The JCVI’s final guidance comes as vaccination was extended to those aged over 45 on Tuesday morning after the government announced it had met its target of offering jabs to all 32m patients in the first nine priority cohorts ahead of its 15 April deadline.
NHS England wrote to PCN vaccination sites on Tuesday advising them that they could begin to invite those aged 45 to 49 for vaccination, ‘where supply permits’. However, it reiterated that most vaccine supply for local vaccination sites during April would be needed for second doses.
The JCVI’s final guidance backs its earlier recommendation that continuing the age-based approach in phase 2 – starting with those aged 40-49, then 30-39 year-olds, followed by 18-29 year-olds – was the quickest and simplest way to achieve rapid deployment and high vaccine uptake across the population.
Phase 2 of vaccination programme
However, it added that in people aged 18 to 49 there was evidence of increased risk of hospitalisations in men, those from certain ethnic groups, people with a BMI of more than 30 and those experiencing deprivation.
The JCVI said it ‘strongly advises’ people in these groups to ‘promptly take up the offer of vaccination when they are offered’. It added that local vaccination teams should use their understanding of ‘local health systems and demographics, combined with clear communications and outreach activity, to promote vaccination in these groups’.
NHS England said alongside specifically targeting these groups, PCN vaccination sites should also continue to do ‘everything they can to ensure as many people as possible in cohorts 1-9 receive their first dose, as well as maintaining an unrelenting focus on second dose delivery’.
The JCVI highlighted that certain occupations have a higher risk of exposure, but concluded that the best way to ensure these people were vaccinated quickly was to continue to vaccinate by age ranges.
Its guidance also confirms that only those aged 18 to 29 will be offered an alternative to the Oxford/AstraZeneca vaccine ‘if available’, which it set out in an update on the programme last week. This latest statement stressed that ‘prompt vaccination’ with the Oxford/AstraZeneca vaccine far outweighed an adverse event in those aged 30 and over.
The JCVI said that phase two of the vaccination programme should also involve ‘continued efforts to extend coverage among those prioritised in phase 1 but who remain unvaccinated, and to complete delivery of second doses to all those given first doses in phase 1’.
The committee also said it supported ‘flexibility’ in delivering the programme to help boost vaccination in groups with lower uptake.
‘JCVI strongly advises that priority is given to the deployment of vaccination in the most appropriate manner to promote vaccine uptake in persons from ethnic minority backgrounds who have not yet been vaccinated,’ the statement said.
This may include ‘easy access to vaccination sites, supported engagement with local ethnic minority community and opinion leaders, and tailored communication with local and national coverage’, it added.
Vaccination sites could also consider delivering the vaccine in multigenerational households or running clinics in religious or community centres, it added.
COVID-19 vaccination in children
No vaccines for COVID-19 are currently licensed for use in children, however the JCVI said it had ‘started to consider evidence on the risk of serious disease in children, the role children may play in transmission, and the safety and efficacy of COVID-19 vaccines in children.’
The JCVI said there was growing data to suggest that vaccination resulted in a reduction in asymptomatic infection, which it said could suggest some impact on reducing transmission as well.