COVID-19 vaccination programme: inclusion of cohort 10 (40-49 year olds) in the booster programme and second dose vaccination for remaining 16 to 17 year olds


The Joint Committee on Vaccination and Immunisation (JCVI) has published on 15 November advice on boosters for cohort 10 (those aged 40-49 years old) and second doses for 16 to 17 year olds not in an at-risk group and the Green Book Chapter 14a has been updated.

This ops note should be read in conjunction with the system letter on boosters for cohort 10 and second doses for remaining 16 to17-year olds on 15 November 2021 and the ops note on next steps to deliver vaccinations up to 31 January and support for housebound vaccinations.

SUMMARY OF KEY DATES

15 November

Joint Committee for Vaccination and Immunisation publish advice on inclusion of cohort 10 (40 – 49 year olds) in the booster programme

Joint Committee for Vaccination and Immunisation publish advice on a second dose for remaining 16 to 17 year olds (those in cohorts 1,2,4, or 6)

w/c 15 November

All vaccination sites review capacity available for 16 to 17 year olds, both via NBS and Grab a Jab

17 November

Interim deadline for regions to confirm the opt in position of those PCN sites using the NBS.

18 November 2021

Final deadline for regions to confirm the opt in position of those PCN sites using the NBS.

22 November

Deadline for PCN Groupings to opt in to deliver booster vaccinations to cohort 10.

w/c 22 November

  1. Patient Group Directions and National Protocols for Pfizer BioNTech / Comirnaty ® COVID-19 vaccine are being revised in order that second doses of the COVID-19 vaccine can be administered to remaining 16 to 17 year olds in line with revised JCVI guidance.
  2. The National Booking System will be available for bookings for:
    • Booster bookings for eligible people in cohort 10, and
    • 2nd dose bookings for remaining 16 -17 year olds.
  1. The Grab-a-Jab walk-in site finder at www.nhs.uk/grab-a-jab will be updated to reflect latest changes.

25 November

National invites will start to be sent to remaining 16 to 17 year olds.

 

Operational Guidance

Patient Group Directions (PGD) or National Protocols

No updates are required to the PGDs and National Protocols for boosters for cohort 10. Moderna/Spikevax ® and Pfizer BioNTech/Comirnaty ® remain the preferred vaccine choices for booster doses.  A Moderna / Spikevax ® booster dose is 0.25ml.

The Comirnaty ®/ Pfizer BioNTech COVID-19 PGDs and National Protocols are being revised for second doses for 16 to 17 year olds not at risk. We expect updated versions to be published week commencing 22 November.

Managing booking capacity

  • From 22 November 2021, the National Booking System will enable all 16 to 17-year olds who have not had their second dose vaccination as part of the Phase 1 offer to book a second dose appointment on the NBS. Patients will see second dose booking appointments from 12 weeks following administration of their first dose.
  • The NBS website will continue to direct at-risk 16 to 17-year olds who are eligible for a second dose 8 weeks after their first dose to alternative offers such as walk-in clinics. The booking journey of 8 weeks is not possible on the NBS and this cohort can only book an appointment on the NBS if they have already passed the 12 weeks interval following their first dose.

Supply

  • Sites that are offering both Moderna/Spikevax ® and Pfizer BioNTech/Comirnaty ® are advised to retain Comirnaty ® capacity/supply to support the operationalisation of the offer to 16 to 17 year olds.
  • If uplifts of vaccine supply are required these can be requested through the Supply Planner following usual processes for future weeks where the plans are still open. If there is a more urgent need for additional vaccine supply, sites should raise this with their SVOC in the first instance.

Vaccinating

  • From 22 November, vaccination sites are required to offer asecondCOVID-19 vaccine dose to all 16 to 17-yearolds.
    • For those not at-risk the JCVI recommend an interval of at least 12 weeks between the first and second dose. For those individuals who have had a first dose and a proven coronavirus infection, JVCI recommend that the second dose should be given at least 12 weeks after the first dose or following the infection, whichever is later. 
    • For those at risk (cohorts 1, 2, 4, or 6) the JCVI continue to recommend an interval of at least 8 weeks between the first and second dose.
  • Following the JCVI advice, the previously categorised 17.75 group will now be incorporated into the 16 to 17 year olds group and will become eligible for a second dose at least 12 weeks after their first. For those who book their second dose appointment once they attain 18 years of age, a minimum 8 week interval will apply. For those 17.75 year olds and above who have already booked their second dose appointment with an 8 week interval, the booking remains valid.  When these individuals attend their appointment they should be informed that they can rebook for a 12 week interval, although if they consent, vaccination can occur at the existing appointment.
  • Sites must only vaccinate 16 to 17-year olds when regionally assured and at times when the requirements of the checklist Part A are being met and a legal mechanism such as a PSD, PGD or National Protocol is in place. PCNs are not required to have regional assurance, however, they must meet the checklist Part A requirements and have a legal mechanism in place. CP and VC vaccination sites that do not yet meet the requirements of the readiness checklist Part A must do so as soon as possible, working with their regional teams and systems who must confirm readiness.
  • VC/CP/HH+s using the NBS must confirm that they can accept this cohort on their QFlow profile (under accessibility attributes).
  • Site leads are responsible for developing local processes to ensure compliance with the checklist Part A, the mechanism (e.g. Patient Group Direction) used for administering the vaccine, and the workforce considerations for vaccinating children. Sites require a dedicated safeguarding professional and clinical lead and are advised to engage with the local safeguarding team when developing the local process.
  • All sites must have the following processes in place at arrival and brief all staff, including front-of-house volunteers and site security on these requirements:
  • to identify 16 to 17-year olds immediately at check-in and ensure they are routed to be seen by appropriately trained staff.
  • to identify at-risk 16 to 17-year olds in cohorts 1, 2, 4 or 6 who are eligible for a second dose 8 weeks after administration of their first dose and ensure they are vaccinated or scheduled.
  • to turn-away those aged 16 to 17 who are not at-risk and request their second dose before the JCVI advised 12 weeks interval after administration of their first dose. The exception to this are those individuals aged 17.75 years who already have a second dose appointment booked with an 8 week interval.
  • sites must consider practical solutions to separate the vaccination of young people from adults. Local risk assessments should be completed to ensure pathways between young people and adults are separated.
  • For disabled young people it is essential that reasonable adjustments are considered with individuals/families and recorded ahead of the vaccination appointment and provided to all members of the Immunising Team involved in the care of the young person involved.