Booster to be offered to the most vulnerable and over-50s in winter top-up
Covid booster vaccinations will be offered to all people over 50 and those at greatest risk of the disease as part of the “toolbox” of measures for controlling coronavirus over the autumn and winter following guidance from the government’s vaccine advisers.
The Joint Committee on Vaccination and Immunisation (JCVI) said a third dose of vaccine would top up the immunity in those whose protection had probably waned since their first round of shots earlier this year.
Prof Jonathan Van-Tam, England’s deputy chief medical officer, said the UK vaccination programme had so far prevented an estimated 24m Covid19 infections and 112,000 deaths but warned that the pandemic was still active. “We know this winter could quite possibly be bumpy at times and we know that other respiratory viruses such as flu and RSV [respiratory syncytial virus] are highly likely to [return]. With all of that in mind the mantra, if you like, is to stay on top of things. We want to live our lives as normally as possible from now on … and a high uptake of the booster programme will give us a much increased chance of doing that.”
Data from the UK suggests that protection from two doses of the Pfizer/BioNTech or Oxford/AstraZeneca vaccines wanes within six months, although it is unclear what impact this has on cases of severe coronavirus disease.
Researchers on the Zoe Covid study, at King’s College London, recorded falls in protection after two shots of Pfizer vaccine, from 88% at one month to 74% at five to six months, and with the AstraZeneca vaccine a decrease of protection from 77% at one month to 67% at four to five months.
Public Health England data shows that in fully vaccinated people aged 65 and over protection against hospitalisation fell from more than 90% to a little under 90% over five months. The concern is that protection declines further in the winter when cases are likely to be rising.
The JCVI advised that all over-50s, frontline health and social care workers, and at-risk groups got a booster of the Pfizer vaccine regardless of the vaccine they had first time around, given at least six months after the second dose. While the advisers stated a preference for the Pfizer shot, an alternative is a half dose of the Moderna vaccine – the amount Moderna is proposing for boosters in its applications to European and US regulators.
The UK Covid-19 vaccine programme started in December 2020 with nine priority groups, including elderly people, those clinically extremely vulnerable, and health and social care workers. Immunity in these people is expected to have waned the most. Boosters will be offered to the same groups.
The Medicines and Healthcare products Regulatory Agency has approved the Pfizer, Moderna and AstraZeneca vaccines as boosters.
The JCVI had been awaiting data from some studies, including the UK’s Cov-Boost study, which assessed the extra protection afforded by third doses of several different vaccines.
Speaking on BBC Radio 4’s Today programme, the vaccines minister, Nadhim Zahawi, said the government had accepted the JCVI advice and Covid booster jabs could be given at the same time as flu shots. “This is probably the last piece of jigsaw to allow us to transition this virus from pandemic to endemic and I hope by next year we’ll be in a position to deal with this virus with an annual inoculation programme.”
An expert review in the Lancet on Monday said that even for the Delta variant vaccine efficacy against severe Covid was so high booster doses for the general population “were not appropriate at this stage”.