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Covid booster vaccines extended to over-40s

over 40

By Caitlin Tilley and Costanza Pearce

15 Nov 2021

Covid booster vaccines will be extended to people aged over 40, following a new recommendation from the Joint Committee on Vaccination and Immunisation (JCVI).

Young people aged 16 and 17 will also be offered a second dose of the Pfizer jab, following the new advice.

The governments of all four UK nations have accepted the advice.

The JCVI advised that ‘in addition to those aged over 50 years and at higher risk from coronavirus , all adults aged 40 to 49 years should be offered an mRNA booster, six months after their second dose, irrespective of the vaccines given for the first and second doses.’

It added that recent UK and international data have ‘provided early signs of a slight fall in the levels of protection against severe disease from the primary doses in those who had their initial vaccines a long time ago’. 

There is ‘no robust evidence’ of a decline in protection against hospitalisation and death from Covid in under-40s who have had two doses of the vaccine ‘as yet’, the JCVI said.

‘JCVI will continue to closely review all available data to develop further advice in due course’, it added.

The JCVI also recommended that all 16 and 17 year-olds who are not in an at-risk group and therefore already eligible should be offered a second dose of the Pfizer vaccine 12 weeks or more after their first jab.

Those in the cohort who have had coronavirus should be given their second dose 12 weeks after a positive Covid test result or 12 weeks or more after their first dose, depending on ‘whichever is later’, it said. 

The JCVI concluded that the ‘balance of risks and benefits supports offering a second dose’ to the group, following a review of the ‘latest evidence’, the JCVI added.

It said: ‘As protection from the first dose will eventually start to decline, the benefits from the second vaccine dose will become more important over time. A second dose may also offer a reduction in the risk of hospitalisation and onward transmission to vulnerable close contacts.’

‘Extremely rare’ adverse reactions such as myocarditis have been reported ‘more frequently after the second vaccine dose compared to the first’ outside the UK, it added.

However, in countries like the UK and Canada where there is a longer interval between doses, ‘rates following the second vaccine dose are closer to the reporting rate after the first dose’, it said.

It added: ‘The latest available data indicate that myocarditis following vaccination usually resolves within a short time, most cases respond well to treatment and where information is available, no major complications have been identified in the medium term (months).

‘Taking these factors into consideration, JCVI has concluded that the balance of risks and benefits supports offering a second dose of the Pfizer-BioNTech Covid-19 vaccine in persons aged 16 to 17 years who are not in an at-risk group.’

JCVI chair of Covid-19 immunisation Professor Wei Shen Lim added that extending booster doses to over-40s and second doses to 16-17s will ‘help extend our protection into 2022’.

Speaking at a press briefing, he confirmed that 40-49s should be given either the Pfizer vaccine or a half-dose of the Moderna vaccine for their booster, in line with the rest of the booster programme so far.

He added: ‘It may well be that adults who are under 40 years might require a booster dose or third dose at some point.’

England’s deputy chief medical officer, Professor Jonathan Van-Tam, said: ‘I have full confidence in both of the decisions that have been announced today. The UK expects to have enough supplies of vaccine to implement these changes. 

‘The details of how to access the boosters for these extra two layers of protection will be announced in due course by the NHS.’

Elderly adults, at-risk patients and health and social care workers ‘remain the top priority for boosters’, he added.

The MHRA said it welcomed the JCVI’s new advice as its ‘safety monitoring to date shows that Covid-19 vaccines continue to have a positive safety profile for the majority of people’ and its ‘proactive monitoring of the safety of booster doses does not raise any new concerns’.

Health secretary Sajid Javid: ‘Today I have accepted the advice from the independent experts at the JCVI to extend the additional offer of a booster jab to people aged 40 and over and offer a second dose of a vaccine to all young people aged 16 to 17 as part of the primary vaccination schedule.

‘I have asked the NHS to prepare to offer those eligible a vaccine as soon as possible.’

He added: ‘We know immunity to Covid-19 begins to wane after six months and new data published today shows a third dose boosts protection against symptomatic infection to more than 90% – this highlights just how important it is that everyone eligible gets their top-up jabs as soon as possible.

‘The JCVI will keep under review whether the booster programme should be extended to all people under the age of 40 and I look forward to receiving their advice in due course.’

Booster jabs have so far been rolled out to all patients in groups 1-9 of the first phase of the Covid vaccination campaign – including those who are vulnerable to Covid and the over-50s – according to JCVI advice.

Meanwhile, the Government accepted new JCVI advice for 16-17-year-olds to become eligible for one dose of a Covid vaccine on 4 August.

At the time, the JCVI had not yet finalised advice for second doses for the cohort, but said the ‘the aim’ was for this to be ‘from’, but not necessarily at, 12 weeks following the first dose.

This story first appeared on our sister website, Pulse.


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