UK vaccine advisers to call for targeted booster programme

UK government advisers are set to recommend third doses of Covid-19 vaccines from September for people with weakened immune systems as part of a “targeted” booster plan.

The programme will be expanded at a later date to the over-70s, according to people close to the decision-making process.

A person close to the Joint Committee on Vaccination and Immunisation, which advises the UK government on its Covid vaccine strategy, told the Financial Times that “somewhere between nobody [and] small numbers” will be getting booster doses in September.

“It will probably be a targeted booster programme, which includes specific vulnerable people,” they added. “It’s definitely not going to be a blanket thing in September, if at all.”

There are more than 500,000 severely immunosuppressed people in the UK, according to official estimates. This group includes cancer patients undergoing chemotherapy, patients on dialysis and certain transplant recipients.

In another part of the plan over-70s could be offered a third dose a certain number of months after their second dose, similar to recommendations made by the US Centers for Disease Control and Prevention. If the UK were to opt for an eight month gap between the second and third dose as the CDC has done, most over-70s would have to wait until December to receive their third dose.

Despite getting off to an early start in its initial vaccine rollout, the UK appears to be more hesitant than other nations in initiating its booster campaign.

In Israel, a booster programme for all over-50s and vulnerable groups is already under way driven by concerns over waning immunity, while France announced plans on Tuesday to give third doses to over-65s and other vulnerable people from October onwards.

Britain is currently awaiting final confirmation from the JCVI before announcing the full details of the booster programme. In June, the committee issued interim advice laying out a blueprint for the first stage of a booster programme focused on healthcare workers, over-70s and people with weakened immune systems.

Speaking last week, health secretary Sajid Javid said he was “confident” the vaccine booster programme would start next month, but admitted that the specific timing and scope of the rollout was yet to be determined.

“We are going to have a booster scheme, it will start sometime in September,” he said. “I couldn’t tell you exactly when because before we start it, as people would expect, we need to get the final advice from our group of experts, our independent scientific and medical advisers — the JCVI.”

Government officials say Boris Johnson, prime minister, wants to give people the maximum possible protection against the virus, consistent with the advice of the JCVI. They are also confident that supply is not an issue. “Our thinking hasn’t changed significantly on this,” said one official. “We have the doses available to do it. We want to be ready to go once we get the final advice.

The UK is expecting a fresh batch of 60m Pfizer doses to begin arriving in September, while on Monday the government announced that it had agreed a deal with BioNTech/Pfizer to purchase an additional 35m doses, due to be delivered from next year.

Halving the dosage of a booster dose is also being discussed by the JCVI in order to conserve vaccine supplies so more can be donated to the developing world and to limit the possibility of any rare side-effects. On Monday, Tedros Adhanom Ghebreyesus, World Health Organization head, warned that vaccine nationalism increased the risk of new variants emerging and called on richer nations “to share what can be used for boosters with other countries”.

Adam Finn, a paediatrics professor at Bristol university and a JCVI member, said the highest priority group for boosters was those who had experienced “primary vaccine failure”.

“Older people may experience a secondary vaccine failure where they made a protective response but then the response wore off, and they became vulnerable again,” explained Finn.

“But many immunosuppressed people may never have made a protective response at the outset so a third dose is not a booster as such, it’s a further attempt to prime their immune system.”

Interim findings from the Octave study of about 600 immunosuppressed patients in the UK, published on Tuesday, found that 40 per cent of them mounted a poor immune response four weeks after their second dose and 11 per cent failed to generate any antibodies at all.

Professor Iain McInness, the lead author of the study, said the findings, which have been shared with the JCVI, suggested a booster dose for immunosuppressed patients with a poor or non-existent antibody response to vaccination “would be a very reasonable next step”.

Danny Altmann, professor of immunology at Imperial College London, echoed that sentiment. He said: “I would be in favour of a staged . . . targeted immune monitoring based approach. That would be a much better way to use vaccine doses.” He added that while there has been “political pressure to roll out booster jabs to as many people as possible”, it was important to be led by science.

“It could be that for most of us who have had a perfectly good response to the first two doses, that a third dose might not have any benefit,” he said. “But we don’t yet know that.”

But Professor Ravi Gupta, a member of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), called on the government to act “sooner rather than later” because the Delta variant “has pushed up the bar for what antibody level we need for protection”.

“There are greater breakthrough infections happening . . . and there’s been quite a few deaths in the elderly who have been double vaccinated — partly because they didn’t get strong enough responses in the first place and then it declined,” said Gupta.

“If they are going to boost the elderly, they need to get on and do it quickly,” he added.

According to the latest government data, 77.2 per cent of the UK population aged 16 and over have now been fully vaccinated. However, infection levels remain high. On Tuesday, 30,838 new cases were recorded across the UK with 174 further deaths reported, while the case rate per 100,000 people now stands at 334.4.

“We are preparing for a booster programme to ensure those most vulnerable to Covid-19 have protection extended ahead of winter and against new variants,” the Department of Health and Social Care said.

“Any booster programme will be based on the final advice of the independent JCVI.”