Updated JCVI guidance for the vaccination of children and young people
- For immediate action
- Vaccination of eligible children and young people aged 12–15 years
- Young adults who are within three months of their 18th birthday
- For all Community Pharmacy-led Local Vaccination Services (CP), Vaccination Centres (VC) and Hospital Hubs
Publication approval reference: C1374
- All GP practices
- All community pharmacy-led vaccination sites
- Vaccination centres
- All CCGs
- All directors of public health
- All directors of children’s services
- All NHS trust chief executives
- All ICS and STP leads
- All local authority chief executives
- NHS regional directors
- NHS regional directors of commissioning
- Chairs of ICSs and STPs
- Chairs of NHS trusts and foundation trusts
5 August 2021
We are writing to you following yesterday’s independent Joint Committee on Vaccination and Immunisation (JCVI) updated guidance in relation to COVID-19 vaccinations for children and young people.
The guidance states:
“For adults aged 18 years and over, JCVI considers that the potential benefits of vaccination with Pfizer-BNT162b2 continue to outweigh potential harms.
“For persons aged <18 years old who do not have underlying health conditions that put them at higher risk of severe COVID-19, there is more uncertainty in the precision of the harm-benefit balance when considering the impacts on children and young people themselves. As with adults, age has a strong influence. In general, older children are more likely to benefit from vaccination compared to younger children.
“At this time, JCVI advises that all 16–17-year olds should be offered a first dose of Pfizer-BNT162b2 vaccine. This is in addition to the existing offer of two doses of vaccine to 16–17 year olds who are in ‘at-risk’ groups. Pending further evidence on effectiveness and safety in this age group, a second vaccine dose is anticipated to be offered later to increase the level of protection and contribute towards longer term protection. Further data and the potential availability of alternative vaccine options will inform exact details which will be provided in a subsequent update of this advice before second doses are due at approximately 12 weeks after the first dose.
“As previously advised by JCVI, 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. This currently includes children with severe neurodisabilities, Down’s Syndrome, underlying conditions resulting in immunosuppression, profound and multiple learning disabilities (PMLD), severe learning disabilities or who are on the learning disability register. Details regarding additional person-groups with underlying health conditions to be offered vaccination will be provided as updates in the Green Book.
“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.
“Further data and experience relevant to the vaccination of otherwise healthy persons aged 12–15 years are accumulating. The current epidemiology of COVID-19 in the UK is also changing rapidly. JCVI considers these factors important in determining the overall harm-benefit balance related to the vaccination of healthy 12–15 year olds. JCVI will continue to review emerging data and provide further advice in a timely manner.
“In all instances, the offer of vaccination to children and young people must be accompanied by appropriate information to enable children and young people, and those with parental responsibility, to be adequately appraised of the potential harms and benefits of vaccination as part of informed consent prior to vaccination.”
A full copy of the report can be found here: https://www.gov.uk/government/publications/jcvi-statement-august-2021-covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years
For immediate action
Vaccinating healthy 16 – 17-year olds
For all primary care network (PCN)-led local vaccination services (LVS)
An updated enhanced specification has now been published to support the vaccination of 16–17-year olds by PCN-led LVS. A full copy can be found here: https://www.england.nhs.uk/coronavirus/publication/ess-vaccination-programme/.
LVS sites can now offer vaccinations to this group and communications that can be tailored for local use will shortly be made available on: https://future.nhs.uk/P_C_N/view?objectId=23714448
Until Public Health England (PHE) updates the national protocol and Patient Group Direction (PGD), sites will need to use a Patient Specific Direction (PSD). PCN-led LVS will also need processes in place to ensure this cohort only receive a first dose until further instruction is given.
For all community pharmacy-led LVS (CP), vaccination centres (VC) and hospital hubs (HH)
The National Booking System is now being updated to reflect the first dose offer as set out by JCVI. We will notify you of developments shortly.
As an interim measure for the next period, and to ensure maximum coverage and availability for 16–17 year olds, CPs, VCs and HHs are asked to make walk-in appointments available for this group by completing the readiness checklist. Sites need processes in place to ensure this cohort only receive a first dose until further instruction is given. Further information will be shared shortly about how to advertise walk-in opportunities.
Until PHE updates the national protocol and PGD, sites will need to use a PSD.
Systems should work with delivery sites to support them to complete the readiness checklist, and work with all partners to ensure coverage promotes equity of access.
Vaccination of eligible children and young people aged 12–15 years
Updated JCVI guidance published on 19 July advised children and young people aged 12 years and over with specific underlying health conditions that put them at risk of serious COVID-19 or who are household contacts of persons (adults or children) who are immunosuppressed, should be offered COVID-19 vaccination.
The guidance can be found here: https://www.gov.uk/government/publications/covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years-jcvi-statement/jvci-statement-on-covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years-15-july-2021
Further details about the eligibility of individuals aged 12 years or above at higher risk of severe COVID-19 infection is included on page 17 of the PHE Green Book.
It is important all delivery models prioritise the vaccination of this group and that all eligible children are offered a first vaccination before the start of the new school year.
HH should continue to proactively offer vaccination to eligible children and young people as a priority via inpatient and outpatient services.
An enhanced service specification for GP-led LVS has been published today and can be found here: https://www.england.nhs.uk/coronavirus/publication/enhanced-service-specification-phase-3-coronavirus-vaccination/. Search guidelines to identify and invite eligible patients will be published shortly, though GP-led services can begin vaccination on publication of the specification. Where practices opt out, they will be required to run searches to ensure all eligible children and young people on registered lists are offered timely vaccination through other delivery models.
Young adults who are within three months of their 18th birthday
For all PCN-led local vaccination services
Many PCN groupings have already started vaccinating young adults who are within three months of their 18th birthday following the amendment made to the enhanced service specification for phases 1 and 2: https://www.england.nhs.uk/coronavirus/publication/enhanced-service-specification-phase-3-coronavirus-vaccination/
PCN-led sites are not required to complete the readiness checklist but are strongly encouraged to review it and ensure their sites remain compliant.
For all Community Pharmacy-led Local Vaccination Services (CP), Vaccination Centres (VC) and Hospital Hubs
CPs, VCs and HHs can vaccinate young people within three months of their 18th birthday subject to completing a self-assessment that declare the site complies with requirements circulated to providers on 4 August 2021.
Completing the self-assessment is a pre-requisite to sites offering walk-in appointments to those within three months of their 18th birthday.
All vaccination sites must ensure there are appropriate mechanisms in place to enable those aged less than 18 years to be identified on check-in and routed so they are seen by appropriate, competent and trained staff. Staff working with individuals under the age of 18 must have an appropriate level of disclosure and barring service (DBS) check. The full details, including how to obtain a fast track check, is here: https://future.nhs.uk/system/login?nextURL=%2Fconnect%2Eti%2FCovidVaccinations%2Fview%3FobjectId%3D108802789
If your site meets the requirements in the checklist, please update Qflow as soon as your site meets the requirements so that individuals are able to book a vaccination.
Thank you for your continued commitment to protecting people throughout the summer months. We appreciate your ongoing focus and support of the vaccination programme.
Professor Sir Keith Willett | SRO Vaccine Deployment | NHS England and NHS Improvement
Dr Nikita Kanani | Medical Director for Primary Care | NHS England and NHS Improvement