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September 2021

COVID booster programme to start immediately

The Government has announced that COVID-19 vaccination boosters will go ahead for everyone over the age of 50. Vaccinations were expected to get underway immediately, and the MHRA has advised they can be administered alongside the seasonal flu vaccination.

It means around 30 million patients will be eligible for a booster, including the over-50s, people living in residential care, patients aged 16 to 49 in at risk groups, and frontline health and social care workers.

The booster should be given at least 6 months after the second dose. To date 89.1% of the UK population has had at least one dose, and 81% have received both doses, but data show that protection from the primary course may decrease gradually over time.

The Joint Committee on Vaccination and Immunisation (JCVI) has stated a ‘preference’ for the Pfizer-BioNTech vaccine for the booster programme, irrespective of which vaccine brand was given as primary doses, based on results of the COV-BOOST trial which indicated that this vaccine is well tolerated as a third dose and provides a strong booster response.

Alternatively, a half dose of the Moderna vaccine could be used. Where mRNA vaccines cannot be used, e.g. due to allergies, the AstraZeneca vaccine can be considered for those who received it in their primary course.

The ComFluCOV trial indicates that co-administration of the flu and COVID vaccines is generally well tolerated with no reduction in immune response to either vaccine. Therefore, the two vaccines may be co-administered where practical – although some patients will already have been given their flu vaccine before they are due a COVID booster.

The decision to offer boosters forms part of the Government’s plan to manage COVID this autumn and winter, but goes against WHO advice.

A review in The Lancet concluded that vaccine efficacy against severe COVID is so high – against both the delta and alpha variants – that boosters for the general population were unnecessary.

In populations with high vaccination coverage, the unvaccinated minority are still the major drivers of transmission, as well as being at the highest risk of serious disease, the review states.

‘The limited supply of these vaccines will save the most lives if made available to people who are at risk of serious disease and have not yet received any vaccine. Even if some gain can ultimately be obtained from boosting, it will not outweigh the benefits of providing initial protection to the unvaccinated,’ said lead author Dr Ana-Maria Henao-Restrepo, WHO.

  • In separate announcements, children and young people aged 12 to 17 years are to be offered COVID vaccinations, and a third dose (primary course) has been recommended for patients with severe immunosuppression.
Practice Nurse 2021;51(7):7