Vaccination of children aged 12 to 15 years with underlying health conditions




Publication approval reference: C1420


  • All GP practices and PCN-led vaccination sites
  • Vaccination Centres which have been regionally approved to vaccinate extremely vulnerable 12 to 15 year-old children or their household contacts
  • Hospital Hubs and Hospital Hubs+
  • All CCGs

Copy to:

  • ICS and STP leads
  • NHS Regional Directors
  • NHS Regional Directors of Commissioning

20 September 2021

Dear colleagues,

Following the JCVI guidance on vaccination of children aged 12 to 15 years old with underlying health conditions (3 September) in which the definition of underlying health conditions was expanded, this note sets out next steps for all practices, vaccination centres, Hospital Hubs/Hospital Hubs+ and CCGs.

Actions for practices and PCN Groupings

PCN Groupings will have already vaccinated a large number of 12-15 year olds with underlying health conditions in line with the JCVI’s previous definition of “underlying health conditions” and our letter dated 13 August 2021.

Now eligibility has been extended in this group, new search tools are available in the GP IT systems to help identify additional 12-15 year old children and young people who are now eligible in accordance with the revised JCVI guidance (3 September).

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 additional small group of patients is offered the opportunity to receive their COVID-19 vaccination as soon as possible.

We ask that all practices identify any further eligible patients in this group by 27 September to enable vaccination to happen as soon as possible.

Once the searches have been undertaken,

  • Practices forming PCN Groupings that have opted to vaccinate 12-15 year olds should ensure that this group is invited to book a COVID-19 vaccination as soon as possible at their vaccination site and by 30 September.
  • 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 (e.g., another PCN-led vaccination site or Hospital Hub) by 27 September. This request is necessary for the reasons of public interest1. CCGs should ensure eligible patients are invited for an appointment by 30 September.

We recognise that not all eligible 12-15 year olds may be identified through the GP record. Therefore, any approach by parents(or someone with parental responsibility) of children at increased risk should be considered by practices and clinical judgement used around eligibility in line with JCVI advice.

If a patient (or someone with parental responsibility) considers the 12-15 year old is eligible under this group but have not been invited for an appointment, we are advising them to contact their GP practice to discuss their eligibility and so that the GP can signpost the patient appropriately.

Actions for Vaccination Centres

For Vaccination Centres, which have been regionally approved to vaccinate extremely vulnerable 12 to 15 year-old children or their household contacts as outlined in our ops note from 31 August 2021, site leads should confirm with their regional SRO/RDC the site readiness to vaccinate additional children cohorts at risk who have been identified by the JCVI (3 September 2021). The regional SRO/RDC need to document their decision to approve the site and ensure site readiness. The requirements outlined in our ops note, including the clinical redlines and workforce considerations, and the criteria of the self-assessment readiness checklist Part A and Part B equally apply for this cohort.

Actions for Hospital Hubs/Hospital Hubs+

HHs/HH+s should continue to proactively offer vaccination to eligible children and young people as a priority via inpatient and outpatient services. Trusts may refer 12-15 year olds with an underlying health condition for a COVID-19 vaccination if they consider them to be eligible.

Actions for CCGs

CCGs will be asked to confirm by Friday 1 October that all eligible 12-15 year old “at risk” patients (in line with the current definition) have been invited to book an appointment. A template will be shared imminently.

Thank you for all you are doing to help vaccinate children and young people.

Yours sincerely,

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

Caroline Temmink | Director of Primary Care Vaccination | NHS England and NHS Improvement