UK: over-75s and vulnerable people to be offered additional Covid booster jab

Over-75s and people with suppressed immune systems in the UK are to be offered another Covid-19 booster vaccination in the coming weeks to increase potentially waning protection, after advice from the government’s vaccines watchdog.

The Joint Committee on Vaccination and Immunisation (JCVI) has formally advised a rollout of an additional booster this spring for groups of people deemed most vulnerable to severe coronavirus.

The recommendation is that additional boosters should be offered to people aged 75 or over, and residents in older people’s care homes, and anyone aged 12 or above who is immunosuppressed.

The announcement came just before Boris Johnson’s formal unveiling of plans to abolish all domestic coronavirus restrictions across England, including an end to mandatory self-isolation. A decision on the precise plan was delayed at the last minute amid tensions between the chancellor, Rishi Sunak, and the health secretary, Sajid Javid, over funds for free Covid-19 testing.

Additional groups regarded as being at greater risk of severe coronavirus are also likely to be offered a further booster jab this autumn, before an expected rise in infections over next winter, the JCVI added.

It is up to health departments in the four UK nations to decide individually whether to accept the JCVI’s advice. Javid said patients in England would be offered the second booster from about six months after their last dose, and that other nations would do the same.

For people with suppressed immune systems, this would be the fifth vaccine jab they have been offered, comprising two boosters as well as three primary jabs. For older people it would be a fourth – two main vaccinations and two boosters. The bulk of the population has been offered three, two vaccinations and one booster.

The JCVI statement said many of the oldest people had received their booster in September or October, meaning their immunity could be waning.

Prof Wei Shen Lim, who leads on Covid vaccinations for the JCVI, said: “Last year’s booster vaccination programme has so far provided excellent protection against severe Covid-19. To maintain high levels of protection for the most vulnerable individuals in the population, an extra spring dose of vaccine is advised ahead of an expected autumn booster programme later this year.

“The JCVI will continue its rolling review of the vaccination programme and the epidemiological situation, particularly in relation to the timing and value of doses for less vulnerable older adults and those in clinical risk groups ahead of autumn 2022.”

Boosters are different to the primary Covid vaccinations, in part as they follow two main jabs and are aimed at boosting the protection already offered, and also as they can be smaller doses.

Adults in both categories getting a second will be offered 50-microgram doses of the Moderna vaccine, while eligible 12- to 18-year-olds will be offered 30 microgram doses of the Pfizer/BioNTech version.

Javid confirmed he had accepted the latest advice. The health secretary said: “We know immunity to Covid-19 begins to wane over time. That’s why we’re offering a spring booster to those people at higher risk of serious Covid-19 to make sure they maintain a high level of protection. It’s important that everyone gets their top-up jabs as soon as they’re eligible.

“The JCVI will keep under review whether the booster programme should be extended to further at-risk groups.”

The decision comes five days after Javid accepted separate JCVI advice for children aged five to 11 in England to be offered a vaccine, while emphasising that parents would be expected to make their own decision.

Daniel Altmann, professor of immunology at Imperial College London said the recommendation was “a good safety measure for the more vulnerable”, adding that such schemes needed to be properly gauged for effectiveness.

“In an ideal world, any advice of this type needs to remain firmly tethered to ongoing monitoring programmes of caseload and immunity – otherwise we’re just operating on guesswork,” he said.

Prof Lawrence Young, a virologist at the University of Warwick, agreed. “It makes sense to continue to protect the most vulnerable – particularly if the requirement for self-isolation is removed and testing is going to become more limited,” he said.

“We know that the elderly and most vulnerable are more susceptible to infection and can mount poor immune response to vaccination. So it makes sense to protect against future variants and to provide longer-lived immune responses for these individuals.”

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