Uncertainty over Covid vaccine booster campaign as start date looms

A wider Covid-19 vaccination booster campaign still hangs in the balance even though it is due to start in less than four weeks.

Experts said they are still assessing data before they confirm whether all over-50s and the clinically vulnerable will need a third jab.

They confirmed a booster will “quite likely” be needed for a small number of people who are immunosuppressed.

There are plans for around 30 million people to receive a third Covid-19 jab alongside a flu vaccine, with the programme due to start on September 6.

But the expert panel that advises the Government – the Joint Committee on Vaccination and Immunisation (JCVI) – is still assessing hospital admissions data and blood test samples before they approve the programme.

On Tuesday Health Secretary Sajid Javid said preparations for the booster campaign were ongoing but ministers were awaiting guidance from the clinical experts.

It has been reported that ministers are already planning a 2022 booster campaign after securing 32 million Pfizer doses for autumn next year.

The Times reported that the doses cost £1 billion.

The Department of Health and Social Care (DHSC) said: “We have secured access to more than 500 million doses of Covid-19 vaccines and we are confident our supply will support potential booster programmes in the future.”

Pfizer said in a statement: “We are unable to comment on the specifics of any supply agreement with the UK. Through all government agreements, Pfizer and BioNTech are using a tiered pricing formula, based on factors including volume and delivery dates, which ensures agreements are bespoke to the needs of each vaccination programme we support.”

Asked about a booster campaign for this year, Adam Finn, professor of paediatrics at the University of Bristol, who sits on the JCVI, told BBC Breakfast: “We’ve been asked to advise as to who might receive a booster if it proves necessary to give boosters.

“I think it’s becoming quite clear that there are a small group of people whose immune responses to the first two doses are likely to be inadequate – people who’ve got immunosuppression of one kind or another, perhaps because they’ve got immunodeficiency or they’ve been receiving treatment for cancer or bone marrow transplants or organ transplants, that kind of thing.

“I think it’s quite likely we’ll be advising on a third dose for some of those groups.

“A broader booster programme is still uncertain – we’ve laid out potential plans so that the logistics of that can be put together, alongside the flu vaccine programme.

“We need to review evidence as to whether people who receive vaccines early on in the programme are in any serious risk of getting serious disease and whether the protection they’ve got from those first two doses is still strong. We clearly don’t want to be giving vaccines to people that don’t need them.”

He said it was difficult to say when the JCVI would have more data on whether a wider booster campaign was needed, but experts would be examining hospital admissions and blood tests.

Danny Altmann, professor of immunology at Imperial College London, told Times Radio: “For a vulnerable person whose immunity is suboptimal, any boosting is better than none, and some of the data is quite promising on getting people back up into that protective zone.”

On Tuesday, Professor Sir Andrew Pollard, director of the Oxford Vaccine Group, told the All Party Parliamentary Group on Coronavirus that any waning of protection provided by vaccines would be “gradual” and would be picked up quickly through UK surveillance systems, adding: “There isn’t any reason at this moment to panic.”

Sir Andrew also suggested the concept of herd immunity was “not a possibility” due to the more transmissible Delta variant of the virus.

He referred to the idea as “mythical” and warned that a vaccine programme should not be built around the idea of achieving it.

“We know very clearly with coronavirus that this current variant, the Delta variant, will still infect people who have been vaccinated and that does mean that anyone who’s still unvaccinated, at some point, will meet the virus,” he told the parliamentarians.

A Government scientific adviser said Covid-19 is unlikely to be eradicated but the “nature of the virus” meant it would become a seasonal infection.

Professor Andrew Hayward, of University College London’s Institute of Epidemiology and Health Care and the New and Emerging Respiratory Virus Threats Advisory Group, told BBC Radio 4’s Today programme that Covid would probably continue to mutate, meaning true herd immunity is unlikely.

He said: “I think the nature of this infection and the nature of the vaccines is such that the level of immunity that is achieved is not enough to consider that.

“If someone could come up with a vaccine that was not only 95% protective against severe disease but 95% protective against infection then, yes, we would stand a chance of eradicating it.

“I think it is a pretty distant prospect and we need to get used to the concept that this will become what we call an endemic disease rather than a pandemic disease.

“A disease that is with us all the time – probably transmits seasonally a bit like influenza where we see winter outbreaks.”

Prof Altmann said new variants could mean vaccine immunity may never overcome the virus completely.

Asked whether coronavirus could “die away” once enough people have antibodies through having caught the virus or vaccination, he said: “That’s still kind of true.

“More vaccination means more people carrying antibodies means fewer susceptible people, which means fewer lungs for the virus to be in, which means less pandemic.

“So it hasn’t all gone out of the window. But nobody said this virus had to be simple.

“There’s Delta at the moment, there may well be other worse ones coming round the curve, and they impact the effectiveness of the vaccines and change their calculations.”

He added: “The experts are very divided and very bad at long-term crystal ball gazing, but the simple answer is, we’re still winning – it’s more complex than we thought, it’s a work in progress, but we’re still winning and the strategy still works.”

He was speaking after the DHSC said three in four adults had received both doses of a Covid-19 vaccine.

A total of 86,780,455 doses have been administered in the UK, with 47,091,889 people receiving a first dose (89%) and 39,688,566 having both doses (75%), the department said.