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Covid-19: Booster Vaccines

Volume 698: debated on Wednesday 30 June 2021

Today the Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice on options for a covid-19 booster vaccination programme for adults this Autumn.

It should be noted that this is interim advice and the JCVI will consider additional scientific data as it becomes available over the next few months ahead of developing its final advice. This includes, but is not limited to, further data on the durability of protection from vaccines beyond six months, and clinical trial data on immune responses following a third vaccination.

In summary, on the basis of current evidence and with the aim of reducing the occurrence of serious covid-19 disease, the JCVI advises the following as the likely shape of the autumn programme.

Any potential booster programme should begin in September 2021, in order to maximise protection in those who are most vulnerable to serious covid-19 ahead of the winter months. Influenza vaccines are also delivered in autumn, and the JCVI considers that, where possible, a synergistic approach to the delivery of covid-19 and influenza vaccination could support delivery and maximise uptake of both vaccines.

Any potential covid-19 booster programme should be offered in two stages.

Stage 1. The following persons should be offered a third dose covid-19 booster vaccine and the annual influenza vaccine, as soon as possible from September 2021:

adults aged 16 years and over who are immunosuppressed;

those living in residential care homes for older adults;

all adults aged 70 years or over;

adults aged 16 years and over who are considered clinically extremely vulnerable;

frontline health and social care workers.

Stage 2. The following persons should be offered a third dose covid-19 booster vaccine as soon as practicable after stage 1, with equal emphasis on deployment of the influenza vaccine where eligible:

all adults aged 50 years and over;

adults aged 16 to 49 years who are in an influenza or covid-19 at-risk group (please refer to the green book for details of at-risk groups);

adult household contacts of immunosuppressed individuals.

As most younger adults will only receive their second covid-19 vaccine dose in late summer, the benefits of booster vaccination in this group will be considered at a later time when more information is available. The initial objective for winter 2021-22 is for persons in booster stages 1 and 2 to receive their influenza and covid-19 vaccines in good time.

Apart from the current UK approved covid-19 vaccines, the UK has placed orders for a range of other covid-19 vaccines, some of which may become available for use in a booster programme.

The JCVI will review the use of these vaccines once they have received UK regulatory approval. Vaccines designed specifically against variants of concern will not be available in time for booster revaccination this autumn. The use of variant vaccines will be considered by the JCVI in due course.

Additional scientific data will become available over the next few months which will require further consideration by the JCVI ahead of any final advice. These include:

further data on the safety and effectiveness of covid-19 vaccines used in the UK and internationally;

clinical trial and real-world effectiveness data on the durability of protection beyond six months;

clinical trial data on immune responses following a third vaccination (booster revaccination);

clinical trial data on reactogenicity and immunogenicity following booster revaccination with the same or alternative covid-19 vaccines;

clinical trial data on other covid-19 vaccines in development;

the emergence of any new variants of concern in the UK or internationally;

data on the duration of immunity following a primary course;

a better understanding of the immune correlates of protection; and

data on the effects of on-going sars-cov-2 circulation in the population and its potential to confer long-term public health benefits.

JCVI note early evidence supports the delivery of both covid-19 and flu vaccines at the same time where appropriate.

Subject to the JCVI’s final advice, we are developing detailed plans for a booster programme. NHS England and NHS Improvement will be asking all local systems to develop detailed plans to ensure they are ready to deliver a booster programme from the start of September in line with this advice, working closely with partners including local authorities and voluntary organisations to ensure equal access and maximise uptake of both covid-19 and influenza vaccines.

All four parts of the UK welcome this interim advice, which will help us ensure we are ready in our preparations for autumn. We look forward to receiving the committee’s final advice in due course.