Senior doctors are calling on England's chief medical officer to cut the gap between the first and second doses of the Pfizer-BioNTech Covid-19 vaccine.
Health officials across the UK extended the maximum wait from three to 12 weeks to get the first jab to more people.
But in a letter seen by the BBC, the British Medical Association said the current plan was "difficult to justify" and should be changed to six weeks.
Prof Chris Whitty said extending the gap was a "public health decision".
Speaking at a Downing Street briefing on Friday, he said it would allow "many more people to be vaccinated much more quickly".
The government's Joint Committee on Vaccination and Immunisation (JCVI) says unpublished data suggests the Oxford-AstraZeneca vaccine is still effective with doses 12 weeks apart - but Pfizer has said it has tested the vaccine's efficacy only when the two doses were given up to 21 days apart.
The World Health Organization has recommended a gap of four weeks between doses - to be extended only in exceptional circumstances to six weeks.
The Department of Health and Social Care said the decision to extend the maximum gap between doses for both the Oxford and Pfizer vaccines "followed a thorough review of the data and was in line with the recommendations of the UK's four chief medical officers".
"Our number one priority is to give protection against coronavirus to as many vulnerable people as possible, as quickly as possible," a spokeswoman added.
In the letter to Prof Whitty, the British Medical Association (BMA) said it agreed that the vaccine should be rolled out "as quickly as possible" - but called for an urgent review and for the gap to be reduced.
The doctors' union said the UK's strategy "has become increasingly isolated internationally" and "is proving evermore difficult to justify".
"The absence of any international support for the UK's approach is a cause of deep concern and risks undermining public and the profession's trust in the vaccination programme," the letter said.
Dr Chaand Nagpaul, chair of the BMA, said there were "growing concerns" that the vaccine could become less effective with doses 12 weeks apart.
"Obviously the protection will not vanish after six weeks, but what we do not know is what level of protection will be offered [after that point]," he told BBC Breakfast.
"We should not be extrapolating data when we don't have it."
There has been understandable enthusiasm over a promising start to the hugely ambitious UK vaccination rollout.
But there has been some tension over the decision to lengthen the time between doses for the Pfizer vaccine to 12 weeks.
Prof Whitty and other health leaders and experts say this will allow many more people to get vaccinated quickly and the first dose gives most of the protection.
But critics argue this goes against Pfizer's recommendation of a three-week gap and there is no data to back up the long delay.
The intervention of the BMA is significant as it shows senior doctors now have widespread concerns, including worries about reliability of supplies if people have to wait longer for a second jab.
This is a private letter to Prof Whitty seen by the BBC and not a grandstanding press release.
The BMA wants to have talks with the chief medical officer about moving to six weeks. Prof Whitty will no doubt restate his case.
It will be interesting to see whether the BMA argument gains traction in the wider medical world.
The BMA also suggested second doses might not be guaranteed after a 12-week delay "given the unpredictability of supplies".
However, Public Health England's medical director said people would get their second dose.
Dr Yvonne Doyle told BBC Radio 4's Today programme that she backed the current strategy, saying it was "about bearing down on transmission" to reduce deaths and reduce the chance of more dangerous variants of the virus emerging.
"The more people that are protected against this virus, the less opportunity it has to get the upper hand," she said.
Other issues highlighted in the letter include:
- Concerns that one dose of the Pfizer jab "does not produce sufficient neutralising antibodies and the potential to reduce transmission"
- A mismatch between policies across the UK - in particular, Northern Ireland's decision to give the Pfizer vaccine to care home residents and staff within three weeks
- Reports from Israel's vaccination programme suggesting "lower protection than expected"
The UK's chief medical officers have said the "great majority" of initial protection came from the first jab, while the second dose is likely to help the protection last longer.
The Pfizer and Oxford vaccine are both expected to work against the variant of Covid-19 that emerged in the UK.
At Friday's briefing, Prime Minister Boris Johnson said early evidence suggests the variant may be more deadly.
Previous work suggests the new variant spreads between 30% and 70% faster than others, and there are hints it is about 30% more lethal.
A further 40,261 cases, and 1,401 deaths within 28 days of a positive coronavirus test were reported on Friday in the UK.
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https://news.google.com/__i/rss/rd/articles/CBMiJmh0dHBzOi8vd3d3LmJiYy5jby51ay9uZXdzL3VrLTU1Nzc3MDg00gEqaHR0cHM6Ly93d3cuYmJjLmNvLnVrL25ld3MvYW1wL3VrLTU1Nzc3MDg0?oc=5
2021-01-23 08:06:00Z
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