JCVI statement on the COVID-19 vaccination programme for 2023: 8 November 2022 - GOV.UK

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Overview

Since the archetypal COVID-19 vaccine was authorised for usage successful the UK successful December 2020, the purpose of the COVID-19 vaccination programme has been, and continues to be, the simplification of terrible illness (hospitalisation and mortality) crossed the population, portion protecting the NHS.

As the modulation continues distant from a pandemic exigency effect towards pandemic recovery, the Joint Committee connected Vaccination and Immunisation (JCVI) has begun to see the 2023 COVID-19 vaccination programme. The existent Omicron epoch is characterised by:

high levels of colonisation immunity acquired done vaccination and/or earthy infection
lower illness severity compared to corruption owed to erstwhile SARS-CoV-2 variants

During this time, the hazard of terrible COVID-19 continues to beryllium disproportionately greater successful those from older property groups, residents successful attraction homes for older adults, and persons with definite underlying wellness conditions. Compared to the archetypal phases of the pandemic, overmuch much is present understood regarding SARS-CoV2 infection. However, determination remains ongoing uncertainty regarding microorganism evolution, the durability and breadth of immunity, and the epidemiology of infection. These uncertainties bounds the contiguous improvement of a regular immunisation programme against COVID-19.

Advice

JCVI’s interim proposal for readying purposes up of 2023 is that:

in autumn 2023, persons astatine higher hazard of terrible COVID-19 could beryllium offered a booster vaccine dose successful mentation for wintertime 2023 to 2024
in addition, for a smaller radical of persons (such arsenic persons of older property and those who are immunosuppressed) an other booster vaccine dose whitethorn beryllium offered successful outpouring 2023
emergency surge vaccine responses whitethorn beryllium required should a caller variant of interest look with clinically important biologic differences compared to the Omicron variant

JCVI besides advises that:

the 2021 booster connection (third dose) for persons aged 16 to 49 years who are not successful a objective hazard radical should adjacent successful alignment with the adjacent of the autumn 2022 vaccination campaign^{[footnote 1]}
otherwise steadfast persons aged 5 to 49 years who make a caller wellness information successful 2023 that places them successful a objective hazard radical would beryllium offered superior vaccination and/or a booster vaccine during the adjacent seasonal vaccination campaign, arsenic appropriate. Vaccination extracurricular these run periods would beryllium taxable to idiosyncratic objective judgement
primary people COVID-19 vaccination should move, implicit the people of 2023, towards a much targeted connection during vaccination campaigns to support those persons astatine higher hazard of terrible COVID-19. This would include:
- residents successful a attraction location for older adults and unit moving successful attraction homes for older adults
- frontline wellness and societal attraction workers
- all adults aged 50 years and over
- persons aged 5 to 49 years successful a objective hazard group, arsenic acceptable retired successful the Green Book
- persons aged 12 to 49 years who are household contacts of radical with immunosuppression
- persons aged 16 to 49 years who are carers, arsenic acceptable retired successful the Green Book
research should beryllium considered to pass the optimal timing of booster vaccinations to support against terrible COVID-19 (hospitalisations and deaths) for groups who are astatine antithetic levels of objective risk

Considerations

It is estimated that implicit 97% of adults successful England had SARS-CoV-2 antibodies, either from corruption oregon vaccination, by the extremity of August 2022 (reference 1). In Great Britain, an estimated 93 to 99% of children aged 12 to 15 years, and 74 to 98% of children aged 8 to 11 years, had antibodies against SARS-CoV-2 astatine the extremity of August 2022 (references 1 and 2). Natural immunity unsocial provides bully levels of extortion against terrible COVID-19 portion the operation of earthy and vaccine-induced immunity (hybrid immunity) is associated with adjacent higher levels of extortion (references 3,4 and 5). This precocious level of beardown colonisation immunity developed implicit the past 2 and a fractional years is nether regular monitoring done UK Health Security Agency (UKHSA) nationalist wellness surveillance programmes.

Not each hospitalisations and deaths ascribed to SARS-CoV-2 corruption are vaccine-preventable events. Due to the precocious transmissibility of the Omicron variant, unneurotic with corruption that tin beryllium asymptomatic oregon lone mildly symptomatic, persons who necessitate infirmary attraction for non-COVID-19 reasons whitethorn beryllium coincidentally infected with SARS-CoV-2. Such hospitalisations are not preventable done COVID-19 vaccination. In contrast, immoderate highly susceptible individuals whitethorn make terrible COVID-19 contempt being vaccinated; these individuals often person underlying wellness conditions that confer precocious susceptibility to terrible illness from different infections arsenic well. In the UK, during the Omicron epoch (up to week 43, 2022), the highest rates of hospitalisations were consistently observed successful persons aged 75 years and over, portion rates of corruption (non-severe illness) were precocious crossed each ages and particularly among younger persons (references 6 and 7).

Revised estimates of the fig needed to vaccinate (NNV) to forestall 1 hospitalisation during the Omicron epoch bespeak that 800 persons aged 70 years and supra would request to beryllium fixed a booster successful autumn 2022 (a 4th dose) to forestall 1 hospitalisation from COVID-19. The corresponding NNV for persons aged 50 to 59 years is 8,000 and for persons aged 40 to 49 years who are not successful a objective hazard radical is 92,500 (Appendix 1).

In November 2021, JCVI advised boosters for steadfast adults aged 40 to 49 years owed to the epidemiology astatine the time. With the emergence of the Omicron variant successful precocious November 2021, the connection was extended to steadfast individuals aged 16 to 39 years arsenic portion of an exigency surge effect (see JCVI update connected proposal for COVID-19 vaccination of children and young people and UK vaccine effect to the Omicron variant: JCVI advice). Since April 2022, uptake of the archetypal booster dose of COVID-19 vaccine has been little than 0.1% per week successful each eligible radical nether 50 years of property (Figure 62c successful notation 8). Based connected the existent data, keeping the booster (third dose) connection unfastened to these groups is considered of constricted ongoing worth and the wide interaction connected vaccine sum is negligible.

The offers of superior people vaccination person been wide disposable since 2021. Uptake of these vaccine offers person plateaued successful caller months crossed each property groups (Figure 62a successful notation 8). Since the opening of 2022, little than 0.01% of eligible individuals per week implicit the property of 12 years, received a archetypal COVID-19 vaccine dose. A much targeted connection of superior people vaccination during vaccination run periods volition alteration these efforts to beryllium much focused and let much businesslike usage of NHS resources.

Although the COVID-19 vaccination programme has been precise palmy overall, determination are immoderate socioeconomic and taste groups wherever vaccine sum remains little (reference 6). Addressing wellness inequalities is simply a semipermanent effort that is applicable to each UK immunisation programmes. Building trust, and specifically vaccine confidence, requires dependable determined investments of time, resources and persons. Appropriate and capable connection should beryllium provided successful beforehand of changes to the superior people vaccination connection to optimise uptake among those who are eligible but person yet to judge the connection of vaccination.

Future variants and their interaction connected epidemiology

As the virulence of immoderate caller emergent variant cannot beryllium reliably predicted, accelerated effect measures whitethorn beryllium required should determination beryllium important changes successful colonisation immunity against the ascendant circulating variant, including immoderate caller variant of concern.

JCVI volition support the epidemiology of COVID-19 nether reappraisal and volition supply proposal for a surge response, arsenic required.