Next phase of NHS COVID-19 vaccination campaign




Publishing approval reference: C1252


  • ICS leads
    CCG Accountable Officers
    NHS Foundation Trust and Trust Chief Executives
    Local Authority Chief Executives
    PCNs and all GP practices
    Community Pharmacies

Copy to:

  • Chairs of ICS
    CCG Chairs
    Chairs of NHS trusts and foundation trusts
    NHS Regional Directors
    NHS Regional Directors of Commissioning

13 April 2021

Dear Colleague

Thanks to your ongoing leadership of the NHS COVID vaccination programme we have now been able to vaccinate 19 out of 20 people aged 50 and over, which is an important milestone in the most successful vaccination programme in the history of the NHS. We are also seeing high numbers of people coming forward for their second dose: 6.5 million people across England have already received their booster vaccination, including three quarters of people aged 80+.

While continuing to deliver on the NHS’s ‘evergreen’ vaccination offer for any who have yet to accept the opportunity, everyone eligible in cohorts 1-9 has now had the opportunity to be vaccinated, so today the independent Joint Committee on Vaccination and Immunisation (JCVI) has published the next set of guidance on vaccinating cohorts 10-12 (people aged in their 40s, 30s, 18, 19 and 20s).

In addition, from today limited initial volumes of the Moderna vaccine became available in England.

Operational next steps

This letter sets out five operational next steps, having now met the 15 April 2021 milestone.

  • Those eligible individuals aged under 30 who had their first vaccination appointment postponed following last week’s updated MHRA/JCVI guidance on Oxford AstraZeneca should now be being contacted by the NHS and offered an alternative vaccine (Pfizer or Moderna), either through GP-led LVSs, Hospital Hubs, or at vaccination centres.
  • As previously set out, most vaccination supply in April will be needed for second doses or remaining first doses in cohort 1-9. Vaccination services should continue to ensure that people are offered their second dose in line with the JCVI guidance on dose intervals.
  • Within overall supply availability we can now make a phased start on cohort 10. Therefore, with immediate effect, all vaccination services are now able to extend their vaccination offer to those aged 45-49 years. The National Booking System has today been opened to this group, and GP-led local vaccination services should now offer appointments to patients within this age range where supply permits. As supply increases, we will write to you to confirm next steps on vaccinating the second half of cohort 10. The JCVI’s age-based approach continues to be based on evidence that hospitalisations and risk of critical care admissions increase with age, including for individuals who are under 50 years of age.
  • The self-referral route for frontline eligible health and social care workers will be reinstated on the NBS by 19 April, and local systems are also asked to continue to ensure local provision for all eligible health and care workers. As set out in our letter to you on 11 February, when using the online or telephone service, social care workers will need to self-declare at the point of booking and will be asked for identification and written authorisation when they attend their vaccination appointment. Appropriate forms of identification include a work photo ID card, authorisation letter from the local authority, a signed letter of authorisation from their employer or wage slip that is dated within the last 3 months. Where work photo ID is not available, alternative photographic identification is required to support verification. All vaccination sites are expected to follow this approach.
  • Finally, vaccination services, supported by their system partners including local authorities and voluntary and community sector organisations, should continue doing 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. JCVI also advises that deployment teams should actively promote vaccination uptake for individuals who are: male, BAME, have a BMI of 30 or more, and those from areas of high socio-economic deprivation, given the heightened risk of hospitalisation for these groups. Therefore, systems are encouraged to refer to practical guidance for implementing a range of interventions to ensure equitable access to COVID-19 vaccination and improve uptake. This can be found here.

National communications will continue to encourage all of those in JCVI cohorts 1-9 who have yet to have been contacted or who would now like to access a vaccination to come forward, with updated materials aimed at encouraging uptake for those in cohorts 10-12 expected to be shared toward the end of the month.

Thank you for your continued leadership on this vital programme.

Dr Emily Lawson | SRO Vaccine Deployment and Chief Commercial Officer

Dr Nikki Kanani | Medical Director for Primary Care