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Frequently Asked Questions regarding the JCVI announcement on third doses

The JCVI is advising that people with severely weakened immune systems should have a third vaccine dose as part of their primary COVID-19 vaccination schedule.

We understand that you may have questions regarding the JCVI's recent announcement. Please use this page to find answers to some of the most frequently asked questions regarding the offer of a third dose of the COVID-19 vaccination for patients who were severely immunosuppressed at the time of their first or second dose.

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that a third dose of the vaccine should be offered to people aged 12 years and over who were severely immunosuppressed at the time of their first or second dose, for example because they have leukaemia, advanced HIV or are receiving or have received immunosuppressive therapy for a solid organ transplant in the previous six months. These patients may not mount a full response to vaccination and therefore may be less protected than the wider population.

Those with less serious immunosuppression are not included in this current advice but are likely to become eligible for another dose as part of a potential booster programme, pending further guidance from the JCVI.

The JCVI advises that for adults aged 18 and older, either the Moderna or Pfizer-BioNTech COVID-19 vaccines be administered for the third dose, as a number of studies have reported an increased immune response in some immunosuppressed people after a third dose of an mRNA vaccine. For those aged 12 to 17, the Pfizer-BioNTech vaccine is preferred.

The AstraZeneca vaccine may be offered on a case-by-case, individualised basis following a decision by a health professional. 

The decision on the timing of the third dose should be made by the patient’s specialist. As a general guide, the third dose should usually be at least 8 weeks after the second dose but with flexibility to adjust the timing so that, where possible, immunosuppression is at a minimum when the vaccine dose is given.

This will enable a better immune response to be generated. For example, it is preferable to give a vaccine dose before someone undergoes chemotherapy, rather than during their treatment.

NHS England and NHS Improvement have asked all specialists working in hospital as well as all GP practices to identify individuals they care for who are eligible under the JCVI’s definition, due to severe immunosuppression at the time of receiving their first or second dose of the vaccine.

If your GP practice is currently part of a GP-led vaccination hub which is delivering COVID-19 vaccines, you will be invited by your GP Practice to attend your third vaccination appointment.

If your GP practice is not currently part of a GP-led vaccination hub, they will share your details with the Clinical Commissioning Group so that our teams can arrange for you to be offered an appointment at another vaccination site. 

In the event of a booster programme, it is expected that severely immunosuppressed people will also be offered a booster dose, at a suitable interval after their third dose.

A third primary dose is an extra ‘top-up’ dose for those who may not have generated a full immune response to the first 2 doses. In contrast, a booster dose is a later dose to extend the duration of protection from the primary course of vaccinations.

This information is correct as at: 17/09/2021