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BHIVA Statement on JCVI recommendations for COVID vaccine

Spring 2023 booster dose

Monday 13 March 2023

On 23rd February 2023 the Joint Committee on Vaccination and Immunisation (JCVI) produced advice on the spring COVID vaccination programme for this year [1]. As a precautionary measure JCVI recommends offering an extra vaccine dose in spring 2023 to individuals aged 5 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 4th or 5th vaccine dose. This spring dose may therefore be their 5th or 6th 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 3rd and 4th vaccine doses are thought to have increased 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/

It is important to ensure that the total number of COVID doses has been recorded correctly for each patient.

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.

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

  • Spring 2023 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), have been licensed but no data is currently available on their use in those with immunosuppression.


References

1) JCVI statement on spring 2023 COVID-19 vaccinations, 22 February 2023 - GOV.UK (www.gov.uk)

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


For further information, please contact [email protected] or for media enquiries, please contact Jo Josh at [email protected] or +44 (0)7306 391875.