Third coronavirus jab to be offered to those severely immunosuppressed

A third dose of a coronavirus vaccine is to be offered to individuals who were severely immunosuppressed at the time of either, or both, of their first two vaccine doses

It comes after new advice from the Joint Committee on Vaccination and Immunisation (JCVI) was issued today for those aged 12 and over.

The JCVI have recommended that the third dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose, including those with leukaemia, advanced HIV and recent organ transplants.

This is because some individuals who are severely immunosuppressed due to underlying health conditions or certain medical treatments may not produce a full immune response to COVID-19 vaccination.

This offer is separate to any potential booster programme. The Joint Committee on Vaccination and Immunisation (JCVI) is still deliberating the potential benefits of booster vaccines for the rest of the population and is awaiting further evidence to inform this decision.

Immunosuppression varies widely in severity and duration. Many people who are immunosuppressed have lower levels of antibodies after coronavirus (COVID-19) vaccination, as some studies have shown.

Preliminary data from the OCTAVE trial showed that almost everyone who was immunosuppressed mounted an immune response after 2 doses, as indicated by either antibodies or T cells. However, in around 40% of people, the levels of antibodies were low. It is not clear how much this may affect protection against COVID-19 as antibodies represent only part of a person’s immune response.

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 advice is that for adults aged 18 and older, either the Moderna or Pfizer-BioNTech COVID-19 vaccines be administered for the third dose, as a number of studies have reported an increased immune response in some immunosuppressed people after a third dose of an mRNA vaccine.

For those aged 12 to 17, the Pfizer-BioNTech vaccine is preferred.

Those with less serious immunosuppression are not included in this advice but are likely to become eligible for another dose as part of a potential booster programme, pending further advice from the JCVI.

Today’s announcement has been welcomed by Wales’ Health Minister Eluned Morgan, who said: “The JCVI advice details the groups who will be eligible and our NHS in Wales will work quickly to identify eligible individuals who will be contacted by their Health Boards.

“The decision on the timing of the third dose will be important for some patients, and will be determined by their specialist clinicians. Their appointment will be at an appropriate time during their treatment plan.

“There is no need for patients to contact their health board or clinicians to check eligibility. Work will begin immediately to identify and plan for patients to be vaccinated and communications from Health Boards will follow as soon as practicable.

“The COVID-19 vaccine continues to be the best way to prevent serious illness and the spread of the virus.

“Anyone who has not had their vaccine yet is urged to take-up their primary dose offer before we move to begin the booster campaign.

“If you haven’t yet had your vaccination, you can find more information on how to get your vaccine here.”