Department of Health and Social Care
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Guidance updated to allow flexibility in booster programme for most vulnerable

Clinical guidance has been updated to allow COVID-19 boosters to be given earlier to those at highest risk where this makes operational sense

  • Flexibility means programme will protect the most vulnerable more quickly
  • Guidance clarification comes as the UK hits seven million boosters administered

COVID-19 booster vaccines can now be given sooner than six months after their second dose to certain vulnerable people where this makes operational sense, as the UKHSA’s Green Book has been updated.

It will for example allow care home residents who may have received their second doses at different times to be vaccinated in the same session, as long as it’s been five months since their second dose. It may also help with other vulnerable groups, such as housebound patients, so that they can have their flu and COVID-19 vaccines at the same time.

The flexibility in clinical guidance will speed up the administration of life-saving booster jabs, making it more efficient to reach the country’s most vulnerable, helping to ensure they’re protected over the coming winter months.

Also under this guidance, people who are eligible for a booster and are about to receive immunosuppressive treatment which would hinder their immune system will be able to get their booster from a minimum of four months after their second dose. This will ensure they can time their booster for when their immune system is best able to respond.

This is the practical approach to vaccination that has made the programme successful so far.

Health and Social Care Secretary Sajid Javid recently said:

We are making great progress with the booster rollout and I want to thank everyone working so hard to get jabs in arms.

This updated guidance will ensure healthcare professionals have the necessary flexibility in the booster programme, allowing more vulnerable people to be vaccinated where it makes operational sense to do so – including our loved ones in care homes.

The UKHSA’s Green Book contains the latest information on vaccines and vaccination procedures in the UK for healthcare professionals.

Those the guidance applies to will not need to take additional steps.

People outside of these specific circumstances will continue to be invited for the COVID-19 booster jab when it’s their turn, six months after their second dose - if they have not been contacted within a week of reaching six months since their second jab they can head online via NHS.UK to book their jab. People who cannot go online can call 119 too.

The independent Joint Committee on Vaccination and Immunisation (JCVI) has advised that those most at risk to the virus receive their booster six months after their second dose, based on the available evidence. The government accepted this advice earlier this year. This advice has not changed and the JCVI keeps its advice under continuous review, using the latest data available.

Vaccines give high levels of protection but immunity reduces over time, particularly for older adults and at-risk groups, so it is vital that vulnerable people come forward to get their COVID-19 booster vaccine to top-up their defences and protect themselves this winter.

The latest evidence from SAGE shows that protection against symptomatic disease falls from 65%, up to 3 months after the second dose, to 45% six months after the second dose for the Oxford/AstraZeneca vaccine, and from 90% to 65% for the Pfizer/BioNTech vaccine. Protection against hospitalisation falls from 95% to 75% for Oxford/AstraZeneca and 99% to 90% for Pfizer/BioNTech.

Although the vaccine efficacy against severe disease remains high, it should be noted that a small change can generate a major shift in hospital admissions (e.g. a change from 95% to 90% against hospitalisation would lead to doubling of admissions in those vaccinated).

The booster programme is designed to top up this waning immunity. Early results from Pfizer show that a booster following a primary schedule of the same vaccine restores protection back up to 95.6% against symptomatic infection.

The news comes as the UK hits over seven million booster jabs, after a record breaking week of more than two million being administered in the last seven days alone.

A total of 7,293,638 people have received their booster jab in the UK. 45,651,222 people have received two doses (79.4%) and 49,882,904 people have received one dose (86.7%).

Vaccines Minister Maggie Throup recently said:

COVID-19 booster vaccinations are extremely important in keeping people and their loved ones safe this winter, and this updated guidance will ensure the programme can adapt to best protect certain groups.

I encourage everyone eligible for their jab to book theirs as soon as possible and secure this protection.

Vaccine confidence is high with data from the Office for National Statistics showing nearly all (94%) of those aged 50 to 69 say they would be likely to get their COVID-19 booster if offered, with the figure rising to 98% for those over 70.

Flu is another winter virus. To give people the best protection over winter, those eligible for a free flu vaccine should come forward and book an appointment at either their GP practice or their local pharmacy, or take it up when offered by their employer or other healthcare provider.

There are more than 500 extra vaccination sites now compared to April this year, with 1,697 vaccination centres in operation in April 2021, and over 2,200 vaccination centres in operation now.

Vaccines are also available for those aged 12-15 to offer the best possible protection this winter in schools, as well as over 100 vaccine centres.


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