A mass Covid booster vaccine campaign for tens of millions of Britons will be launched next week in a race to avoid a winter lockdown, it was announced today.
The Government’s vaccine advisory panel finally signed off on the plans after weeks of deliberation, with third doses now being recommended for roughly 32million over-50s, as well as frontline health and care workers.
Professor Jonathan Van-Tam, England’s deputy chief medical officer, told a Downing Street press conference that the booster programme would provide ‘very good’ immunity and help ‘keep the lid on’ the epidemic this winter.
The NHS will start inviting eligible Britons from next week. People are only being invited to come forward if they had their second injection at least six months ago, which officials said was the ‘sweet spot’ for boosters.
Third doses will be rolled out to the top nine priority groups who were first in line during the initial vaccination programme, with the elderly and vulnerable first in line.
It took about four months to cover those groups with a first dose earlier this year, but officials expect the booster scheme to move quicker now because the infrastructure and expertise is already in place.
Members of the Joint Committee on Vaccination and Immunisation (JCVI) approved the plans on the back of growing real-world data in Israel and elsewhere, as well as a major British study, which showed vaccine-induced immunity wanes slightly within months.
Eligible Britons will be given the Pfizer vaccine in the first instance, no matter which jab they were given originally. When there are supply constraints, the Moderna vaccine will be offered as a booster, but only as a half dose.
Officials said there was more evidence that the mRNA vaccines were safe and effective when given as a third dose, which is why they are not recommending AstraZeneca’s. Moderna’s is being given as a half dose because the lower dosage is associated with fewer side effects and still produces a strong immune response, the JCVI said.
However, in the rare case that a person is allergic to the ingredients in the Moderna and Pfizer vaccines, they will be offered the AstraZeneca jab, which still stimulates an immunity boost, just not as well as the other two.
The announcement comes ahead of what is widely accepted will be a challenging winter for the NHS with an unusually low amount of natural immunity to flu and other respiratory viruses due to more than a year of social restrictions.
Sajid Javid was heckled by Tories today as he made clear another lockdown cannot be completely ruled out – admitting that ministers can only give Britons the ‘best possible chance’ of avoiding brutal curbs.
The Health Secretary said the country must be ‘vigilant’ with the disease expect to surge with colder, wetter weather over the coming months. In a statement to MPs, he stressed that vaccines can help ‘build defences’ against the disease, with boosters for the over-50s and jabs for under-16s starting next week.
But Mr Javid was hit with howls of rage from Conservatives in the Commons as he said the blueprint includes the ‘Plan B’ of making masks compulsory ‘in certain settings’, more working from home and social distancing if the NHS is under threat.
Vaccine passports will be kept ‘in reserve’ and could be introduced in England with a week’s notice, even though they will not go ahead from next month as originally intended.
The above groups will be the first to receive doses of the Covid vaccine. Britain’s vaccine advisers say the ‘sweet spot’ for boosters is about six months after the second dose is administered. Booster shots are set to be rolled out in descending order from group one — elderly residents in care homes — to nine
The above slide was shown at the Downing Street press briefing. It estimates that maximum protection from a second dose of the Covid vaccine lasts for six months, based on real-world data from Israel
Effectiveness of vaccines against hospitalisation drops slightly after more than 20 weeks in people aged 65 and over. The JCVI said that while the absolute effectiveness saw only a slight drop, the risk of waiting and hoping over winter was not worth it
Booster shots will be rolled out to groups in the above order, with the programme working down through the age groups
Professor Jonathan Van-Tam told a Downing Street press conference that the programme would provide ‘very good’ immunity and help ‘keep the lid on’ the epidemic this winter
From left to right, Chief Medical Officer for England Chris Whitty, Chief Scientific Adviser Sir Patrick Vallance and Prime Minister Boris Johnson leaving 10 Downing Street, London, today after revealing the winter Covid plan
Professor Van-Tam called on all over-50s to get their booster jabs today, saying they will make a ‘very substantial impact’ on tackling Covid over the coming year.
He told a Downing Street press briefing: ‘I think if there’s good uptake of the booster dose, and I have no reason to doubt that at all…
‘I think the booster programme will make a very substantial impact on keeping the lid on things Covid-wise in terms of hospitalisations and deaths, and keeping pressure off the NHS this winter.
‘We want to live our lives as normally as possible from now on and we want a normal winter life too.
‘A high uptake of the booster programme is going to give us a much increased chance of doing that in my view.’
England’s deputy chief medical officer said the booster shots would give people ‘optimal’ immunity to the virus, saying he would not consider those who did not get them as having the best possible protection.
Professor Van-Tam also compared dishing out booster jabs early rather than waiting for more evidence on post-vaccination immunity to campers who prepare their tents against an incoming storm.
He told the briefing: ‘I don’t know if many of you are used to crawling into small tents on mountainsides?
‘But if you do so and you know there’s a storm blowing in the night, it’s better to put some extra guy ropes on there and then, than it is to wait until the middle of the night when it’s howling with wind and rain, and you’ve got to get out of your tent and make your tent secure. By the time you crawl back in, you’re soaking wet.
‘So it’s better to be pre-emptive and to be prepared and plan for the worst possibilities.’
Professor Van-Tam warned of a ‘bumpy’ winter ahead as he set out the findings of the review of Covid booster jabs.
He said vaccines had been ‘incredibly successful’ and had so far prevented an estimated 24million Covid-19 cases and 112,000 deaths.
He added: ‘We know that this pandemic is still active, we are not past the pandemic, we are in an active phase still.
‘We know this winter could be bumpy at times and we know that winter viruses such as flu and RSV (respiratory syncytial virus) are highly likely to make their returns.
‘So with that in mind, the aim if the game, the mantra, is to stay on top of things.’
Professor Wei Shen Lim, head of the JCVI’s Covid vaccine unit, said the recommendation of at least a six-month gap between the second jab and a booster shot was an attempt to find an immunity ‘sweet spot’.
‘We want to suggest a six-month limit as a lower limit because we don’t want people to feel they need to rush to have this booster dose,’ he told a Downing Street press conference.
‘Getting a booster dose too early might mean getting a dose when they don’t actually need to have vaccination because they still have a high level of protection.
‘And, as we have seen with the first and second dose, it may be that a longer interval to the third booster dose may actually be beneficial in the longer term.
‘On the other hand, we don’t want to wait too long before offering a booster dose, so trying to find a sweet spot between going too soon and going too late we are suggesting that the booster dose is given no earlier than six months after the second dose.’
He added: ‘Hopefully, this will mean that the levels of protection people have will be highest during the coldest months of the winter.’
Professor Lim said the first groups to receive a booster vaccine would be those that got their first dose in December last year, at the start of the vaccination drive.
Elderly people in care homes were first in line for jabs then, followed by the over-80s and NHS staff.
Professor Lim said it was preferable for people to get an mRNA vaccine as a booster — Pfizer and Moderna — because there was more evidence compared to the AstraZeneca jabs that these are safe and effective.
He told the briefing: ‘The AstraZeneca vaccine obviously is a very good vaccine for its primary cause.
‘We’ve seen data that suggests that the mRNA vaccines given, whatever the primary cause for the vaccination is, gives a very good boost.
‘And for a range of reasons including simplicity and delivery of the programme, we felt that overall there was a preference for mRNA vaccines for the third booster dose.’
Moderna’s vaccine has been recommended as a half dose booster due to concerns about side effects. Professor Van-Tam said that as a 57-year-old healthcare worker, who will be eligible for a booster vaccine, he would be ‘content’ with getting a full Pfizer or half Moderna dose because they produce similar immune results.
But Professor Lim said the JCVI does not want the UK to be in trapped in a cycle in which boosters are being dished out every six months.
There is a pressing need for boosters because we are in a ‘very active phase’ of the pandemic, he claimed, with high transmission and the risk of catching Covid remaining high.
It’s hoped that as the pandemic progresses, there will be a lot less virus in the community meaning people are not exposed to the disease as often.
Professor Lim said it was likely that natural infection gives ‘mini boosts’ to immunity, which he hopes will provide an extra layer of protection to people moving forward.
Data published today to justify the booster plan showed that vaccine effectiveness against symptomatic disease – after two doses – wanes quickest, although remains above the 50 per cent threshold
AstraZeneca’s protection against hospitalisation appears to wane quicker than Pfizer’s, dropping to around the 80 per cent mark compared to Pfizer’s 90-plus per cent
But protection against death remained higher still. Officials say they are uncertain how quickly effectiveness will wane over the coming winter months so boosters have been recommended as a precautionary measure
Britian has ordered more than 135million doses of the Pfizer vaccine, and 17million of Moderna.
The Government bought an additional 35million Pfizer jabs in August, to be delivered in the second half of 2022.
Official data shows more than 40million Pfizer doses and 2.3million Moderna doses have already been dished out. The NHS has also administered 48.9million doses of the AstraZeneca vaccine.
Officials said today’s announcement did not mean that Covid booster doses would be needed every six months.
Professor Lim also urged everyone who was eligible for the Covid vaccine to also get their flu shots. He said these could be administered on the same day, although into different arms.
Britain was hit by flu jab shortages last week leaving several GP surgeries having to cancel vaccinations. Reports suggest the shortage was sparked by a lack of lorry drivers to get the jabs to the country.
The chief of Britain’s medical regulator — the Medicines and Healthcare products Regulatory Agency (MHRA) — said Covid booster jabs could be given to over-50s at the same time as flu vaccines.
She told a Downing Street briefing: ‘The data reviewed showed that giving the booster jabs with flu vaccines at the same time is safe and does not affect an individual’s immune response to either vaccine.
‘Therefore, Covid booster doses may be given at the same time as flu vaccines.
‘We have in place a comprehensive safety strategy for monitoring the safety of all Covid vaccines, and this surveillance includes the booster jabs.
‘As with first and second doses, if anyone has any suspected side effects, please report using Yellow Card.’
She added that the Moderna, Pfizer, and Astra-Zeneca vaccines can safely be used as booster jabs.
‘The regulatory position, having looked at all the data, is that it is a very safe and effective vaccine, so no-one needs to hesitate.
‘If the decision is that you have it for your booster then no worry at all, be reassured that it will be effective.
‘In terms of longer-term impact we, as JCVI, will be following Public Health England’s really helpful and impressive and timely work to make judgments.’
Professor Van-Tam also defended the decision to roll out booster vaccines in the UK while poorer countries lag behind in the numbers of vaccinations.
When asked whether the booster programme would undermine global vaccine equality, he said: ‘Of course as public health people we take a very strong view that it is important that the whole world has access to vaccines, and that until everyone has access to them, none of us are fully safe.
‘By the same token, the job given to us is to define what is best for the UK and that is what JCVI has done.
‘Based on the information that my colleagues have given to me (at the end of August), nine countries have already announced that they are actively starting some form of booster campaign, and there is further intelligence that 18 others are also considering it.
‘So from that perspective the UK is not alone in thinking that it will need to do this to give maximum protection to its population this winter.’
Austria, Ireland, Hungary and Israel are among the countries that have already announced booster programmes for their more vulnerable populations.
It comes as Boris Johnson is due to set out his blueprint for ‘living with the virus’ through the winter during a Tuesday afternoon press conference.
There are concerns in Whitehall about an increase in coronavirus cases hitting at the same time as a flu outbreak, with experts warning ‘we’re not out of the woods’.
Vaccine minister Nadhim Zahawi said further lockdowns will be an ‘absolutely last resort’ under the plan.
He told the BBC the boosters could be the ‘last piece of the jigsaw to allow us to transition this virus from pandemic to endemic’ and by next year there could be a flu-style annual jab.
Earlier, Professor Calum Semple, a member of the Scientific Advisory Group for Emergencies (Sage) panel which advises ministers, warned of a tough time ahead for the NHS.
‘Now that we’re opening up society, we’ve got to… live with not just Covid but the flu will come back, RSV bronchiolitis will come back, so I think we’re going to have a bit of a rough winter,’ he told the BBC.
He added: ‘I can predict that the NHS is going to have a really tough time and it wouldn’t surprise me if local directors of public health may be suggesting use of face masks in shops and on public transport.’
The winter plan will see vaccines as the first line of defence, supported by testing, public health advice and a new variant surveillance system.
It is thought ministers will retain the options of a return to wearing face masks in public places and restoring work-from-home advice if cases take off again.
However, other measures — such as requiring vaccine passports for people attending nightclubs or other crowded venues — have been shelved.
It is expected the Government will announce it is repealing a swathe of powers taken through the Coronavirus Act which are no longer considered necessary.
They include measures to close down sectors of the economy, apply restrictions to events and gatherings and powers to detain infectious people.
Some measures will be retained — including sick pay from day one for people who are self-isolating, powers to direct schools to remain open if they close against Government guidance, and helping the NHS get emergency resources.
It will remain a legal requirement for people to self-isolate if they test positive for the disease.