Thanks CWS, very insightful! I think you are right for the most part.

My first jab felt very rushed, it was very much in and out again. Whereas this time there was the queue to get in so a chance to calm down (I'm an anxious person by nature if you hadn't guessed :D), then once I got to the booth both the administrator and the vaccinator didn't seem rushed at all - even when they couldn't find me on the system again (NIMS perhaps?) it was all very laid back, and she took my NHS Number off me this time rather than faffing about 5 different ways to try and find me.

Then came the jab itself, she explained everything calmly and started the distraction technique (what are you doing this afternoon after etc), 30 seconds later I was being handed my sticker and sent on my way to sit in the car for 15 mins.

I checked the NHS app at 2am and my second jab was showing already, so perhaps they have sped that up now too (I'm sure it took a few days last time).
Side effects so far are a headache and a sore arm, but nothing a few paracetamol hasn't cleared up.

The Twickenham mass vaccination pop up centre has 15000 jabs available today on a walk-in basis, 10am to 8pm, although you can book an appointment.

1st jabs only, 30 years + only, targeted at residents of Brent, Ealing, Hammersmith, Harrow, Hillingdon, Hounslow, Kensington and Chelsea, and Westminster.

https://www.chelwest.nhs.uk/about-us...holiday-monday

That's an absolutely huge number of jabs. Pharmacies will do perhaps 50 jabs a day, GP centres perhaps 500 to 1,170. Mass national vaccination centres 1,000 to 5,000. My GP led system, which is now on the national website, can do up to 3,000. So 15k is quite something.

But the key message is for anyone over 30 (or perhaps 29 or.....) to get themselves to Twickenham rugby stadium. It's a few minutes well marked walk from Twickenham rail station. Frankly I would ignore the "West London residents" bit, since there will be people all over the London area who can get to Twickenham easily on a Bank Holiday Monday. In the highly unlikely chance that you are asked about this, just say you work at Heathrow, which will probably be true at least occasionally. I suspect booking an afternoon slot online would reduce further the tiny risk of any questions. BRING YOUR NHS NUMBER if you can find it easily, and mention it at check-in. Ideally write it on a post it note with your date of birth and surname.

oh no. So no full reopening until zero Covid ?

I doubt it. The two tests relevant to this area are (a) no bad increase in hospitalisation so that the NHS can't cope and (b) variants running out of control, to paraphrase. NHS staff are complaining a bit but it's from the pent up demand for non-Covid related treaments, so not relevant to the test. Variants are increasing in number but I wouldn't say, at this point, it's out of control, it is still confined to just a few areas. Hopefully vaccinations will help to keep it there.

So get yourself down to Twickenham!

Just be mindful, if you want to reach Twickenham via Richmond or Putney, that the District Line isn't working and Overground is operating with reduced service.

Great :)

Speaking of the bike sheds at T5, bring some very sturdy locks. Despite all the cameras and the armed police van parked 10 meters away from the south bike sheds, there have been some very brazen thefts. I'm talking 20 bikes in broad daylight, and multiple times. They even managed once to cart off motorbikes parked next to the Sofitel. HAL claimed complete ignorance and the Met, well, they were having the 3rd latte break over in Ritazza.

I got an NHS text telling me to get to Twickenham to get my jab. But I've received my first jab exatly 20 days ago and the NHS website itself is only showing slots from July 27th onwards for the second jab. Bit misleading.

Well go and get your second jab then !

If the advice is to wait at least 3 weeks, and learned ones like c-w-s advise to wait until at least 6-8 weeks if not longer... I'll sit that one out if you don't mind.

corporate-wage-slave - I think you have previously said you don't think we should be getting our second jab anytime earlier than 8 weeks apart. For pfizer jabs specifically, why is this the case? I ask purely from wanting to understand. What is the difference between 6 and 8 weeks for the second dose? Is it just the long term effect?

If Israel and US does it in 3 that’s fine by me. The UK delayed it due to shortages which makes sense but I think we are past that phase

Are you a medical professional by any chance?

Based on the most recent ECDC data, Greeze has only received 30k J&J/Janssen doses and used 19k. Near term guidance (before July) for future EU deliveries is unfortunately a best case of 40% of what was expected and a worst case of 10% of what was expected. On the basis the UK is sourcing its supply from Belgium as well, I don’t expect J&J to be a material contributor to any vaccination plan for a while yet.

My understanding, on spacing of jabs is that standard vaccine procedures in a multiple stage process is to let the first dose establish itself, and then boost after the first dose was well established.
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Because of the protocols mandated by medical trials, the manufacturers had to go with something that was quick to get tested yet would have a high probability of doing the job, and they mostly went with 2-4 weeks. They could have gone with a longer time period, but because of the testing protocols this would have delayed the testing process by a greater time period (going from 3 weeks to 6 weeks would imply an extension to the testing and analysis period of more then 3 weeks).

When the UK JCVI made the decision to delay the administration of 2nd doses they did this not only on the need to get as many 1st doses done in the face of the UK varient, but also on sound epidemiological theory that equal or better immunity could provided by extending the standard manufacturers recommendation of 3 weeks between doses out to 12 weeks. There was no direct evidence for this approach at the time but it was based upon how other similar vaccines work.

As time has come to pass it now seems that the UK JCVI has been proven right and there is now good evidence that extending the time period is a good thing and can improve the immune response, and I think the current understanding is that mRNA (Pfizer and Moderna) vaccines seem to optimise around 8 weeks between doses and the AZ and by implication Jansen optimise around 12 weeks. I note that other countries are now adopting the evidence from the UK in their vaccine rollouts.

Hopefully when CWS has finished his shift he can confirm the above or tell me where I have got it wrong.

There is a core immunological process behind having 2 doses of a vaccine. The first dose starts the immune process and primes the body with a certain level of (in this case) S (spike) protein antibodies in readiness for any real infection. The way a vaccine works is to fool the body into thiinking a real infection is about to start, so the body braces itself for it. However it's a fake illness here, the vaccine doesn't have the virus in question. But that's what the side effects are all about - the body being braced for a wave of infection versus immune response battles. After a few days the immune response steps down a bit, the side effects go away, but the immune response is dialed down in preparation for next time. Next time is actually dose 2. The antibodies are still there, the body again braces itself once more, but again there isn't really an infection. What dose2 is add speed / depth to the immune response, and longevity. Now getting the timing right is a complex area, but in essence if your antibody situation is still good, then you would ideally delay your second dose until it starts to dip so much that you need a bit of boost. Moreover the longer you leave it, the longevity is also increased. Now imagine you had dose 2 one week after dose 1, you can see at this point it's a waste of time, your antibodies from dose1 are still in place and the boost is probably going to be quite small, and you do next to nothing to the longevity aspect.

Now of course the problem is that everyone is different and public health experts and immunologists have to work out the best trade offs here. There may well be an argument - more for AZ - to delay dose2 for 6 months since we see AZ antibodies at a high level after 3 months. But human behaviour kicks in too, we know asking people to wait 6 months means a lot of people won't bother to turn up for dose2, they forget or CBA. If at the 6 month time period there isn't any Covid about and it's in anyway hassle-some to get the jab then people won't do it.

Now let's consider your fiancée who has had Covid previous confirmed via PCR, so they enter dose1 with probably a decent level of antibodies, and a well primed immune system. For them the vaccine is equivalent of getting your dose2, hence from an immunological point of view it's difficult to see the point of having a second dose: it's not going to boost the immune levels any more, it's unlikely to add yet more longevity. Incidentally it also explains why those who have had Covid once already and then are vaccinated get a walloping with side effects, since the immune reponse goes into hyper mode for the mother of all battles, which then doesn't actually happen. Not very nice for the patient but they are then usually left with sky high antibodies, sometimes over 1,000 u/ml on S proteins, compared to 50 to 200 for most people.

Now when the vaccines were made, vaccines which have now saved hundreds of thousands of lives, they needed to get medical authorisation quickly. If you are doing a trade off with 30,000 trial participants, you want dose2 to be as soon as necessary to demonstrate a greater than 50% benefit, which is what the influenza vaccine does. Now you don't need a degree in immunology to realise that 3 or 4 weeks would probably do the trick - the figures would get FDA / MHRA / EMA etc approval. Thank goodness they did this. But's an entirely different question as to whether this makes sense in the real world or not. Indeed as far as I know every since study in this area has since shown that for Pfizer (and AZ) a longer duration is better since these vaccines are actually very good indeed, they have better staying power than the 3 or 4 week period allows for.

The UK decided - after actually talking to immunologists - that dose2 should be 10 to 12 weeks after dose1, this is a science led approach. It also allows people to get their dose2 at 8 weeks. and increasingly we have allowed 6 weeks too, though this only really makes sense if you suspect someone's immune level to drop a lot. If you're 30 and in good health that is most unlikely. If you are 90 years old and your immune system is crocked then you can see the point - even more so if there is a dangerous variant on the loose. Moreover with Pfizer, there is the added complication of a not entirely secure supply chain, with a risk a large batch goes off-spec at the quality control stage and it all has to be destroyed. So if you aim for 11 weeks, the patient perhaps gets ill with an unrelated illness, then there isn't a supply available (etc etc) you can see how making second appointment at 11 weeks is a bit risky.

In short, if you are reasonably healthy and you think your immune system is OK / average / good then for either vaccine you shouldn't really go for your second dose before 8 weeks, 10 weeks is better. Is it the end of the world if it is 7 weeks? Probably not. If it's AZ can you wait longer still? Yes. But if you are healthy then I'd stick to 10 weeks but go for 8 weeks if a nice opportunity arises. From the s protien research we are seeing it's actually questionable whether most people under 40 should get a second vaccine at all, but because people that young tend not to have had much medical history to draw conculsions upon, that's a dangerous message from a public health point of view, we absolutely do want to see everyone back for their second dose. Just not too soon please.