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Community version: BHIVA Statement on JCVI recommendations for COVID vaccine Spring 2022 booster dose

Tuesday 29 March 2022

On 21st February 2022 the Joint Committee on Vaccination and Immunisation (JCVI) published advice on spring COVID booster vaccines [1]. The JCVI is the national group that advises the government on vaccines. JCVI recommends offering a “spring vaccine” dose to individuals aged 12 years and over who are immunosuppressed, including all people with HIV, about 6 months after their last vaccine dose.

Based on previous recommendations, most people living with HIV will already have had a 3rd or 4th vaccine dose. This spring dose could therefore be their 4th or 5th dose of vaccine.

Many people with HIV are not thought to have a weakened immune system. For some the risk of becoming very unwell with COVID is similar to that for people without HIV. Offering a spring booster to all people with HIV keeps things simple and ensures that everyone at higher risk is protected.

BHIVA strongly encourages all people living with HIV to have the recommended COVID vaccines. Responses to first and second vaccine doses can be lower in some people with HIV, particularly those with a damaged immune system (a CD4 count less than 350 or with a detectable HIV viral load.) These people are a particular priority for extra vaccine doses which should boost their immune responses.


How to get your vaccine dose

Your HIV clinic will have information on vaccination. You will be able to book online if you are eligible for another dose:

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/

Most people with HIV should have had 3 vaccine doses. People at higher risk (lower CD4, detectable viral load, or other risks for severe COVID) should have had 4. Some of the vaccines have been coded differently, as a third dose OR a booster, but that is not important as long as you get the correct number in total.

Some people with HIV received an extra vaccine dose (i.e. a 4th dose) although they did not need it, as they were not at greater risk. If this is the case, BHIVA recommends that a spring Booster should still be given about 6 months after the most recent dose (i.e. 5 doses total).


People who have not been vaccinated at all

BHIVA strongly recommends that everyone living with HIV should have COVID vaccines to protect them. People who have not yet had the COVID vaccine, but who would now like to, should tell their doctor that this will be their first course of vaccine. BHIVA recommends that the first 2 doses should be 4 weeks apart (or the shortest gap approved for the specific type of vaccine,) followed by extra doses in line with the intervals listed below.


Timings

Based on JCVI advice:

  • The 3rd vaccine dose, only if required – check with your HIV clinic - should be given at least 8 weeks after the 2nd and as soon after that time point as possible.

  • Autumn 2021 boosters should be given at least 3 months after the 2nd or 3rd vaccine dose.

  • Spring 2022 boosters should be given around 6 months after the last vaccine dose.


Vaccine type

JCVI recommends that:

  • eligible persons aged 18 years and over are offered booster vaccination with 30mcg Pfizer-BioNTech (Comirnaty) vaccine or 50mcgModerna (Spikevax) vaccine.

  • eligible persons aged between 12 and 18 years are offered booster vaccination with 30 mcg Pfizer-BioNTech (Comirnaty) vaccine.

New vaccine products, including vaccines which are more closely matched to future circulating virus(es), may become licensed and available in 2022.


References

1) https://www.gov.uk/government/publications/joint-committee-on-vaccination-and-immunisation-statement-on-covid-19-vaccinations-in-2022/joint-committee-on-vaccination-and-immunisation-jcvi-statement-on-covid-19-vaccinations-in-2022-21-february-2022#fn:1

2) Greenbook COVID-19 chapter 14a (publishing.service.gov.uk)

3) C1399-Updated-JCVI-guidance-for-vaccinating-immunosuppressed-individuals-with-third-primary-dose.pdf (england.nhs.uk)


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