Booster Vaccines and the Winter Plan
Booster Vaccines
The JCVI has recommended and DHSC has accepted that booster vaccines should be given to those that are in the original priority groups 1 to 9:
Those living in residential care homes for older adults
All adults aged 50 years or over
Frontline health and social care workers
All those aged 16 to 49 years with underlying health conditions that out them at higher risk of severe COVID-19, and adult carers
Adult household contacts of immunosuppressed individuals
The booster programme will start from Monday 20 September.
A booster vaccine dose will be offered no earlier than 6 months after the completion of the first 2 doses. The JCVI has a preference for the Pfizer vaccine for boosters but alternatively a half dose of Moderna can be offered. AstraZeneca is only to be offered where mRNA vaccines cannot be offered, for example, due to allergies. The flu vaccine can be administered at the same time.
This announcement is separate from the recent advice for those who are immunosuppressed to have a third dose.
The Winter Plan
At the outset, let me say that we expect a dedicated Social Care Winter Plan to follow in due course distinct from the one below - there is very little new for adult social care.
The ‘Autumn and Winter Plan’ was published earlier today by the government. It describes two plans: Plan A and Plan B. The second doesn't have much detail.
Plan A
There are 5 ‘pillars’ to the Plan A:
Building our defences through pharmaceutical interventions: vaccines, antivirals and disease modifying therapeutics
Identifying and isolating positive cases to limit transmission: Test, Trace and Isolate
Supporting the NHS and social care: managing pressures and recovering services.
Advising people on how to protect themselves and others: clear guidance and communications
Pursuing an international approach: helping to vaccinate the world and managing risks at the border
Pillar 1 – strengthening pharmaceutical defences with interventions
Renew efforts amongst those who are eligible but have not yet taken up the offer.
Introduce a new plan for booster doses. This morning the advice from the JCVI was published, recommending offering booster doses to priority groups 1-9 and in the same order as the first roll-out – see my summary above.
Booster doses will be offered as of next week and people will be contacted in due course.
Yesterday the CMOs recommended a universal offer of a single dose of a vaccine for all people aged 12-15 using Pfizer.
A third vaccine dose will be given to people aged 12 and over with severely weakened immune systems as part of their primaryschedule. This is distinct from the booster vaccine programme – it is likely that those who fall into this category will also need a booster vaccine 6 months after the third vaccine dose.
The government is looking at what might be needed longer term with regards to vaccination with a potential annual COVID-19 vaccine programme along the lines of the flu vaccine programme.
The antiviral taskforce is leading the search for antivirals that are able to treat COVID-19 infections.
Pillar 2 – Identifying and isolating positive cases to limit transmission
Test, Trace and Isolate remains central.
Legal requirement to self-isolate for 10 days after a positive test will remain in place.
PCR tests for symptomatic and contacts of confirmed cases will continue to be available free of charge in the Autumn and Winter.
LFD testing will continue, especially for those who are unvaccinated, education, NHS, social care and prisons.
LFD tests will continue to be free but ‘as the Government’s response to the virus changes, universal free provision of LFDs will end, and individuals and businesses using the tests will bear the cost’. – NCF will seek clarification on the timescales for this and whether the government was thinking about care providers when making this statement.
NHS Test and Trace will continue. Those who are contacts of cases will be advised to take a PCR test.
Practical and financial support will be available for those required to self-isolate and will be reviewed in March next year. – we think this is a reference to the NHS Test and Trace Support Payment Scheme but we will be asking for specific guarantees for social care staff.
Pillar 3 – Supporting the NHS and Social Care
Largely reiterating the announcements of last week: £5.4bn for NHS over the next 6 months to deal with COVID-19. This includes £1bn for the backlog.
There are no additional measures to help social care in this section despite the workforce crisis. – We will continue to raise this with DHSC.
Repeated the announcement of a consultation on making vaccinations a condition of deployment among frontline NHS and wider social care staff.
Those previously considered as Clinically Extremely Vulnerable should continue to follow the same guidance as the rest of the population
Free flu vaccination will be available to the following (we will be asking for more clarification for the social workforce specifically which we believe is also included):
Primary school children
65 year olds and over
Vulnerable groups
Pregnant women
Secondary school children
50-64 year olds
Pillar 4 – Advising people on how to protect themselves and others
Government will continue to encourage behaviours to prevent the spread of cases, including ventilation.
Pillar 5 – Pursuing an international approach
Essentially an outline of what the government says it has done in terms of infection control at boarders, the COVAX scheme and efforts to accelerate access to vaccines, therapeutics and diagnostics.
Plan B
The backup plan if hospitalisations rise to the point of putting unsustainable pressure on the NHS:
Communicating early and clearly the need for caution
Legally mandating face coverings in certain settings.
Covid passports will be held in reserve.
Would consider asking people to work from home.
Precise details would depend on the situation and data