COVID-19 vaccination programme for Autumn 202218 July 2022 The Joint Committee on Vaccination and Immunisation (JCVI) has recently provided updated guidance on the roll out of the autumn COVID-19 booster vaccine programme. Their advice follows on from data suggesting that “large proportions of the UK population have developed at least partial immunity against COVID-19.” This has led to their guidance focusing on protection of those who are considered to still be at increased risk of the most serious clinical outcomes from the virus throughout the coming winter months. “To achieve this, a planned and targeted vaccination programme is considered more appropriate than a reactive vaccination strategy.” The following groups have been identified by the JCVI as eligible for the autumn booster: Residents in a care home for older adults and staff working in care homes for older adults.Frontline health and social care workers.All adults aged 50 years and over.Persons aged 5 to 49 years in a clinical risk group, as set out in the Green Book, chapter 14a, tables 3 and 4.Persons aged 5 to 49 years who are household contacts of people with immunosuppression.Persons aged 16 to 49 years who are carers, as set out in the Green Book, chapter 14a, table 3. For adults living with RA and JIA this detail is given for eligibility (taken from table 3 of chapter 14a of the COVID-19 SARS-Cov-2 green book): Individuals who are receiving immunosuppressive or immunomodulating biological therapy including, but not limited to, anti-TNF, alemtuzumab, ofatumumab, rituximab, patients receiving protein kinase inhibitors or PARP inhibitors, and individuals treated with steroid sparing agents such as cyclophosphamide and mycophenolate mofetil.Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults.Those who require long term immunosuppressive treatment for conditions including, but not limited to, systemic lupus erythematosus, rheumatoid arthritis, inflammatory bowel disease, scleroderma and psoriasis. The JCVI also advises that household contacts to those who are immunosuppressed and carers are vaccinated (see below): Individuals who expect to share living accommodation on most days (and therefore for whom continuing close contact is unavoidable) with individuals who are immunosuppressed (defined as immunosuppressed in tables 3 or 4).Those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable. Table 4 covers the eligibility for clinically at risk groups between 5 and 15 years of age. For those with JIA the following is stated: Immunosuppression due to disease or treatment, including:Those receiving immunosuppressive or immunomodulating biological therapy.Those treated with or likely to be treated with high or moderate dose corticosteroids.Those receiving any dose of non-biological oral immune modulating drugs e.g. methotrexate, azathioprine, 6-mercaptopurine or mycophenolate.Those with auto-immune diseases who may require long term immunosuppressive treatments.Children who are about to receive planned immunosuppressive therapy should be considered for vaccination prior to commencing therapy. It is important to remember that the JCVI has cautioned that these lists are not exhaustive and that the specialist consultant should “apply clinical judgment to take into account the risk of COVID-19 exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from COVID-19 itself.” Exact details of the timescale and logistics for roll out has yet to be clarified but the JCVI advises that for optimal protection, the autumn boosters should be administered by the beginning of December 2022. This ideal completion date for the boosters will of course be subject to operational flexibility as needed. At present there are no concerns that the roll out of the autumn boosters will interfere with that of the annual influenza immunisation programme, and it has also been noted that where needed the two can be administered concurrently. Further Reading If you would like to read the full JCVI statement on the coronavirus (COVID-19) autumn booster programme for 2022, click here. Additionally, in February GOV.UK released the COVID-19 Greenbook Chapter 14a.