COVID-19: Vaccinations and older people
The BGS was pleased that older people were prioritised for access to the first and second doses of the COVID vaccine. As the booster programme gets underway in the UK, this page brings together current information on vaccination, including BGS statements and useful external links.
COVID-19 vaccines in older people
|Please note: The situation regarding the COVID-19 vaccine is changing rapidly and we will update this document as and when changes are made to the vaccination programmes. We will review this regularly to ensure we capture changes. However, readers are advised to check www.gov.uk/coronavirus for the latest official UK advice.|
About the COVID-19 vaccination programme
The COVID-19 vaccination programme began on 8 December 2020 with the world’s first Pfizer/BioNTech vaccine being administered to 90-year-old Margaret Keenan at University Hospital in Coventry. The programme initially used the Pfizer/BioNTech vaccine only, but was expanded as time went on to include vaccines developed by AstraZeneca and Moderna.
At the beginning, the vaccination programme prioritised those at highest risk of serious illness or death as a result of COVID infection including older people, those considered clinically extremely vulnerable and health and social care professionals. However, the programme expanded rapidly to include all adults by early summer 2021, and now includes young people aged 12 and over.
While initially people were given second doses of the vaccine two weeks after receiving the first dose, the Government made a decision to prioritise first doses of the vaccine to ensure that as many people as possible had at least some protection from COVID. The gap from first to second dose was therefore lengthened from two to 12 weeks. This decision was supported by the UK’s four Chief Medical Officers.
While the vaccination programmes have been led by the Governments of each of the four nations, each Government takes advice from the Joint Committee on Vaccinations and Immunisations (JCVI). As such, the four vaccination programmes have remained broadly in step with each other with people entitled to receive the vaccine at around the same time as similarly-aged people in other parts of the UK.
Impact of the vaccination programme to date
The COVID-19 vaccination programme has been primarily led by general practice and community pharmacies and has been the largest vaccination programme rolled out in NHS history. Uptake of the vaccine has been high – as of 13 September 2021, 89.2% of the population aged over 16 had received one dose of the vaccine and 81.2% had received both doses. In total, over 92.5 million doses of the vaccine have been administered. (For up-to-date statistics, see here).
Estimates suggest that in England, by 9 September 2021 vaccinations had averted over 143,600 hospitalisations from COVID, prevented between 24.4 and 24.9 million infections and prevented between 108,600 and 116,200 deaths.1
As we approach the winter months, the majority of the UK adult population will have received two doses of the vaccine. The JCVI have advised the Government that people in priority groups who received their second dose of the vaccine more than six months ago should be offered a booster jab. Governments across the UK have indicated that they have accepted this advice and that people in this group will be offered booster jabs from 20 September. The priority groups will be the same groups as those prioritised when the vaccine first became available and include care home residents, health and social care workers, people aged over 50, those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19, adult carers, and adult household contacts of immunosuppressed individuals.
People will be offered either a full dose of the Pfizer/BioNTech vaccine or a half dose of the Moderna vaccine, following scientific evidence showing that both provide a strong booster response. This will be regardless of which vaccine the individual previously had.
Where neither can be offered, for example in those who have a history of allergic reactions or other contraindications, the JCVI advise that the Oxford/AstraZeneca vaccine can be used for those who received this vaccine for their first and second doses.
Third ‘primary’ doses
The JCVI also recommends that people who are severely immunosuppressed (such as those with certain kinds of cancer, autoimmune diseases such as HIV/AIDS, or transplant recipients) or those receiving immunosuppressive therapy, which may include some older people, should receive a third ‘primary’ dose in their immunisation schedule. This is separate from the booster vaccination. The timing of this third primary dose depends on several clinical factors and should be determined by a specialist and communicated to the patient’s GP, but should be at least 8 weeks from the second primary dose (see here for further information). People are not able to self-refer for a third primary dose. Those eligible need to get a letter from their specialist or GP which they can use to access the vaccination. It is expected that these individuals will also be eligible for a routine booster dose, if appropriate, around 6 months from their third primary dose.
Combination with flu vaccines
Many people in priority groups for booster vaccines will also be eligible for free flu vaccinations and the JCVI have advised that the two vaccines can be co-administered. The NHS is now considering the practicalities and whether co-administration would be appropriate, as well as ensuring that waiting for one vaccine would not unduly delay the other.
Mandatory vaccinations for healthcare staff
It is now mandatory for people working in care homes in England to be vaccinated against COVID, and the Government is currently consulting on whether this requirement should be extended to all health and care professionals.