JCVI issues advice on third dose vaccination

September 2, 2021

The Joint Committee on Vaccination and Immunisation (JCVI) is advising that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule.

According to the JCVI, this third dose should be offered to people over 12 years who were severely immunosuppressed at the time of their first or second dose, including those with leukaemia, advanced HIV and recent organ transplants. The JCVI has said that these people may not mount a full response to vaccination and therefore may be less protected than the wider population.

This offer is separate from any potential booster programme. The 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. A third primary dose is an extra ‘top-up’ dose for those who may not have generated a full immune response to the first 2 doses. In contrast, a booster dose is a later dose to extend the duration of protection from the primary course of vaccinations.

Preliminary data from the OCTAVE trial showed that almost everyone who was immunosuppressed mounted an immune response after two 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.

People with severe immunosuppression are more likely to be severely ill if they do catch COVID-19.

Studies are ongoing to see how effective a third dose is for immunosuppressed people, but it is very unlikely to cause any harm. Therefore, on balance, the JCVI’s view is that a third dose can be safely offered as it may increase their protection.

Health and Social Care Secretary Sajid Javid said, 'We know people with specific conditions that make them particularly vulnerable to COVID-19 may have received less protection against the virus from two vaccine doses. I am determined to ensure we are doing all we can to protect people in this group and a third dose will help deliver that. The NHS will contact people as soon as possible to discuss their needs and arrange an appointment for a third dose where clinically appropriate.

'COVID-19 vaccines have saved more than 105,000 lives and prevented 24 million infections in England alone. They are building a wall of defence and are the best way to protect people from serious illness. I encourage everybody who is eligible to get their jabs as soon as they can.'

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.'

Visit the Government website for more information on immunosuppression.

In other news, the Government has welcomed new members to the Voluntary Community and Social Enterprise (VCSE) Health and Wellbeing Alliance.


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