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Select immunosuppressed people should have third vaccine separate to booster programme

Covid vaccine

By Isabel Shaw
Reporter

01 Sep 2021

A select group of people who are considered severely immunosuppressed should be offered a third dose — or ‘top up’— of the Covid vaccine separate from the national booster programme, the vaccine committee has recommended.  

The Joint Committee on Vaccination and Immunisation (JCVI) has decided that a third dose of the vaccine should be offered to between a select number of people with compromised immune systems.  

Those over the age of 12 will be offered the Pfizer vaccine, while people over 18 could be offered the Pfizer or the Moderna vaccine. 

The JCVI confirmed that the number of people included in this group was around 400,000 to 500,000 people across the UK.  

Those who would be eligible for the third dose will not include all those who were previously considered clinically extremely vulnerable. Instead, it will only include those who have underlying health conditions that weaken immunity – such as those with HIV  and those who take drugs that weaken their immune system – such as transplant patients.  

The JCVI said that the decision on the timing of the third dose will be made by each patient’s GP or consultant.

This comes after recent evidence from the OCTAVE trial suggested that 40% of those who had two vaccines and were immunosuppressed had low levels of antibodies suggesting that they could have low levels of protection against Covid. 

This vaccine rollout is separate from the booster plan, for which details are still being decided by the JCVI. 

Professor Wei Shen Lim, chair of Covid-19 immunisation for the JCVI, said: ‘We want people with severely suppressed immune systems to have the best chance of gaining protection from  

Covid-19 via vaccination. Therefore, we are advising they have a third vaccine dose on top of their initial two2 doses, as we hope this will reduce their risk of severe outcomes such as hospitalisation and death.’ 

‘Those with less serious immunosuppression are not included in this advice but are likely to become eligible for another dose as part of a potential booster programme, pending further advice from the JCVI. 

‘In the event of a booster programme, it is expected that severely immunosuppressed people will also be offered a booster dose, at a suitable interval after their third dose. 

‘A third primary dose is an extra ‘top-up’ dose for those who may not have generated a full immune response to the first two2 doses. In contrast, a booster dose is a later dose to extend the duration of protection from the primary course of vaccinations.’ 

The autumn booster programme is provisionally due to begin on 6 September, with phases one and two due to end on the 31 October to ensure pharmacies have time to offer the first two doses of the vaccine to all adults in England. 

In July, NHS England said that community pharmacies will be expected to deliver 3.5 million vaccines per week over the booster period. 


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