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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) produced advice on the spring COVID vaccination programme [1]. 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 have already received a 3rd or 4th vaccine dose. This spring dose may therefore be their 4th or 5th dose of vaccine.

Many people with HIV are not regarded as having a weakened immune system, and for some, the risk of complications from COVID is similar to that for people without HIV. The JCVI decision to offer a spring booster to all people living with HIV has been made in the interest of simplicity and to ensure protection of those who may be at higher risk.

BHIVA strongly encourages all people living with HIV to have the recommended COVID vaccines. There is evidence that responses to first and second vaccine doses can be lower in some people with HIV, particularly those with immune suppression (CD4 count <350 cells) or with detectable HIV viral load. Additional vaccine doses are expected to boost responses in this group and are a particular priority.


Logistics

We recommend all clinics have clear, accessible patient information on vaccines.

Online booking is available for all who are eligible for a booster: https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/

Boosters and the 3rd dose of a primary vaccine course are coded differently. Ultimately, as long as people in need of a 3rd dose receive the 3rd dose, it’s not overly important whether that is coded as a 3rd dose or a booster. We recommend that services keep a record of patients eligible for a 3-doses primary vaccine course, so they can be advised that they should also have an Autumn 2021 booster and Spring 2022 booster (i.e., 5 doses in total).

Some people with HIV received an additional vaccine (i.e. a 4th dose) without a clinical indication. Here we recommend that a spring booster should still be administered about 6 months after the most recent dose (i.e. 5 doses total).

Previously unvaccinated people who now wish to receive the COVID vaccine should have their primary vaccine course (2, or where indicated, 3 doses), with the first 2 doses separated by ~4 weeks (or the shortest licensed interval for the specific vaccine type), followed by a 3rd dose (if indicated) given 8 weeks after the 2nd. Boosters should then be planned in line with the intervals below.


Timings

Based on JCVI advice:

  • The 3rd primary vaccine dose, if required, 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 may be offered booster vaccination with 30mcg Pfizer-BioNTech (Comirnaty) vaccine or 50mcgModerna (Spikevax) vaccine.

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

New vaccine products, including variant 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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