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UK to give third Covid jab to immunosuppressed people


Top-up for those with weakened immune systems separate to planned booster campaign, says health secretary

Researchers have cautiously welcomed the UK’s move to give people with severely weakened immune systems a third Covid-19 vaccine dose.

In much-anticipated guidance, the Joint Committee on Vaccination and Immunisation said on 1 September that an extra top-up dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose. This will mean a booster shot for people with leukaemia, advanced HIV or recent organ transplants, among others.

When accepting the recommendation from the JCVI, health secretary Sajid Javid said that these top-up jabs did not mark the start of a wider ‘booster’ campaign that the government is planning for September. That move is controversial, with some health experts calling for vaccine doses to be prioritised for unvaccinated poor people in the global south, rather than for top-ups for citizens of wealthier nations.

But the JCVI advice has been less controversial, as people with severe immunosuppression may be less well protected from vaccination than other people.

“It is good to see this advice from the JCVI offering a third vaccination shot to patients with certain immune disorders,” said Penny Ward, a visiting professor of pharmaceutical medicine at King’s College London.

“We have known for some time that this group responds less well to vaccination than fully immune competent individuals, and recent publications have shown that adding a third dose to the primary dose schedule can increase response in this group.”

At-risk groups

The advice comes after preliminary data from the Octave clinical trial suggested that 40 per cent of people with weakened immune systems showed a low, or undetectable, immune response after two doses of a Covid-19 vaccine.

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 two doses, as we hope this will reduce their risk of severe outcomes such as hospitalisation and death.”

Javid emphasised that the move would not mark the start of the planned booster programme. “We are continuing to plan for this to begin in September to ensure the protection people have built from vaccines is maintained over time and ahead of the winter,” he said. “We will prioritise those most at risk to Covid-19, including those who are eligible for a third primary vaccine, for boosters based on the final advice of the JCVI.”