Just half a million Britons with severely suppressed immune systems will be invited for a third Covid jab after the Government’s vaccine advisory panel finally signed off on plans for boosters doses tonight.
Between 400,000 and 500,000 of the most vulnerable patients — including those with leukemia, HIV and organ transplant patients — will be made eligible for the top-up doses when the rollout expands in the coming days.
The Joint Committee on Vaccination and Immunisation (JCVI) said there was evidence to suggest a significant number of these people did not mount a strong immune response after their first two injections.
Adults aged 18 and above will be offered either the Pfizer or Moderna jab even if they were initially immunised with AstraZeneca’s, after a number of studies showed the mRNA vaccines make safe and effective third doses.
Immunosuppressed children aged 12 to 17 will only be offered Pfizer’s vaccine due to a lack of safety and efficacy data on the other jabs in this age group.
The JCVI said a third dose was ‘very unlikely’ to cause any harm to immunocompromised people and had the potential to protect them, which swung the balance in favour of revaccination.
However, the group insisted the new recommendation is separate from a broader booster programme which would target healthy elderly people and other vulnerable Britons with underlying illnesses.
The JCVI said it was waiting on more evidence that these people would benefit from another dose and claimed that the ‘vast majority’ of the population still had high protection.
There has been growing pressure for the UK to follow Israel, which has managed to curb rising hospital admissions after rolling out boosters for over-60s in July. The country has since expanded the scheme to all over-30s.
A number of studies in the UK and US have also suggested that vaccine effectiveness is already waning in elderly groups. Health Secretary Sajid Javid welcomed the announcement tonight but said the Government was continuing to plan for a wider booster programme to begin this month.
Former Health Secretary Jeremy Hunt earlier today called for boosters ‘not just for the clinically vulnerable but for everyone’, citing Israel’s success and evidence of dwindling immunity. Covid cases remain stubbornly high in the UK — there are about 35,000 each day on average — and hospital rates have been creeping up as the country moves into the colder months and schools go back.
Just half a million Britons with severely suppressed immune systems will be invited for a third Covid jab after the Government’s vaccine advisory panel finally signed off on plans for boosters doses tonight. Patients who are eligible are listed above
The decision was made on the back of results from the Octave study published last week. It found about one in 10 in the vulnerable group failed to generate any detectable Covid antibodies four weeks after their second dose of Pfizer or AstraZeneca. A further 30 per cent generated a significantly lower antibody response than healthy people, according to the study published as a pre-print in The Lancet
Between 400,000 and 500,000 of the most vulnerable patients — including those with leukemia, HIV and organ transplant patients — will be made eligible for the top-up doses when the rollout expands in the coming days. The UK’s rollout has seen more than 90 doses in total administered so far
There had been growing pressure for Britain to go with a more broad booster programme like in Israel. Professor Eran Segal, a mathematician at the country’s Weizmann Institute, tweeted today that hospitalisations had started to fall just two weeks after the top-up campaign started. This graph shows how Covid hospitalisations have started to level off in Israel just two weeks after its booster programme began. When the drive was started hospitalisations were doubling every week. Predictions suggested this would continue (green line). But just two weeks after the jabs were given out actual hospitalisations have slowed (blue line)
There are more than 3.7million extremely clinically vulnerable people in the UK, according to the Office for National Statistics. Of these, around 500,000 are classified as immunosuppressed
Today’s decision came after a trial found that 40 per cent of extremely immunosuppressed people have low levels of antibodies after two vaccines. Ten per cent of them had no detectable levels at all weeks after their second jab.
Immunosuppressed patients who were made eligible for third doses are being advised to wait at least eight weeks after their second dose before scheduling the third appointment.
They should also consult with their doctor about the best time to get the top-up vaccine to give their body the best chance of a strong immune response.
For example, it is preferable to give a vaccine dose before someone undergoes chemotherapy, rather than during their treatment.
Professor Wei Shen Lim, chair of Covid immunisation for the JCVI, said: ‘We want people with severely suppressed immune systems to have the best chance of gaining protection from Covid via vaccination.
‘Therefore, we are advising they have a third vaccine dose on top of their initial two doses, as we hope this will reduce their risk of severe outcomes such as hospitalisation and death.’
Officials have insisted the new recommendation is different from a booster programme because the third doses being offered now are to ‘top up’ immunity in people who never had a good response after two injections.
A study by King’s College London last week suggested vaccine immunity against infection is already waning. Scientists monitored break-through Covid infections in 1.2million people who had received two doses of either the Pfizer or AstraZeneca vaccine. They found that immunity wanes over time. For the Pfizer jab (blue line) it dropped from 88 per cent protection against infection to 74 per cent up to six months after the second dose. And for the AstraZeneca jab (pink line) it dropped from 77 per cent to 67 per cent five months after the second dose. Experts suggested the effectiveness could drop to 50 per cent by the winter
According to a study being reviewed by the Centers for Disease Control and Prevention (CDC) in the US, protection against hospital admission from the virus drops to as low as 75 per cent in under a year in some vulnerable people, from 95 per cent shortly after vaccination. Pfizer’s (blue could be as low as 75% in over-75s) while Moderna’s is around 80% in that age group
WHO IS ELIGIBLE FOR A THIRD COVID VACCINE?
Group 1: Patients with conditions that weaken their immune systems, including:
• Acute and chronic leukaemias, or cancer of the white blood cells
• Aggressive lymphomas (including Hodgkin’s lymphoma), a type of cancer
• Indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias, or types of cancer
• Adults on medication for HIV/AIDS with low levels of white blood cells
• Lymphopaenia suffers, a condition where there are fewer white blood cells than normal
• People who have received a stem cell transplant in the last two years
• Agammaglobulinaemia sufferers, who are less likely to make antibodies
Group 2: Patients on medication that suppresses their immune system, including:
• People receiving immunosuppressive therapy after an organ transplant in the past six months
• People who received therapy for autoimmune disease in the past three months
• People who have received immunosuppressive chemotherapy or radiotherapy in the past six months
Group 3: Patients with chronic immune-mediated inflammatory disease who were receiving treatment, including:
• High dose corticosteroids for more than 10 days in the previous month
• Long term moderate dose corticosteroids in the previous three months
• Patients who got methotrexate, azathioprine, 6-mercatopurine and mycophenolate in the previous three months
• Those who got immunosuppresants other than hydroxychloroquine or sulfasalazine
• Patients receiving methotrexate with leflunomide in the previous three months
Group 4: Patients who received high dose steroids a month before they were vaccinated
This is different from a booster, they claim, which is something you give to people who have generated good response to two sometime later in order to extend duration.
An announcement on the true booster programme is expected in the coming weeks and could include people with less severe immune problems, as well as the very elderly.
No decision has been given either on any extension of the vaccine programme to include all healthy 12 to 15-year-olds.
Mr Javid said he has accepted the JCVI’s recommendation for third doses but would continue to plan for a booster programme.
He said: ‘We know people with specific conditions that make them particularly vulnerable to Covid-19 may have received less protection against the virus from two vaccine doses.
‘I am determined to ensure we are doing all we can to protect people in this group and a third dose will help deliver that.
‘The NHS will contact people as soon as possible to discuss their needs and arrange an appointment for a third dose where clinically appropriate.
‘This is not the start of the booster programme – we are continuing to plan for this to begin in September to ensure the protection people have built from vaccines is maintained over time and ahead of the winter.
‘We will prioritise those most at risk to Covid-19, including those who are eligible for a third primary vaccine, for boosters based on the final advice of the JCVI.’
Data from Israel has bolstered calls for booster doses to be dished out urgently.
The country, which has been ravaged by a third wave despite its world-leading roll-out, has seen the number of seriously ill patients start to tail off over the past week — despite cases only starting to fall in the past few days.
Israel started to offer over-60s — who are the most at risk of being hospitalised if they catch Covid — third jabs at the start of August. Last week it expanded the drive to everyone who’s already had two doses.
Ahead of the JCVI announcement tonight, former health secretary Jeremy Hunt questioned why a wider rollout was not being recommended.
He tweeted: ‘The clear lesson for the UK seems to be…get on with booster jabs, not just for the clinically vulnerable but for everyone. The latest Zoe study showed vaccine effectiveness dropping after six months, so why are we hanging around?’
Real-world data already suggests vaccine efficacy is waning. Elderly people were the first to be jabbed when Britain’s roll-out began last December.
US health chiefs last night released figures showing jabs now only cut the risk of hospitalisation by around 75 per cent against the Delta variant, compared to 95 per cent when the shots first became available — but they insisted its ability to prevent serious disease was still high overall.
And a study by King’s College London last week found two doses become noticeably less effective at stopping infections within months.
Protection after two shots of Pfizer decreased from 88 per cent at one month to 74 per cent at six months and for AstraZeneca, effectiveness dropped from 77 per cent to 67 per cent.
One of Britain’s top Covid experts, Professor Paul Hunter, yesterday said he saw no reason ‘whatsoever’ why it had taken No10’s advisers so long to sign off on booster dose plans. The infectious disease expert, from the University of East Anglia, called for over-80s and immunocompromised people to get their shots ‘pretty soon’.
But despite calls to hurry up and act before the next uptick in cases, the JCVI is still dithering over exactly who should be eligible for the third injections.
A SAGE adviser today repeated the claim that booster jabs should be for most vulnerable and not widespread.
University College London epidemiologist and SAGE member Professor Andrew Hayward told the BBC Radio 4 Today programme this morinng Britain needed to be ‘very careful’ about how it rolled out booster shots.
‘I think there is a case for vaccinating the most vulnerable again with booster doses,’ he said.
‘But that still leaves the UK massively over-ordered in terms of the amount of vaccines that it has, and still conservatively leaves somewhere between 100-200million doses that it could donate by the end of the year.’
Professor Hayward also called on Britain to help boost the vaccination drive around the world.
He said: ‘If rich countries can’t sort out a problem like vaccinating the world, what hope have we got in pulling together to sort out a complex problem like climate change?
‘This really is an opportunity for global leadership. This is a relatively simple technical problem that can be solved with the political will and resource.’
Covid vaccines are less effective at stopping hospitalisations over time, US data shows
Pfizer and Moderna’s Covid vaccines become less effective at preventing hospitalisations over time, a real-world American study has found.
Protection against hospital admission from the virus drops to as low as 75 per cent in under a year in some vulnerable people, from 95 per cent shortly after vaccination.
The research by the US Centers for Disease Control and Prevention (CDC) said the lower threshold only applied to people aged 75 and over.
Most people still enjoy protection much closer to the 95 per cent figure touted when the mRNA vaccines were first doled out in late 2020.
Dr Sara Oliver, a viral diseases expert at the CDC, said even at 75 per cent the vaccines were still hugely effective — seasonal flu jabs can be as low as 30 per cent.
The study did not look at patients with weakened immune systems, but studies elsewhere suggest a large portion of them have low immunity after two shots.
The CDC and the Food and Drug Administration (FDA) have already green-lit booster doses for certain immunocompromised people, which will be rolled out this month.
But officials in the US are still mulling whether a mass rollout is necessary, with pressure building on Western nations to dish out spare doses to poorer nations.