Millions of older Brits will miss out on third Covid-19 jab doses for now - after Britain restricted them to a minority with serious illnesses.
Around 500,000 Brits with compromised immune systems will get a third dose of the vaccine, the government announced today.
They are the first people in the country to get confirmation that they will have a third dose, after months of pressure to kick-start a booster rollout ahead of this winter.
Yet the Joint Committee on Vaccination and Immunisation (JCVI) insisted today’s announcement does not technically count as a “booster” programme.
Instead, these third doses are being offered to people for whom the first two jabs were unlikely to have worked.
Scroll down for the full list of who can get third doses
This includes people with conditions which mean their immune system does not function properly, such as those with HIV or blood cancers such as leukaemia.
Others eligible will be people with solid cancers, severe autoimmune diseases and organ transplant recipients who were on drugs that suppressed their immune system at the time of earlier doses.
Hopes of a wider booster jab announcement today were dashed, as JCVI experts are still combing through the data.
The Government insisted it was still planning to extend booster jabs to the over-80s in September, despite the continued delay from the experts.
Government scientists believe Britain’s decision to extend the interval between first and doses means protection is lasting longer here.
It comes on the day France started giving booster jabs to all over-65s and as Israel gives third doses to all over-12s.
Prof Jonathan Van Tam, Deputy Chief Medical Officer for England, said: “We know there are people with severe immunosuppression for whom the first two doses of vaccine have not provided the same level protection.
“We should be doing all we reasonably can to ensure that this group is not disadvantaged and a third primary dose is one step in this direction.”
The Government is keen to extend third doses as booster jabs to the general public, but is waiting for its independent scientists to agree.
NHS England had been told to prepare for a booster rollout from September 6.
Ministers have also been urging the JCVI to approve first and second jabs for all children aged 12 to 15, rather than only the most vulnerable.
Officials have been told to plan for a rollout to all 12-15s from mid September, giving the vaccines in schools with parental consent, but again only if the JCVI gives the green light.
The 500,000 Brits eligible for a third dose now should discuss the timing with their specialist.
The government said “as a general guide”, the third dose should be at least eight weeks after the second but timing can vary case by case to generate a better immune response.
This could include giving a third dose early, if it ensures the recipient will get it before starting chemotherapy.
Those with less serious immunosuppression are not included in today’s advice, but are likely to become eligible in a booster programme.
Health Secretary Sajid Javid said: “Today I have accepted the expert recommendations from the independent Joint Committee on Vaccination and Immunisation to offer a third vaccine dose to people aged 12 and over with severely weakened immune systems as part of their primary schedule following data from trials of those who are immunosuppressed.
“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.”
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 2 doses, as we hope this will reduce their risk of severe outcomes such as hospitalisation and death.”
The JCVI has been accused of “dithering” as other countries start offering third jabs to the general population and initial doses to children.
However the committee believes it got it right by pioneering an eight-week dose interval between first and second jabs and are holding firm until they get sure evidence that protection from severe disease is waning.
Fiona Loud, Policy Director at Kidney Care UK, said: “For months we have heard from immunosuppressed kidney patients that they are worried they don’t have the same protection from Covid-19 vaccines as others.
“Some of them have continued to shield or are going back into shielding because they see infection rates going up in their area.
“This third dose will increase their chances of protection so we welcome today’s announcement that it will be offered to people who are vulnerable to Covid-19.
“We need to see this clearly communicated and enacted by medical teams as soon as possible.”
Data from abroad suggested third doses were unlikely to cause harm in the immunosuppressed so gave the green light.
Most data covered the Pfizer and Moderna jabs so only these two are being offered as third doses - even to those who received the AstraZeneca jab for their first two.
It was announced on the day France began giving booster shots to all over-65s whose second dose was at least six months ago.
The French government said last month that “recent studies suggest a fall in the vaccine’s effectiveness, especially with the Delta variant”.
The elderly and people with underlying health conditions were the most affected by the drop over time, the authority said.
The booster shot was already available in France for the clinically vulnerable.
Authorities in the German capital Berlin have started offering booster shots to elderly care home residents. Several other German states have already begun offering boosters to vulnerable people.
US health officials recently announced plans to dispense booster shots to all Americans starting this month(Sept).
Israel has expanded its coronavirus booster shot programme to include anyone aged over 12 in the latest phase of a booster programme that began in July with the over 60s.
The head of the World Health Organisation’s European branch, Dr Hans Kluge, said this week that a third dose of coronavirus vaccines could help protect the people most vulnerable, and it should not be seen as a “luxury booster”.
Former Health Secretary Jeremy Hunt yesterday(Wed) said the UK needs to “get on with” triple jabbing the population.
Now chair of the Health and Social Care Select Committee, he tweeted: “The headline data coming out of Israel - where 80% of adults are double jabbed so higher than here - is concerning.
“Yesterday they recorded their highest ever daily number of new cases.
“Cases there have been rising since July so the govt has responded with an aggressive booster vaccine programme, mandating masks and vaccinating teenagers.
“Some aren’t convinced even that is enough to control the Delta variant.
“BUT...the third dose campaign is clearly working. There was a big drop in rate of growth of severely ill patients two weeks after it started.
“The clear lesson for the UK seems to be...get on with booster jabs, not just for the clinically vulnerable but for everyone... why are we hanging around?”
Full list of people who can get a third dose of Covid vaccine
Individuals with primary or acquired immunodeficiency states at the time of vaccination due to conditions including:
- acute and chronic leukaemias, and clinically aggressive lymphomas (including Hodgkin’s lymphoma) who were under treatment or within 12 months of achieving cure
- individuals under follow up for a chronic lymphoproliferative disorders including haematological malignancies such as indolent lymphoma, chronic lymphoid leukaemia, myeloma, Waldenstrom’s macroglobulinemia and other plasma cell dyscrasias (Note: this list is not exhaustive)
- immunosuppression due to HIV/AIDS with a current CD4 count of <200 cells/µl for adults Primary or acquired cellular and combined immune deficiencies – those with lymphopaenia (<1,000 lymphocytes/ul) or with a functional lymphocyte disorder.
- those who had received an allogeneic (cells from a donor) or an autologous (using their own cells) stem cell transplant in the previous 24 months
- those who had received a stem cell transplant more than 24 months ago but had ongoing immunosuppression or graft versus host disease (GVHD)
- persistent agammaglobulinaemia (IgG < 3g/L) due to primary immunodeficiency (e.g. common variable immunodeficiency) or secondary to disease / therapy
Individuals on immunosuppressive or immunomodulating therapy at the time of vaccination including:
- those who were receiving or had received immunosuppressive therapy for a solid organ transplant in the previous 6 months.
- those who were receiving or had received in the previous 3 months targeted therapy for autoimmune disease, such as JAK inhibitors or biologic immune modulators including B-cell targeted therapies (including rituximab but in this case the recipient would be considered immunosuppressed for a 6 month period), T-cell co-stimulation modulators, monoclonal tumour necrosis factor inhibitors (TNFi), soluble TNF receptors, interleukin (IL)-6 receptor inhibitors., IL-17 inhibitors, IL 12/23 inhibitors, IL 23 inhibitors. (N.B: this list is not exhaustive)
- those who were receiving or had received in the previous 6 months immunosuppressive chemotherapy or radiotherapy for any indication.
Individuals with chronic immune-mediated inflammatory disease who were receiving or had received immunosuppressive therapy prior to vaccination including:
- high dose corticosteroids (equivalent ≥ 20mg prednisolone per day) for more than 10 days in the previous month
- long term moderate dose corticosteroids (equivalent to ≥10mg prednisolone per day for more than 4 weeks) in the previous 3 months
- non-biological oral immune modulating drugs e.g. methotrexate >20mg per week (oral and subcutaneous), azathioprine >3.0mg/kg/day; 6-mercaptopurine >1.5mg/kg/day, mycophenolate >1g/day) in the previous 3 months
- certain combination therapies at individual doses lower than above, including those on ≥5mg prednisolone per day in combination with other immunosuppressants (other than hydroxychloroquine or sulfasalazine) and those receiving methotrexate (any dose) with leflunomide in the previous 3 months
Individuals who had received high dose steroids (equivalent to >40mg prednisolone per day for more than a week) for any reason in the month before vaccination
Individuals who had received brief immunosuppression (≤40mg prednisolone per day) for an acute episode (e.g. asthma / COPD / COVID-19) and individuals on replacement corticosteroids for adrenal insufficiency are not considered severely immunosuppressed sufficient to have prevented response to the primary vaccination.
