THE THIRD SHOT: ... is not the same as a booster... - CLL Support

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THE THIRD SHOT

bennevisplace profile image

... is not the same as a booster shot. See

healthunlocked.com/cllsuppo...

Here is the body of an email I sent to the Practice Manager at my GP surgery, in case anyone feels like following suit

On the practice website I read that you will soon be starting to call in patients for their Covid booster injections. Please note that I have not yet been called in for my third Covid dose for immunosuppressed individuals, even though NHS England instructed all GP practices to begin vaccinating this group with a third dose as part of their primary

vaccination course by 13 September 2021. I refer to NHS England's letter dated 2 September england.nhs.uk/coronavirus/...

According to the guidelines issued by JCVI, I should be given a third dose as someone "under follow up for chronic lymphoproliferative disorders including haematological malignancies such as indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias (note: this list is not exhaustive)" from the NHS letter, Annex A – JCVI list of eligible individuals

I would be grateful if you would take urgent action to ensure that I, and all other eligible patients of the practice, are invited to have their third dose as a matter of priority.

Many thanks,

78 Replies

I messaged our local group who have been administering covid vaccine as GP's here haven't got involved.Reply back was they didn't start like large hubs did and were a month behind so they won't start booking booster jabs until mid October.

The notice to them about me having my third jab went straight over their heads as usual.

It was same with first jab.

We'd be called in age order!!

Dave

grrrr it seems as if some foundations are just ignoring government guidelines

On W&W it's not clear you are entitled to a Third Shot. In your shoes I would ask my haematologist to recommend one rather than wait in line for a booster.

Fliffis profile image
Fliffis in reply to teakbank12

I received a text today to tell me to book my booster as I am classed as at increased risk of complications from Covid 19 is how they put it. They gave me a link to use to book which I did with no problem and I am booked to have it next week.

I have asked both my local haematology unit and my GP with no results, I am finding the waiting quite stressful and it seems to confirm that those with blood cancer are forgotten ?

Try my approach? See below.

Well, my email was not in vain. Within 10 minutes of sending it I got a phone call from the surgery admin team.

First I was told I would have to wait until mid October for a "booster" shot, i.e. 6 months after my second shot. So I reiterated the content of the email... Reaction: please hold, I'll go and speak to the practice manager. Next: I can arrange an appointment for you... the earliest we can do is 6th October, and would you like a flu jab at the same time? Well I thought, I don't believe you're booked up until then, but OK, deal - I've won a week over your opening offer.

So I accepted, but added: you will ensure that I get a full dose appropriate to immunosuppressed individuals in line with the JCVI guidelines? Reaction: I don't know about that, I'll ask...

15 minutes later I get another call back from the surgery: can you come in on the 24th September as we may run out of flu vaccine by 6th October. I thought, really?

I realise a lot of this does not compute (they may try giving you the runaround anyway), but it does show the value of making a specific complaint in writing, with reference to an NHS directive that they should be following but haven't.

HopeME profile image
HopeME in reply to bennevisplace

Don’t forget, it’s a pressure cooker in these practices. Not everyone can be accommodated immediately as there are lots of qualified (age, immunocompromised, etc. ) patients. I’m not being critical of you, just pointing out how over worked and under appreciated some of these healthcare workers are.

Best,

Mark

bennevisplace profile image
bennevisplace in reply to HopeME

Good point, implementation of policy is a struggle at the moment for those on the front line. Still, priority patients deserve to be treated as such.

Good result for you but it's shameful the chaos that exists in what should be fairly straightforward criteria of who gets what and when. Further be interesting to see if you still get offered a booster, a 4th jab, perhaps after Christmas. 🤷‍♂️

Agreed. How is all this being handled in NI?

I've heard nothing, same for my brother who is immuno-suppressed through transplant meds but in the same practice. Wife is NHS, some chat they will be done within the next few weeks,nothing firmed up yet.

Newdawn profile image
NewdawnAdministrator

I was in my GP surgery today for blood tests and enquired about the ‘third jab’. The receptionist told me there was no third jab just a booster. I explained about the Govt website and the 3rd vaccination for immunocompromised people. They were concerned but nobody had a clue I’m afraid so I booked my flu jab and was advised to wait until they send for me! 🙄 It’s all very messy and unclear. My surgery don’t even know when they’re getting the booster vaccines at the moment.

As I’ve got other health issues to resolve at the moment I’m not too concerned about pushing for further vaccinations just now.

Newdawn

Well, good luck with it all Newdawn.

1ofakind profile image
1ofakind in reply to Newdawn

It’s a shame and very frustrating but it takes time from when the new policy (to give the third dose to immunocompromised )is publicized and when it is implemented in reality….It is upsetting and the fear of being one of those who falls through the cracks and gets Covid in the time between , is very real.

Unfortunately, , although we have to keep asking and trying , it does take time!!

Hope anyone who wants that third dose will get it very soon!!

Belfastbees profile image
Belfastbees in reply to 1ofakind

Remember the advice at the time of the announcement specifically not to contact GPS, you will be called when it's your time. I understand the reasoning behind that but as time passes with no word its going to be necessary to make that contact.

1ofakind profile image
1ofakind in reply to Belfastbees

Absolutely, even if it just helps them get more efficient in implementing the new policy!!

Belfastbees profile image
Belfastbees in reply to 1ofakind

Efficiency in gov, there's a great idea! It seems there's not much making it out to the practices, even now.

Still heard nothing here.

Well you qualify for the Third Shot. Time to get proactive?

The 3rd dose is separate from the booster, except in translation both terms have become interchangeable and the rollout is shambolic.

I spoke to my GP last week and he said that my name is flagged up on the system as ‘high risk for Covid-19 due to CLL’. and that my name had been sent to the GP Federation, who are organising the 3rd doses rather than the GP surgeries. In London they’re the ‘out of hours’ group of GP’s.

He told me to speak to the Practice Manager who would sort it out, as he did for my initial 2 jabs. I did this and he said he’d speak to the GP Fed. and get back to me. He rang me back saying the GP Fed. needed written confirmation from my CLL Consultant that I had to get the 3rd dose. F* sake!! More jumping through hoops! I texted my CNS to explain I needed an email sending to the surgery from my CLL Prof or indeed anyone asap, or I wouldn’t get the 3rd dose.

Btw, my CNS confirmed that all CLL patients are classed as immunocompromised and are all eligible for the 3rd dose, irrespective of having been treated or not.

I waited a couple of hours before ringing her on Monday and she’d emailed the surgery on behalf of the Prof, who she’d spoken to and Ccd. The email also stated that I was to be given either the Pfizer or Moderna vaccine. My GP and Practice Manager had already told me it would be the Pfizer.

I then called the Practice Manager again to check he’d received the email and he confirmed he had and that he’d already forwarded it to the GP Fed. and that I’d hear from someone soon...

I received a call yesterday to arrange an appt for the 3rd dose. I asked which vaccine it would be - er... AZ was the reply. My heart sank again. I explained that there was no point me having that as I needed an mRNA vaccine and I’d understood it would be the Pfizer.

She said I could discuss this with the clinician at my appt which is today at 10am and they would explain the benefit of receiving that vaccine. I said there wouldn’t be any benefit and it’s not what my Consultant had requested. My CNS said if there was any problem then to refer them to the email which she’d sent me and if that didn’t work they are to get in touch with my CNS or my Consultant. My CNS told me they’re mixing vaccines already with other types of immunocompromised patients and trials eg., Com-COV are demonstrating a more robust antibody response after mixing the vaccines.

The ‘booster’ shots are to be different from people’s first two jabs, so there’s no rational reason why the mixing of vaccines shouldn’t be employed for the ‘3rd dose’. I shall refuse the AZ if they won’t recognise my need for the Pfizer. I don’t even hold out much hope for either vax making any difference but I hope. We’ll see... 🤞

Be proactive if you want the 3rd dose, is my advice.

Take care, good luck and be well all.

sparkler x

Wow, well done in negotiating such a tricky assault course. It's the inconsistency of implementation that is so perplexing.

My saga is different.

Last Tuesday received text from Lambeth Federation ( what used to be Primary Care Trust ) for my 3rd vaccine that I had last Saturday.

Yesterday same hub sent text for booster vaccine.

Yesterday hospital I had the first two ( not my haematology one ) text asking me for booster.

This morning email from NHS inviting me for booster.

This has become a nightmare and as Sparkler’s experience we need to make sure we get Pfizer or Moderna.

All I can suggest is trying to speak to Surgery and or CNS.

Sorry feeling guilty that people are falling over themselves to give me the vaccine.

I know that when I emailed my federation with a list of complaints they did say timing was dictated by when they receive vaccine.

Colette

Amazing, all the vaccine is in London. No drivers to transport it to the provinces?

Sorry ! But perhaps all the flu vaccines have gone north ! As a 4week delay to mine.Also my Borough has one of the lowest vaccine take up in the country ! Currently only 56% double vaccinated. 🙁

Whoa, 56%! Take care Colette.

Thank you,

Sadly I hardly ever go out ! 😕

AnneHill profile image
AnneHill in reply to mrsjsmith

Shortage of drivers from pharmaceutical co Im told.

How can that be? Only two days ago the PM tweeted about "getting on with delivering for the people of this country".

I have enquired with the pharmacist at the surgery. She says they are giving the full dose. Then I will get a second dose with the recommended space.Anne uk

PS The JCVI recommends mRNA vaccine for the 3rd shot, see letter from NHS England of 2 September, link in original post.

Yes, I know and I screen-grabbed the page; ready with my ipad at hand in case of any resistance. I actually had the Pfizer just less than an hour ago. There was so much confusion at the centre and everyone referred to both ‘3rd dose’ and ‘booster’ without knowing which they really meant and I don’t think most of the staff there knew there was any difference.

People were rushing around like headless chickens... the ‘greeting’ volunteer had gone awol so there was a cluster of people by the entrance not knowing where to go. Anyone would think they weren’t exactly ready....

I tried to get them to give my husband his booster but it was 6 days short of the 6 month gap between 2nd dose and booster, so obviously could not break from protocol, nor take 2 mins to listen to my reason. She (a dr) said if she had her phone with her she could’ve sorted it but as she didn’t have her phone she couldn’t and anyway they were only ‘dealing with patients today’... what?! I despair.

Yes I'm afraid that cohabitants of immunocompromised rank down the order for boosters. I'm in the same boat. Yet my wife will get a flu jab on Friday as my carer. Go figure.

I am so enjoying my reading today. Never laughed so much for ages. Thanks for posting. It’s diabolical at best!! I am aghast! 🤷‍♀️🤦‍♀️

Belfastbees profile image
Belfastbees in reply to sparkler

I'm pretty sure my recall is correct here. When it was announced about the 3rd dose, a few weeks ago and before any announcement of the booster shots, I think a shot of pfeizer or moderna was mentioned. No mention of AZ at all.

To be fair, mRNA vaccines were first choice with AZ as cover. From the NHS England letter of 2 September:

For those aged 18 years and over, JCVI advises a preference for mRNA vaccines

for the third primary dose, with the option of the AstraZeneca Vaxzevria vaccine for

individuals who have received this vaccine previously where this would facilitate delivery.

In exceptional circumstances, persons who received a mRNA COVID-19 vaccine

previously may be offered a third primary dose of AstraZeneca Vaxzevria vaccine following a decision by a health professional on a case-by-case, individualised basis".

This is quite laughable to read, indeed shocking. It’s almost what I feel would happen to me. I don’t feel brilliant at the moment so not having flu or Covid jabs, but I think when I do I shall go back to the hospital for it. And hope they don’t run out of the vaccines. Flu jabs are always at my pharmacy who are much more efficient and it is a walk in service. Take care and good luck. P.s. still shaking my head in disbelief 😏

My husband received a text and email from the NHS on Wednesday inviting him to book his Booster, which he had yesterday; Pfizer.

Bearing in mind that I had my ‘3rd dose’ nine days ago, though it still hasn’t appeared on my online medical bit of Patient Access under ‘Immunisation’. My first two jabs are there, along with my flu and various Pneumonia shots but no reference at all to my 3rd dose.

I described earlier the shambles at the vaccination centre; they didn’t access my medical notes before giving me the jab. They took a few details ie., my name and date of birth and gave me the little card with my name; both first and surname spelled incorrectly, despite me spelling each for the man taking the details. The card said Pfizer with a #3 hand written over a different printed #. So with the card clutched tightly in my fist I went for the jab, determined not to be thwarted by anything. The vaccinator said ‘you’ve already been asked about allergies haven’t you?’ I mumbled a quiet “mmm’ and replied ‘no’ to her question about any problems with previous jabs. I hadn’t been asked but I was fine after the AZ double jabs and I just wanted that Pfizer jab asap before another spanner appeared! I assumed the records would be updated ‘later’ but I had doubts as I felt a bit ‘off piste’ with this 3rd dose.

Then yesterday I also received a text and email from the NHS inviting me to make an appt. for a Booster. My email was slightly different from my husband’s, as it referred to my increased risk of complications from Covid and was more individually tailored towards me, with different paragraphs inserted in between the generic text. There was a link to the NHS ‘Booster Booking’ site or I could ring 119.

After some thought, I decided to try my luck at booking another jab... After all, the NHS was inviting me and as a mere patient amongst confused professionals, what do I know? Yes, rather unethical and not following the rules but nevertheless I reckoned it was worth finding out what was possible. I was hoping I could book for a second Pfizer but with the original recommended 3 week gap between jabs.

After trying many different approaches in completing the application form to book, it wouldn’t let me and each attempt led to the same message - that I didn’t need to book any Covid vaccination using this service and if I thought this was incorrect to contact my GP.

I can only assume that there is an NHS record of my 3rd dose, just not on my Patient Access medical notes. I should be glad really but I thought I might be able to beat the system 😀

sparkler x

mrsjsmith profile image
mrsjsmith in reply to sparkler

It’s a mess. I have lost count of the various texts and emails (after my original 3rd vaccine ) I have had from NHS and the hospital where I had my original. I did fill out I have already had the vaccine so we shall see if it’s recorded somewhere.The girl that did mine was in such a hurry she put the time where she should have put the date 🙄

Sorry to anyone who hasn’t heard from anyone yet.

My hospitals senior cancer nurse is clear that it’s our Consultants responsibility to tell our GP’s

Colette x

System design: F. Kafka

Shall we contact our GP ?

bennevisplace profile image
bennevisplace in reply to al444

Yes why not - it worked for me.

It does seem to be pretty erratic. Our GP surgery (in Surrey UK) seems to be very well organised and they are getting directly involved in the vaccination rollout. As I understand it 7 local surgeries got together and contracted a shared facility for the vaccination programme which they have leased until late this year. The GP's from all practices are up there giving jabs (along with many others) and they seem to be very much "on the front foot" in getting things done. As soon as the Gov gave the green light they kicked things into action. They have had to separate flu and covid vaccinations apparently because they had to place orders for the flu jab earlier in the year. Incidentally I also got a text invitation for my flu jab yesterday. I hope others get their invitations soon.

I was contacted by my GP surgery 15 Sept inviting me for 3rd vaccine with appointments available on the next two days. 10.00 17th Sept I had received my 3rd dose plus my flu jab. Flu jab advice only came through to the my surgery the previous evening. Some are getting it right. Info leaflet given at jab states minimum of 8 weeks after 2nd dose before third.

bennevisplace profile image
bennevisplace in reply to peghip

Your surgery has done it by the book, full marks to them. Judging from other members' experiences many practices have ignored the Third Shot group, who comprise the most vulnerable and should have been prioritised.

Sorry to be confused but my surgery have said its exactly the same jab.Is it a bigger dose? I had AZ last time. It will be pfizer in a month.

Im taking Ibrutinib. My consultant says it wont work.

Peggy4 profile image
Peggy4 in reply to AnneHill

Me too Ann. I was told the same today. The two were exactly the same all but the timing for some and whether in my case today was called the ‘third shot’ or the booster made no difference. Third shots can be given to immune compromised people quite soon after the second dose whereas a booster is given after 6 months. The Government have only just given the go ahead so Having had my second dose in February I met the criteria for both and today was basically either.. They said they were in the process of flagging up people like myself six months from now for a booster. .Now extremely confused and fed up. Would have hoped that all professionals dealing with this would know the difference (if any) and be ready to know the answer to questions.Peggy

Husband had 6 monthly consultation by phone yesterday with a member of hisCLL team and was told he’ll receive a letter in the next week or so for him to get his third vaccine. We’ll see…

My guess was that going via my haematologist would take longer than going direct to the GP practice, which has done all previous rounds of vaccination. If you need to get the practice to move, the letter from NHS England to all GP practices is an essential lever.

Hi everyone

I'm really confused.

Can someone explain the difference between a 3rd shot and a booster. I thought they were referring to the same thing?

I'm in Kent UK

Thanks very much

Jamyang

The Third Shot is an extra dose of vaccine for individuals who the JCVI classed as immunosuppressed. NHS England directed that GP practices and vaccination centres should begin vaccinating this group from 13 September. It instructed both GP practices and consultants to identify eligible patients, with the result that in many cases neither party seems to have taken the initiative, keeping a lot of vulnerable immunosuppressed patients waiting in vain to be called. It didn't help that shortly afterwards the JCVI/ Health Secretary decided to proceed with the much larger Booster programme, see below.

The Booster Shot is a separate vaccination programme, to top up antibody levels in a much wider population group, including front line health workers, immunosuppressed and their cohabitants, and everyone aged 50+. This programme is underway, and its implementation is obscuring the prior requirement to give a 3rd dose to the most vulnerable individuals.

In your position, on watch and wait, I would ask my haematologist to initiate a request for a 3rd shot. Alternatively you can wait your turn for a booster.

UPDATE! One of the practice admins called half an hour ago. After input from the practice manager (whom I emailed yesterday), she offered me an appointment tomorrow for a dose of Pfizer vaccine plus a dose of flu vaccine. This brings forward my Third Shot by another two weeks. RESULT!

I received a copy of the report from my latest consultation which was sent to my GP. In that report the practice was asked to arrange my BOOSTER dose in due course.

I spoke to a secretary for my consultant yesterday and she had not heard of the third primary dose so went to see my consultant who also HAD NOT HEARD OF IT. Wow!

I emailed a link to the NHS letter of the 2nd Sept to her and she confirmed today that she had passed it on to the consultant.

I then sent a link to the letter (via e-consult) stressing that the third primary dose is not the same as the booster and got the following reply: "Thank you for your recent eConsult request. Thank you for your enquiry regarding your 3rd Primary dose of Covid vaccination. You will receive an invitation by text or letter advising you to book your vaccination in due course."

So, frustratingly, I don't really have a clue as to whether I am getting somewhere or not. At least none of them can say they don't know about it any more!

bennevisplace profile image
bennevisplace in reply to MickUK

Thanks, your story is another illustration of the disparate ways people interpret and relay information. Two quite distinct directives have been fused together in many people's minds. The overarching theme: more confusion and misinformation.

Well this discussion prompted me to message my GP this afternoon. Surprise, surprise had a message back within 30 minutes telling me it is not a third jab but a booster jab and to wait until I am contacted (ie. get back in line). Armed with the responses from here I have messaged back politely pointing out they are mistaken and attaching the 2 September letter. I now wait for the next response but am gearing up for battleDavid

Well played. As you are in post treatment follow-up you definitely qualify for the 3rd shot, and if you live in England your invitation - according to NHS England's directive - is overdue.

Interestingly I received a letter this morning from my GP practice. I thought at first it was my vaccine invite as it started off saying I had been identified as someone who was immunosuppressed due to my health condition. It went on however to advise that any 12-15 year olds in my household were now eligible to he vaccinated. At least I am identified in their system as such.Thanks

David

Belfastbees profile image
Belfastbees in reply to CguLLer

I got a similar letter at the end of July. I'm on w+w but thus far I've not heard anything from anyone in the NHS regarding any further jabs.

FeistyGirl profile image
FeistyGirl in reply to CguLLer

I had the same letter a few weeks ago but nothing about a 3rd vaccine for me!

Quick update. Just got another message back in response to my reply (I can’t fault their efficiency or speed in replying) saying they were referring it to their manager as they were not aware of the third dose. Watch this space …….

So far the responses you've had from your GP surgery are pretty much identical to what I had from mine. If it continues thus, you should have an appointment within a day. Fingers crossed.

Let’s hope so. My next move if not is to call my Haematologist Consultant to ask if they know what is going on. I am East Sussex so sounds like East and West are about as good as each other!

David

Ah, your avatar name relates to your home town perhaps?

Partly. I am in Seaford and we do get a lot of pesky seagulls. Mainly however as a long time supporter of Brighton and Hove Albion. David

So home team then. They are doing well at the moment. As it happens one of the Seagulls' regular players is the son of my study nurse on the FLAIR trial.

Ha, you have me trying to guess which player it is.Anyway latest is I had a message back from my GP practice today to say they have passed my request onto the federation that is administering the vaccine of behalf of our local GPs. Hopefully these people know about the third jab and can fix up an appointment soon.

David

Yes I hope so. It's a battle isn't it.

Interesting development today. I received a letter from Royal Marsden (Sutton) who monitor my CLL. They advise that I am now eligible for the 3rd dose because of my immunosuppression. They advise that I can make an appointment with them to have this done at Sutton. They also advise that as this is seen as part of my primary course of vaccination I will probably be offered a further "booster" dose in 6 months from now.

The Marsden is on the ball. So far, my haematology unit (West Sussex) has been silent on this issue.

This makes complete sense to me. Thank goodness for the RM. Albeit Hammersmith Hospital seem to be singing from the same hymn sheet!

Some may be wondering why a number of us are so adamant about getting the third primary dose rather than just accepting the booster. For me there are three reasons:- firstly timing. The JCVI talk about proximity to the first and second doses. This is not a booster for someone who has a response but whose protection is waning slightly after 6 months. It is for those that may have little or no protection after two doses. So the sooner the better.

- secondly, it is so we get the right vaccine ie. mRNA and the right dose for our conditions.

- thirdly, and for me the most important, is that we should be in line for a booster after 6 months. If we accept getting the booster now then I can see the system saying no in 6 months time.

David

mrsjsmith profile image
mrsjsmith in reply to CguLLer

Excellent explanation David.

Colette

Thank you. Take care

LATEST! This morning I had Pfizer vaccine in one arm and flu vaccine in the other. No reaction yet (was already a bit nasal and headachy).

The senior practice nurse Anna confirmed that the Third Dose and the Booster Dose of Pfizer are both 0.3 ml.

I was phoned today to go for 3rd primary dose on Friday at a clinic being run by the primary care network in Shropshire. The clinic is for immuno compromised patients only. So it is starting to happen. I was expecting to have a fight on my hands as I am Stage 0 with stable lymphocytes. I did email our practice last week asking when clinics would be starting so I don’t know whether that helped. I will ask what the vaccine is being recorded as.

Good to hear. Please let us know how they are recording your 3rd shot.

Had my 3rd shot (Pfizer) last Saturday no side effects. I also had no side effects from the two AZ jabs before. Just checked and this 3rd jab is not yet recorded at all on either NHS App or Patient Access

I haven't checked my patient records. I was handed a pink slip as a souvenir though.

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