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Another point I think is important is that generally, longer spacing between doses does lead to better overall protection in other vaccines.
There is obvious uncertainty here, not least because the Pfizer and Moderna vaccines are different to traditional vaccines. However, the Moderna has shown evidence that longer spacing may be appropriate.
With the AZ vaccine, which is the more traditional approach, my understanding is that longer spacing is almost always preferable.
This also needs to be considered against the demographic of how the disease is spreading. Generally, it builds in the younger population, who are out and about more, and seeps into the older population.
If we give all the vaccine to the most vulnerable, who are more likely to be holed up indoors, we will do nothing about bringing down the transmission rates in the portion of the population driving transmission. This is a strong argument for trying to spread the vaccine as widely as possible, while also imploring those who have been vaccinated to maintain social distancing etc.
Scrabble-
If we give all the vaccine to the most vulnerable, who are more likely to be holed up indoors, we will do nothing about bringing down the transmission rates in the portion of the population driving transmission.
https://www.wired.com/story/covid-19-vaccine-super-spreaders/
(Not my opinion, but an opinion).
Fox
This is the point that the previous comments have been trying to make.
The recommendations from the manufacturers are based on the testing they did. The testing they did was constrained by the need to get the vaccine out ASAP.
The expectation is that if there wasn't such a rush to get the vaccine out they would have had more time to their testing and their recommendations would then be to have a longer gap between the doses.
But the manufacturer cannot make that claim without being able to back it up with testing. What the virologists are saying is that, in general, longer gaps between vaccines usually make them more effective in the long term, so that it isn't much of a gamble to extend the doses.
From the BMJ report:-
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What do the manufacturers say?
In a joint statement Pfizer and BioNTech said, “The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design . . . There is no data to demonstrate that protection after the first dose is sustained after 21 days.”
The European Medicines Agency has said that the gap between the first and second doses of the Pfizer-BioNTech vaccine should not exceed 42 days. “Any change to this would require a variation to the marketing authorisation as well as more clinical data to support such a change, otherwise it would be considered as ‘off-label use,’” the agency said.
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People are taking "There is no data to demonstrate that protection after the first dose is sustained after 21 days." to mean "Protection is not sustained after 21 days." but it obviously doesn't mean that.
If I study a cat for 21 days and then say "There is no data to demonstrate that the cat stays alive after 21 days." does not mean the cat drops dead soon after 21 days, it just means I've no idea what happens after 21 days. Obviously the cat doesn't live forever, but I can't use this info to make a guess at how long cats live, it could be 3 months, 3 years, 30 years. If I want to do that then I need a study that is much longer than 21 days, but we couldn't wait longer for a longer vaccine trial, otherwise more people would be dying. (This is what they are going to be doing with the vaccine programme now, they will be studying the cases with the extended programme.)
Also, if a year ago people had said that a vaccine would have been available with 70% efficacy and we'd be getting ~2 million doses of it a week people would have been over the moon about it and amazed at the turnaround and scientific effort. However, throw in the chance that 92% (or whatever) is possible and now people focus on that higher number and feel they're being short changed.
The simple fact is that the JCVI believe that spacing out the dosing will save more lives as it allows some level of immunity to be conferred on more people rather than giving half those people a greater level of immunity.
If supply wasn't a problem they'd follow the manufacturers recommendation although there would still be a chance that this is not the path to greatest protection.
The UK has ordered enough vaccines, more than enough, the limit is due to the suppliers. They can't make it quick enough, especially as the suppliers will have contracts with hundreds of different countries. The Government can't magically force them to make more or make it quicker.
I would hope, also, that the Government is considering giving some of the vaccines they have purchased to other countries. If they have bought 360mm doses, and they only need ~130mm doses for the current population (and ~1mm doses per year ongoing) then a huge chunk of those extra doses should be going to other countries as a form of international aid. And yes, as a fit healthy person in their 40s with no underlying health conditions I'd be happy to wait even longer so that more vulnerable or aged people in other countries get a vaccine before me.