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References

Coronavirus: WHO warns against pandemic complacency after recent vaccine progress. 2020. https://tinyurl.com/wsm8za3w (accessed February 2021)
Polack F, Thomas S, Kitchin N Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020; 383:2603-2615
Voysey M, Clemens S, Madhi S Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Lancet. 2021; 397:99-111
Baden L, El Sahly H, Essink B Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021; 384:403-416
Department of Health and Social Care. Statement from the UK Chief Medical Officers on the prioritisation of first doses of COVID-19 vaccines. 2021. https://tinyurl.com/k9hf2uk8 (accessed February 2021)

Letters to the Editor

From Volume 48, Issue 3, March 2021 | Page 242

Authors

Kiran Singh

Dental Core Trainee in Oral and Maxillofacial Surgery, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust

Articles by Kiran Singh

Sanford Grossman

Specialty Registrar in Oral Surgery, Torbay Hospital, Torbay and South Devon NHS Foundation Trust

Articles by Sanford Grossman

Kevin McMillan

Specialist Registrar, Oral & Maxillofacial Department, University Hospital Birmingham Foundation NHS Trust

Articles by Kevin McMillan

Article

Vaccine complacency

There has been growing concern that, with the recent lockdown announced on 4 January 2021, the nation may be at risk of pandemic complacency,1 following an arduous and protracted series of frequently changing restrictions and lockdowns.

With the recent advent and widespread delivery of two COVID-19 vaccine systems (from Pfizer/BioNTech and AstraZeneca/Oxford) and the recent approval of a third (Moderna) by the Medicines and Healthcare products Regulatory Agency (MHRA), it can be anticipated that soon all clinicians in primary and secondary dental care settings will have been offered a vaccination. We would like to warn that this may lead to a vaccine complacency centred around presumed immunization.

Each vaccine produces reportedly varying levels of immunity. Regarding the Pfizer/BioNTech vaccine, the efficacy has been reported at 95.0% after two doses.2 With the AstraZeneca/Oxford vaccine, the efficacy varies depending on dose regimens. Two standard doses reportedly yield 62.1% efficacy, whereas a low dose followed by a standard dose results in 90.0% protection.3 The Moderna vaccine, which is likely to be the next available, reportedly yields an efficacy of 94.1% following the second dose.4

The accepted efficacy rates are complicated by the fact that in response to recent recommendations from the Joint Committee on Vaccination and Immunisation (JCVI) and the four UK Chief Medical Officers, many vaccine providers are adhering to a 12-week delay between doses in an attempt to provide at least partial immunity to an increased number of people.5 The implication of this may be that the actual efficacy of each vaccine is different to the reported levels of protection described in the clinical trials.

Of further relevance is that owing to the nature of the relatively quick development of the vaccines in response to a rapidly worsening pandemic, long-term observational studies on immune levels are not yet available.

Suffice to say, none of the current vaccine models is likely to provide 100% immunity in either the short or long term.

We therefore wish to warn clinicians about the risk of lowering one's guard with regard to personal protective equipment (PPE) and social distancing measures following vaccination. There is still scope for vaccinated clinicians to acquire and transmit COVID-19 to both colleagues and patients. It would be prudent that clinicians continue to persevere and observe such strict measures in spite of vaccinations and the mounting pandemic fatigue that undoubtedly has a toll on everyone. This is key for maintaining staff, patient and public safety, until the virus has been successfully eradicated.