site (> 80%)
Fatigue (> 60%)
Headache (> 50%)
Myalgia (> 30%)
Chills (> 30%)
Arthralgia (> 20%)
Pyrexia (> 10%)

For Oxford/AstraZeneca, the most frequent adverse reactions were:

Injection site tenderness (>60%)
Injection site pain, headache, fatigue (>50%)
Myalgia, malaise (>40%)
Pyrexia, chills (>30%)
Arthralgia, nausea (>20%)

MHRA Chief Executive, Dr June Raine, said in a statement: "The data we have collected provides further reassurance that the COVID-19 vaccines are safe and continue to meet the rigorous regulatory standards required for all vaccines. We remain confident that the benefits of these vaccines outweigh any risks."

Munir Pirmohamed, chair of the Commission on Human Medicines’ COVID-19 Vaccines Benefit Risk Expert Working Group told a news briefing: "We’ve seen more data coming through from AstraZeneca as more people are completing the trial, which highlights again that efficacy in the elderly is seen, and there’s no evidence of lack of efficacy."

Vaccine Uptake

Latest Office for National Statistics (ONS) social impact data show 91% of adults not yet offered a COVID-19 vaccine would be very or fairly likely to have a jab if offered. That's up slightly from 88% last week.

Among those unlikely to be vaccinated, key reasons were:

Worries about the side effects (45%)
Worries about the long-term effects on health (44%)
Waiting to see how well vaccination works (35%)

The latest OpenSafely data analysed in a preprint by the University of Oxford and London School of Hygiene & Tropical Medicine found that among over-80s, White people were nearly twice as likely to have been vaccinated as Black people (42.5% vs. 20.5%).

The authors conclude: "Targeted activity may be needed to address lower vaccination rates observed among certain key groups."

Cabinet Office plans for local elections in England talk about the vaccination programme "which we plan will have reached all nine priority cohorts by May".

As of yesterday, 10.97m people have had a first dose of a COVID-19 vaccine, and 505,993 a second dose.

Infection Survey

ONS infection survey data estimate 1 in 65 people in England had COVID-19 in the week ending 30 January.

In Scotland it was 1 in 115, in Wales it was 1 in 70, and for Northern Ireland 1 in 65.

Sarah Crofts from ONS said: "While infections in England have decreased to below one million, they still remain high. Northern Ireland and Scotland have also seen a decrease in infection rates whilst in Wales they have remained level.

"The percentage of people testing positive compatible with the new UK variant has fallen across most regions in England but has levelled off in the East of England and the trend is uncertain in the East Midlands and Yorkshire and The Humber."

The UK's R number is now 0.7 to 1.0 and the growth rate is -5% to -2% per day.

In today's daily data another 19,114 UK positive tests were reported and 1014 deaths.

Another 2578 COVID-19 patients were admitted to hospital. The total is now 30,508 , and 6847 ventilator beds are in use.

Hotel Quarantine Delayed

Plans for hotel quarantine for international arrivals from 'red list' countries to help keep out virus variants announced 9 days ago will come into force in 10 days time, a Government minister said today.

Foreign Office minister James Cleverly said more time to prepare was needed to set up the 'managed quarantine facilities'. Officials have sought advice from Australia and New Zealand who imposed restrictions earlier in the pandemic.

The Department of Health and Social Care also highlighted current measures: "It is currently illegal to go on holiday, and passengers travelling to the UK must provide proof of a negative test before they travel, and self-isolate on arrival. With increased police presence at airports and more physical checks at addresses to make sure people are self-isolating, we are taking decisive action."

Colchicine

A small Brazillian clinical trial found colchicine helped to reduce hospital stays and the need for supplemental oxygen in COVID-19 patients.

The study reported results from 72 patients with moderate to severe COVID-19 with half randomly assigned to standard treatment with colchicine for 10 days, the rest with standard treatment plus placebo. The results are published in RMD Open .

The median time for requiring oxygen was 4.0 days in the colchicine group and 6.5 days in the placebo group. Average hospital stays were 7 days for the colchicine group and 9 in the placebo group.

Commenting via the Science Media Centre (SMC), Professor Martin Landray, University of Oxford, joint chief investigator for the RECOVERY trial, said: "There is a lot of interest in the possibility that colchicine, an anti-inflammatory treatment commonly used for gout, might improve outcomes for patients with COVID-19. This is a very small randomised trial that is consequently unable to answer this question. Much larger randomised trials are ongoing and should provide the answers we need. For example, the RECOVERY trial has already randomised over 8000 patients hospitalised to COVID-19 to colchicine vs. usual care."

Iodine Mouthwash

A French study involving 24 patients published in JAMA Otolaryngology – Head & Neck Surgery looked at whether gargling povidone iodine mouthwash could reduce viral load in non-severe COVID-19.

Mean relative difference in viral titers between baseline and day 1 was 75% in the intervention group and 32% in the control group.

Martin Addy, emeritus professor of dentistry, University of Bristol, told the SMC: "Unfortunately this study design would appear to have significant shortcomings and its findings don’t support a clinically significant difference between the two groups."

Vitamin D

Yesterday we reported how Boris Johnson was asked to have negative guidance on vitamin D treatment for COVID-19 re-reviewed. Today The Guardian reports England's Health Secretary Matt Hancock has asked NICE to do that. It quotes a NICE spokesperson: "Research on the impact of vitamin D and COVID-19 is ongoing, and we are working with Public Health England and the scientific advisory committee on nutrition to review new evidence as it emerges."

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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