Covid booster jabs to be extended to 40-49 age group and second doses for 16 to 17 year olds

The Covid vaccine booster programme is being extended to include healthy 40 to 49-year-olds.

Health officials are also advising that all 16 to 17-year-olds should be offered a second jab.

The Joint Committee on Vaccination and Immunisation (JCVI) has advised that all adults aged 40 to 49 years should be offered a booster, 6 months after their second dose, irrespective of the vaccines given for the first and second doses.

The JCVI says 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.”

Booster vaccines are being offered to eligible groups to help them maintain high levels of protection against hospitalisation, severe illness or dying over the winter.

The vast majority of the UK adult population has received a COVID-19 vaccine since the programme was launched in December 2020 – including 87.9% of the population who have received a first dose and 80% who have received 2 doses.

JCVI has previously advised booster vaccination for all adults aged 50 years and over and those in a COVID-19 at-risk group.

The offer has now been broadened to include those aged 40 to 49 years.

“Booster vaccination should be with either the Pfizer-BioNTech vaccine, or the Moderna vaccine, as previously advised.”

“Both of these vaccines are expected to give a good level of extra protection.”

The advice comes as the UK Health Security Agency (UKHSA) publishes the first data on booster vaccine effectiveness in the UK.

The analysis shows that people who take up the offer of a booster vaccine increase their protection against symptomatic COVID-19 infection to over 90%.

Protection against more severe disease is expected to be even higher.

Following 2 doses of the vaccine – as yet – there is no robust evidence of a decline in protection against severe COVID-19 (hospitalisation and deaths) in those aged under 40.

JCVI says it will continue to closely review all available data to develop further advice in due course.

The JCVI is also advising that all 16 to 17 year olds who are not in an at-risk group should be offered a second dose of the Pfizer vaccine. The second vaccine dose should be given 12 weeks or more following the first vaccine dose.

For those in this age group who have had COVID-19 infection, the second vaccine dose should be given 12 weeks or more following the first vaccine dose, or 12 weeks following a positive COVID-19 test result – whichever is later.

This advice is in addition to the existing offer of 2 doses of vaccine to 16 to 17 year olds who are in ‘at-risk’ groups.

The decision to advise the second dose is based on a review of the latest evidence of the benefits of the vaccine programme, compared to the risks of any side effects.

JCVI says that “a second vaccine dose increases the level of protection and is important for extending the duration of protection.”

“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.”

In reports originating from outside the UK, extremely rare adverse reactions, such as myocarditis (inflammation of the heart) have been reported more frequently after the second vaccine dose compared to the first vaccine dose.

However, in countries such as Canada and the UK, who have a longer interval between the first and second doses, rates following the second vaccine dose are closer to the reporting rate after the first dose.

“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).” JCVI says.

“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.” It adds.

Professor Wei Shen Lim, Chair, COVID-19 immunisation, JCVI said:

“Booster vaccine doses in more vulnerable adults, and second vaccine doses in 16 to 17 year olds are important ways to increase our protection against COVID-19 infection and severe disease.”

“These vaccinations will also help extend our protection into 2022.”

Welsh Government health minister Eluned Morgan has confirmed that Wales will be following this advice.

In a written statement she said:

Firstly, following discussion and consideration of the evidence, the JCVI has recommended that a second dose should be offered to young people aged 16–17 year olds, who are not in an ‘at-risk’ group.

The JCVI looked at the key benefits and risks of offering a second dose to 16-17 year olds and found that a second dose offered more durable protection against COVID-19 and further reduced the risk of infection and serious illness, hospitalisation and intensive care unit admission. These benefits were balanced against data showing the rare incidence of adverse events following vaccination in young people.

The JCVI recommended that the second vaccine dose should be given 12 weeks or more following their first dose. For those young people who have had a COVID-19 infection at any time after having their first dose, they should be given the second vaccine dose 12 weeks or more following the COVID-19 infection.

As always, they advise that individuals should receive sufficient information on the potential risks and benefits of vaccination to allow them to make a valid decision about whether and when to accept the second dose based their own personal circumstances. We will ensure there is a range of information sources available for young people to make an informed choice.

Turning to the booster, the JCVI has considered if the roll-out should be extended to include further cohorts who are under 50 and not in an ‘at-risk’ group. Based on the current available evidence, the Committee has recommended that a COVID-19 booster should be offered to those aged 40-49 years old, at 6 months or more following their second dose.

They will make a further decision on whether to offer a COVID-19 booster dose to those aged 18-39 at a later date, pending further evidence on vaccine waning in this group. As most younger adults will have received their second dose in late summer or early autumn, they will still have a high level of protection.

I would like to thank the JCVI for their considerations and advice and for taking care to form a balanced view.  Our intention, as it has been from the start of the pandemic, is to follow the clinical and scientific evidence and therefore we accept the JCVI’s advice. We will work with NHS Wales to take this advice forward and will keep members updated.