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Covid-19: JCVI advises further booster for vulnerable adults and health and care workers

BMJ 2022; 377 doi: https://doi.org/10.1136/bmj.o1277 (Published 20 May 2022) Cite this as: BMJ 2022;377:o1277
  1. Jacqui Wise
  1. Kent

An additional booster dose of covid-19 vaccine will be offered to the most vulnerable adults and some health and social care workers this autumn, under draft guidance from the Joint Committee on Vaccination and Immunisation.

However, most people in the UK under the age of 65 will be excluded from the autumn booster programme if the interim advice, which has been issued for “purposes of operational planning,” remains in place.

The JCVI said that considerable uncertainty remained over the likelihood, timing, and severity of any potential future wave of covid in the UK in the year ahead. Despite this uncertainty, winter will remain the season when the threat from covid is greatest for individuals and for healthcare workers, it said.

The committee added that the primary objective of the 2022 autumn booster programme would be to increase population immunity and protection against severe covid disease, specifically hospital admissions and deaths, over the winter period.

It recommended that in autumn 2022, a further covid vaccine should be offered to:

  • Residents and staff of care homes for older adults

  • “Frontline” health and social care workers

  • All those 65 years of age or over, and

  • Adults aged 16-64 years who are in a clinical risk group.

Currently a narrower group is being offered a spring booster: the over 75s, residents in care homes for older adults, and people aged 12 or over who are immunosuppressed.

Wei Shen Lim, chair of covid-19 vaccination on the JCVI, said, “Last year’s autumn booster vaccination programme provided excellent protection against severe covid-19, including against the omicron variant. We have provided interim advice on an autumn booster programme for 2022 so that the NHS and care homes are able to start the necessary operational planning, to enable high levels of protection for more vulnerable individuals and frontline healthcare staff over next winter.”

The JCVI said it will continue to review 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. Final plans, including further detail on the definitions of clinical risk groups, will be published in due course.

Commenting on the advice, Jonathan Ball, professor of molecular virology at the University of Nottingham said, “We know that immunity to covid-19 following vaccination or indeed infection contracts over time, so giving those individuals most at risk from developing severe covid-19 a boost just before virus circulation is likely to pick up during autumn and winter months seems sensible.”

But Ball added, “The exact timing will be important, as you don't want to wait until virus circulation has already started to increase, although hopefully those most at risk have already had their spring booster, which will be standing them in good stead.”

However, Christina Pagel, professor of operational research at University College London and a member of the Independent SAGE group, commented on Twitter. “What this means is that JCVI has effectively given up on trying to prevent infections and that will have consequences (bad ones) for long covid.”

Meanwhile, in the US, the Centers for Disease Control has recommended vaccine boosters for children aged 5 to 11 years. Boosters were recommended for adults in November and for children 12 or older in January.

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