- 12–15 year olds with specific underlying health conditions that put them at risk of severe COVID-19
- Household contacts of the immunosuppressed
- Further updates for practices delivering COVID-19 vaccinations to eligible 12-15 year olds
- Annex A: Template letter to severely immunosuppressed individuals for GP practices to adapt and issue
Publication approval reference: C1383
- All GP practices
- PCN-led vaccination sites
- ICS and STP leads
- All CCGs
- NHS Regional Directors
- NHS Regional Directors of Commissioning
13 August 2021
Further to our letter following the updated JCVI guidance for vaccinating children and young people, this letter provides detail on the actions we need all practices to take to help identify eligible 12-15 year olds (cohort 13) to ensure they are offered a COVID-19 vaccination appointment by 23 August 2021. Overall, the number of people in this cohort is low and we have sought to minimise the associated work for practices.
The JCVI has advised that
“persons aged 12–15 years with specific underlying health conditions that put them at risk of severe COVID-19 should be offered two doses of Pfizer-BNT162b2 vaccine with an interval of eight weeks between doses”.
Please refer to the Green Book for details on who is eligible.
As it is not currently possible to identify eligible children and young people in this group nationally, we need all GP practices to run local searches to ensure that this small group of patients is offered the opportunity to receive their COVID-19 vaccination as soon as possible. We ask that all practices identify eligible patients by 19 August 2021 to enable vaccination before school term starts in September. To minimise the work for practices, searches will be made available by each of the system suppliers by close of play 14 August.
Once the searches have been undertaken:
- PCN Groupings that have opted to vaccinate eligible 12-15 year olds should invite them to book a COVID-19 vaccination as soon as possible at their vaccination site and by 23 August 2021.
- Practices forming PCN Groupings that have opted out of vaccinating 12-15 year olds and practices that are not delivering the COVID-19 vaccination enhanced service should share a list of eligible patients with their local commissioner so they can arrange for these patients to be offered an appointment at another provider (eg another PCN-led vaccination site or Hospital Hub) by 19 August*. This request is necessary for the reasons of public interest.
*Practices are required to provide information to the local commissioner under the duty of co-operation requirement in their GMS / PMS / APMS contracts.
We recognise that not all eligible 12-15 year olds may be identified through the GP record. Therefore, any approach by parents of children at increased risk should be considered and clinical judgement used around eligibility in line with JCVI advice. In addition, trusts may refer 12-15 year olds for a COVID-19 vaccination if they consider them to be eligible.
“Children and young people aged 12 years and over who are household contacts of persons (adults or children) who are immunosuppressed should be offered two doses of Pfizer-BNT162b2 vaccine on the understanding that the main benefits from vaccination are related to the potential for indirect protection of their household contact who is immunosuppressed. The offer of vaccination may help to alleviate stress and anxiety experienced by the children and young people living in these difficult circumstances. This advice is provided recognising that persons who are immunosuppressed are at higher risk of serious disease from COVID-19 and may not generate a full immune response to vaccination themselves.”
You also have an important role to play in identifying adults and children with immunosuppression who are at higher risk of serious disease from COVID-19 and advising them that any 12-15 year old household contacts are now eligible for a COVID-19 vaccination (in addition to household contacts aged 16 years and over).
Practices should identify individuals on their registered patient lists who fall into the Green Book definition of severely immunosuppressed and write to advise them that their 12-15 year old household contacts are now eligible for a COVID-19 vaccination. Please use the letter in Annex A.
- Practices delivering the COVID-19 vaccination enhanced service, who have not opted out of vaccinating patients in cohort 13, can vaccinate eligible 12-15 year olds now.
- Practices that opted out of phase 2 (cohorts 10-12), but continue to deliver COVID-19 vaccination to cohorts 1-9 can vaccinate eligible 12-15 year olds, if they have not opted out of vaccinating patients in cohort 13.
- We have published this set of FAQs. The LVS Standard Operating Procedure will shortly be updated to reflect the revised JCVI guidance.
- New public facing resources are available to order from Public Health England.
- In addition to the £12.58 item of service fee for administration of a COVID-19 vaccination, a further supplement of £10 can be claimed per vaccination dose to eligible patients aged 12-15 years old (cohort xiii.1 and cohort xiii.2). Only one £10 supplement per vaccination is claimable. The Point of Care system providers will incorporate a couple of additional requirements to support recording vaccination events for this cohort
- recognition of the supplementary payment of £10 through the amendment of the existing ‘home of housebound’ data field to reflect the inclusion of Eligible Children
- additional consent options to support the vaccination of children.
For vaccination events carried out before the Point of Care system is updated, sites are asked to record the vaccination as administered at the home of a housebound patient. This will ensure the £10 supplement is recorded and will avoid retrospective recording of the data. The screens within the NHSBSA Manage Your Service portal are also being updated to reflect these changes, which will be evident within the September declaration window.
Please continue to do everything possible to minimise any inequalities in vaccine uptake working with CCG, local authority and community partners, including for adults aged over 80+ with a learning disability or severe neurodisabilities, where uptake levels for these patients are lower than in other age groups.
In addition please continue to invite 16 and 17 year olds to book a COVID-19 vaccination appointment alongside national call/re-call processes so that all 16 and 17 year olds have the opportunity to have a COVID-19 vaccination before the start of the school term.
Thank you for your ongoing support in ensuring that the most vulnerable children and young people, and the household contacts of immunosuppressed people, are offered a COVID-19 vaccination in a timely manner.
Dr Nikita Kanani | Deputy SRO, COVID-19 Vaccination Deployment Programme | Medical Director for Primary Care | NHS England and NHS Improvement
Annex A: Template letter to severely immunosuppressed individuals for GP practices to adapt and issue
12-15 year old household contacts of people who are severely immunosuppressed are now eligible to receive the COVID-19 vaccination
We are writing to let you know that household contacts aged 12-15 of those who are severely immunosuppressed are now eligible to receive the COVID-19 vaccination. You fall into that category of adults given your current health condition, and we therefore want to ensure any household contacts aged 12-15 are offered a COVID-19 vaccination.
This is because the Joint Committee on Vaccination and Immunisation (JCVI) has recently advised that household contacts of young people aged 16 years and over and adults with severe immunosuppression should be offered COVID-19 vaccination. This aims to reduce the risk of infection to you by vaccinating those most likely to transmit to you, as even though you may have received your COVID-19 vaccination, you may have lower protection from the vaccine given that you are immunosuppressed.
The revised JCVI advice applies to household contacts who are 12 to 15 years old with whom you “expect to share living accommodation on most days… and therefore, for whom continuing close contact is unavoidable.” Household contacts aged 16 years and over are already eligible for a COVID-19 vaccination.
Please let any household contacts in that age group know they can now book a vaccination appointment via their registered GP practice, who will then invite them to attend their GP-led Local Vaccination Service.
Your household contacts will need to use this letter, together with proof of address of the immunosuppressed contact which should match the address held by the practice. This should happen on arrival for their vaccination appointment. They may also be asked for their date of birth.
Members of ‘bubbles’ that do not live with an immunosuppressed person for the majority of the week (frequent visitors and other non-carers who might visit the house often but not for the majority of the week, including overnight stays) are not included in the definition of ‘household contacts’ for the purpose of this vaccination programme, and should follow current advice on vaccination access, insofar as it relates to them.
For more information about the coronavirus vaccine, read the leaflet that came with this letter, or visit www.nhs.uk/covid-vaccination