COVID-19 vaccination deployment: booster vaccination for cohort 10 and second doses for 16 and 17-year olds




Publication approval reference: C1454

To: ICS and STP Leaders

Copy to:

  • CCG Accountable Officers
  • PCN Led Local Vaccination Sites
  • Community Pharmacy Led LVS
  • Chief Executives of all NHS trusts and foundation trusts
  • NHS Regional Directors
  • NHS Regional Directors of Commissioning
  • Directors of Public Health
  • All Local Government Chief Executives

15 November 2021

Dear Colleague

Today the Government has accepted updated advice from the Joint Committee on Vaccination and Immunisation (JCVI) on booster vaccinations for those aged 40-49 and second dose vaccination for those aged 16-17 years.

For those in cohort 10, the independent JCVI updated advice now recommends that:

“JCVI advises that all adults aged 40 to 49 should also be offered a booster vaccination with an mRNA COVID-19 vaccine, 6 months after their second dose, irrespective of the vaccines given for the first and second doses.

Booster vaccination should preferably be undertaken with either the Pfizer-BioNTech vaccine (BNT162b2/Comirnaty®), or a half dose of Moderna (mRNA-1273/Spikevax®) vaccine, as previously advised.”

A full copy of the advice can be found here.

The JCVI also updated advice for those 16-17 year olds who are not in an at-risk group. The advice states:

“JCVI advises that young people aged 16 to 17 years who are not in an at-risk group should be offered a second dose of Pfizer-BioNTech (Comirnaty) COVID-19 vaccine.

The second vaccine dose should be given 12 weeks or more following the first vaccine dose.

For persons who have had proven SARS-CoV-2 infection and a first dose of vaccine, the second vaccine dose should be given 12 weeks or more following the first vaccine dose, or 12 weeks following SARS-CoV-2 infection, whichever is later.”

A full copy of the advice can be found here.

Actions now required

All sites are now asked to take the following immediate actions.


Systems are now asked to review capacity and work with sites to update all vaccination site calendars to ensure maximum availability. The National Booking System will open for bookings for those aged 40 – 49 from 22 November, with the first tranche of national invitations issued shortly thereafter. NBS will be opened to individuals from 152 days (5 months) after their second dose, enabling booking on or after the recommended 182 days (6 months).

For those aged 16-17 years, the NBS will be available from 22 November for second dose bookings, with appointments available to this group no earlier than the recommended twelve weeks after their first.

To support delivery, the UK HSA is updating the Patient Group Directive (PGD), the National Protocol and Green Book Guidance to reflect the changes for 16-17 year olds. We expect the PGD to be updated by no later than 22 November and the National Protocol to follow shortly thereafter. Until these have been updated, only sites meeting the prescribing requirements for working under a Patient Specific Direction (PSD) should start to administer booster vaccines and/or second doses for 16-17 year olds. There is no change required to the PGD and protocol for the addition of cohort 10.

Booster vaccination for cohort 10

All Vaccination Centres, Hospital Hubs + and community pharmacy-led local vaccination services should plan to start delivering booster vaccinations to cohort 10 from 22 November.

We recognise the pressures general practice is under and that not all networks will have capacity to deliver boosters to Cohort 10 alongside core primary medical services and winter pressures.

PCNs are therefore asked to inform their local commissioner by 22 November if they wish to opt in to vaccinate this cohort. The General Practice Phase 3 COVID-19 Vaccination Enhanced Service has been updated to reflect this and can be found here. Further details on the opt in process are included in the operational guidance which will be issued shortly.

Community pharmacy-led sites will be able to vaccinate this cohort under the current LES, PGD and protocol from 22 November. A copy of the PGD and protocol can be found here.

Second dose vaccination for healthy 16 – 17-year olds

All assured sites for 16 and 17-year olds should plan to start delivering second doses, at a minimum of twelve weeks after the first dose or proven SARS-CoV-2 infection (where later), from 22 November.

An updated enhanced specification for primary care network (PCN)-led local vaccination services (LVS) has been published today to support the vaccination of 16–17-year olds for assured PCN sites. A copy can be found here.

Assured community pharmacy-led local vaccination services are able to vaccinate this cohort under the current Local Enhanced Service specification for Community Pharmacies. CP-led LVS can only start to offer vaccination to this group once the PGD and National Protocol have been updated.

At risk 16 and 17-year olds (those in cohorts 1, 2, 4 or 6) should continue to be offered a second dose at a minimum of 8 weeks after the first dose via local booking or walk-ins.

Further details are included in operational guidance which will be issued shortly. Collectively, the NHS in England has delivered over 91 million vaccinations, including over 10 million booster doses. As we continue to accelerate the delivery of boosters and maintain the evergreen offer, we would like to thank you for your continued commitment to making the NHS-delivery of this programme a resounding success.

Yours sincerely

Dr Emily Lawson | NHS SRO Vaccine Deployment | NHS England & NHS Improvement

Dr Nikki Kanani | Deputy SRO, COVID-19 Vaccination Deployment Programme, Medical Director for Primary Care | NHS England & NHS Improvement