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GPs delivering Moderna jab will have to observe patients for ‘at least’ 15 minutes


By Costanza Pearce
23 February 2021

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Patients given the Moderna Covid vaccine will have to be observed for 15 minutes following the jab, according to new guidance.

And GPs can consider ‘pre-treatment’ with antihistamines and a 30-minute observation after vaccination with any Covid jab for patients with certain anaphylaxis history, Public Health England (PHE) said.

The Moderna vaccine was authorised for use in the UK last month, with doses to become available from the spring.

The Government said it will be deployed through ‘similar methods’ as the Pfizer and Oxford vaccines – via hospital hubs for ‘NHS and care staff and older patients’, vaccination centres and ‘community services’ staffed by ‘local teams and GPs’.

An update to PHE’s Green Book chapter on coronavirus said that patients given the Moderna jab should be monitored for a ‘minimum of 15 minutes’ following vaccination, as with the Pfizer jab.

The guidance, which was updated last week, said: ‘All recipients of the Pfizer BioNTech and Moderna vaccines should be kept for observation and monitored for a minimum of 15 minutes. 

‘Facilities for management of anaphylaxis should be available at all vaccination sites.’

Last month, guidance was updated to clarify that GPs do not need to observe patients after administering the Oxford/AstraZeneca Covid vaccine.

The Green Book added that GPs should seek advice from allergy specialists before administering second doses to patients who had immediate systemic allergic reactions or delayed reactions that required medical attention after their first jab.

Those with immediate or delayed local swelling or rash after their first jab can be given a second dose of the same Covid vaccine in any setting but must be observed for 30 minutes, it said.

And patients with a delayed reaction that was self-limiting or resolved with oral antihistamines can also have the same second dose in any setting but GPs should ‘consider pre-treatment with non-sedating antihistamine, 30 minutes prior to vaccination’.

PHE added that for all Covid vaccines, GPs should discuss with an allergy specialist before vaccinating patients with certain allergy histories.

This includes those with a history of idiopathic anaphylaxis, immediate anaphylaxis to multiple drug classes where the trigger is ‘unidentified’ or anaphylaxis to a vaccine, injected antibody preparation or a medicine likely to contain polyethylene glycol (PEG).

GPs can also consider a 30-minute observation for these patients and ‘pretreatment’ with antihistamines ‘if vaccination proceeds’, but antihistamines ‘may mask initial symptoms of a reaction’, the guidance said.

It reiterated that patients with previous anaphylaxis or allergic reactions to food, insect stings and ‘most medicines’ can now receive any Covid vaccine as long as they are not allergic to any specific vaccine ingredients.

GPs should also vaccinate those with a family history of allergies, previous ‘non-systemic’ reaction to a vaccine, hypersensitivity to non-steroidal anti-inflammatory drugs and mastocytosis, PHE said.

Meanwhile, PHE outlined further characteristics of the soon-to-be-deployed Moderna vaccine, which comes in multidose vials containing 10 doses.

Patients should be given two doses at a ‘minimum’ of 28 days apart but GPs are ‘recommended’ to ‘routinely’ schedule second doses ‘between four and 12 weeks after the first’, as with the Pfizer and Oxford vaccines, it said.

The frozen vials can be stored between -25C and -15C for up to seven months and once thawed can be stored in a fridge between 2C and 8C for up to 30 days if not punctured and protected from light, PHE added.

Unopened vials are ‘stable’ for 12 hours at 8C to 25C, it said.

Last month, NHS England said GPs should recall patients who were unable to have the Pfizer vaccine due to allergies to receive the Oxford vaccine instead.

It followed guidance – now retracted – that said GPs should not give the Pfizer vaccine to patients with a history of ‘significant’ allergic reaction to a vaccine, medicine or food, following two incidents related to the vaccine.

This story first appeared on our sister title, Pulse.

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