Update from the London COVID-19 Vaccine Clinical Reference Group

We have three clinical updates for local vaccination teams and GPs this week (23.09.2021):

  1. Overseas vaccinations
  2. Recording of overseas vaccination
  3. Patients who’ve taken part in clinical trials

1. Overseas vaccinations

Please refer to the Covid-19 programme guidance for healthcare workers (publishing.service.gov.uk) which includes information on individuals who received COVID-19 vaccine overseas (page 15). It states:
If a person has received a first dose of a COVID-19 vaccine overseas that is also available in the UK, they should receive the same vaccine for their second dose. If the vaccine they received for their first dose is not available in the UK, the most similar alternative should be offered (see table in Appendix 1). If the vaccine received overseas is not listed in the table, a full course of the appropriate vaccine recommended for the individual in the UK (which may depend on their age) should be given. The recommendations in this table will be reviewed regularly as more vaccines and information about the efficacy of these vaccines becomes available.
The various groups of vaccines are:
• Adenovirus (ChAdOx) vector: AstraZeneca, Covishield
• mRNA: Pfizer, Moderna
• whole inactivated Coronavirus: Sinopharm, Sinovac, Covaxin
The other adenovirus-based vaccines (Janssen, Sputnik, CanSinoBio) use different vectors and so are not immunologically the same as either the AstraZeneca or Covishield adenovirus vector vaccines. However, as they, and the Novavax vaccine, are all based on a spike protein, the vaccine course can be completed with any of the locally available vaccines as appropriate for the individual’s age.
Appendix 1 of Covid-19 programme guidance for healthcare workers (publishing.service.gov.uk) contains a useful table that healthcare workers can use to determine which vaccine to give a patient who has received a COVID-19 vaccine overseas.


2. Recording of overseas vaccinations

At the moment vaccines administered overseas cannot be recorded in the UK National Immunisation Management system (NIMS) which is the system used to show your vaccination status in the NHS App.  Therefore the ability to show any “overseas” Vaccination Certificate and request a Vaccination Passport is not currently available from the NHS. This issue is being worked on at a national level and an update is expected shortly.  Any queries regarding this issue need to be directed to NHS 119 or to NHS App support rather than the GP practice: https://www.nhs.uk/contact-us/nhs-app-contact-us/. If people cannot access online services, and they are due to travel abroad in the near future, they can call 119 to request a letter that will provide evidence of their vaccination status. The NHS Vaccine Resolution Centre has now gone live for those who had COVID vaccinations abroad. This is accessible through 119.


3. Patients who've taken part in clinical trials

CARS have been receiving a number of enquiries concerning patients who’ve taken part in clinical trials. The Greenbook states the following regarding this:
“Individuals who are participating in a clinical trial of COVID-19 vaccines who present for vaccination should be referred back to the investigators. Eligible persons who are enrolled in vaccine trials should then be provided with written advice on whether and when they should be safely vaccinated in the routine programme.”
Vaccinations that are currently under development or trial will not be accessible via the certification service. NHSE/I are working to ensure those who volunteered to receive a test COVID-19 vaccine in a clinical trial, where that vaccine has now been approved, can access their vaccine status via the NHS App or by calling 119.

Published: Sep 28, 2021