Four Covid vaccines recommended for autumn boosters

Getting a Covid booster in good time before the winter season is more important for those eligible than the type of vaccine that is received, the Government has said.

It comes after the Government this week accepted JCVI advice for Moderna’s updated Omicron vaccine to be offered as part of the programme.

This means that four vaccines have now been recommended for the booster campaign, as the JCVI’s full advice on which Covid vaccines should be used in the campaign also includes the original Moderna and Pfizer jabs, as well as the Novavax vaccine.

The three mRNA vaccine types should be prioritised but Novavax can be used off-label as a booster dose for over-18s ‘in exceptional circumstances’.

The AstraZeneca Covid vaccine is excluded from the autumn campaign.

Under last year’s booster programme, Pfizer and Moderna vaccines were recommended, although anyone unable to have the mRNA vaccines could have an AstraZeneca jab instead.

All UK patients aged under 40 had been offered Pfizer or Moderna vaccines instead of AstraZeneca following concerns over rare blood clots.

However, a large UK study concluded that Covid infection carried a substantially higher and longer risk of blood clots and other related adverse events than Covid vaccines, including AstraZeneca.

The Novavax jab was approved by UK regulators in February following a series of delays and was tipped to ‘replace’ Pfizer and Moderna this coming winter due to its lower cost.

The UK Health Security Agency (UKHSA) said: ‘Studies indicate the Moderna bivalent vaccine produces a marginally higher immune response against some variants than the Moderna mRNA Original “wild-type” vaccine. The clinical relevance of these small differences is uncertain.

‘All of the available boosters provide good protection against severe illness from Covid-19 and the committee has emphasised that getting a booster in good time before the winter season is more important for those eligible than the type of vaccine that is received.’

It added that the JCVI also stated that ‘where feasible, it would be preferable for a single type of booster vaccine to be offered throughout the duration of the autumn programme for simplicity of deployment’.

However, the JCVI advised that ‘if sufficient doses of mRNA bivalent Original ‘wild-type’/Omicron BA.1 vaccine become available to complete the autumn booster programme, JCVI considers that it is expedient to aim to offer authorised bivalent vaccines throughout the autumn programme, subject to operational considerations’. 

It added: ‘Where substantial delays might be incurred in deploying a bivalent vaccine, the principle of timeliness should take priority and an alternative UK-approved booster vaccine offered, such as a monovalent Original ‘wild-type’ mRNA vaccine.’

And the JCVI said that where there are ‘constraints to vaccine supply or deployment, priority for vaccination should be given to those at higher individual clinical risk of severe Covid-19, such as those of older age’.

It also suggested that healthcare workers could be vaccinated ‘closer to the winter months’ as this ‘would optimise the benefits to the NHS’.

‘Operational flexibility is however appropriate in delivery of vaccines to health and social care workers’, it said.

The committee will consider any additional bivalent vaccines for use in the programme as and when they are approved by the MHRA, UKHSA said.

Covid booster vaccines will be extended to people aged 50 and over from September alongside other at-risk groups, following a final recommendation from the JCVI last month.

A version of this story was first published on our sister title Pulse.