The Health Secretary for England, Steve Barclay has accepted the recommendations of the Government’s Joint Committee on Vaccination and Immunisation (JCVI) for COVID booster shots this. Winter. NHS England will now organize the roll-out which will probably run alongside the flu vaccination campaign. Health is a devolved matter but the recommendations of the expert committee are almost certainly going to be accepted by the Health Secretaries in the other three nations that make up the UK.
General eligibility for NHS flu shots was reduced during the pandemic to over-50s. This will now return to the previous age of 65. General eligibility for both is now 65, with a number of additional groups (see below). The general procedure is for the local GP to send a text or letter inviting their patient inviting them to make an appointment. For COVID shots, this has been organized by age cohort so the most vulnerable are protected first. Since the risks will be similar, there should be no problem in giving both at the same appointment however not all GPs have the facilities to store COVID vaccines.
The groups who will be included in the roll-out are:
- Residents in a care home for older adults
- All adults aged 65 years and over
- People aged six months to 64 years in a clinical risk group
- Frontline health and social care workers
- People aged 12 to 64 who are household contacts of people with immunosuppression
- People aged 16 to 64 who are carers and staff working in care homes for older adults
This excellent report by Paul Gallagher at the i gives a lot of useful information and I’ll pluck out a few paragraphs of particular note, highlighting some parts. It is important to remember that the purpose of vaccines is not to prevent all infections but to reduce the symptoms and for the more vulnerable reduce the number hospitalized.
Dr Mary Ramsay, Director of Public Health Programmes at UK Health Security Agency, said: “The Covid-19 virus has not gone away and we expect to see it circulating more widely over the winter months with the numbers of people getting ill increasing. The booster is being offered to those at higher risk of severe illness and by taking up the booster vaccine this autumn, you will increase your protection ahead of winter, when respiratory viruses are typically at their peak.”
Data compiled during the pandemic by the government’s Office for National Statistics showed that the vast majority of the population had good levels of COVID antibodies (IIRC at some points sampling showed up to 95%). The UK health system is very data rich because of centralized computer records. Consequently the efficacy of the booster vaccinations last year can be shown.
Last year’s autumn booster programme ended on the 20 February 2023. Data up to 12 March showed that 73.2 per cent of 65-70 year olds in England had been vaccinated and this increased in older cohorts rising to 83.7 per cent (just under 2.5 million people) in the over 80s.
Data from last autumn’s programme showed that those who received a booster were around 53 per cent less likely to be admitted to hospital with Covid in the two to four weeks following vaccination, compared to those who did not receive a booster.
I presume that period was chosen as it would represent the peak level of neutralizing antibodies after the booster but the reduction in risk is notable. The booster would also have re-stimulated the other parts of the immune system so there is longer term protection.
While they haven’t declared the formal status, the UK health authorities are addressing the COVID virus as if it is endemic, with a similar annual progression and decline to influenza. Those with lowered immune systems and those around them are vaccinated while the expectation is that the disease will not require hospitalization in the other cohorts. This is, of course, a strategic decision to prevent the NHS systems becoming overwhelmed by a dual COVID/flu episode.
There is a particular comparison between the UK and USA that should be noted. There is a clear flu season associated with colder, wetter weather resulting in more people gathering indoors. The UK in much further North than the contiguous US states (closer to Alaska) so the Winter months are darker much longer. The peak periods of absences through illness in UK schools is in the Spring Term (the semester from New Year to Easter). In contrast, (particularly this year!) in the USA more people gather indoors during the Summer to avoid excessive heat, so the season of high cases will be different from, say New England.
The other significant difference is that the US population as a whole appear to have more co-morbidities than in the UK. This could be a product of the NHS General Practitioner system, in particular the relatively recent emphasis on promoting good health rather than just treating disease. (So my local GP clinic, along with others, promotes a local weekly park run. These are inclusive for different ability levels and part of the idea is to promote mental health through the social meeting.)
These are some of the reasons that the UK experience cannot be used to precisely predict the stage at which the SARS-CoV-2 is in the US. The kicker is that in this respect TFG’s prediction “It’ll be just like the flu” seems to be coming true in the UK.