This year's NHS flu and COVID-19 vaccine programmes will start earlier than planned in England due to the potential risk from a new a variant of SARS-CoV-2.
The precautionary measure was taken to protect the most vulnerable, health chiefs said.
Both programmes had been due to start in October because the "best protection was usually provided by getting vaccinated with as short a gap as possible" before exposure to circulating influenza and COVID-19 viruses", explained the department of Health and Social Care (DHSC). But now, those most at risk — including adult care home residents — will be offered a vaccine from 11 September, on the advice of the Joint Committee on Vaccination and Immunisation (JCVI).
Potential Impact of the BA.2.86 Variant
Concerns were raised by the DHSC and the UK Health Security Agency (UKHSA) on the risks presented by the new BA.2.86 variant, which was first detected in the UK on 18 August. Dame Jenny Harries, the Agency's chief executive, said that there was "limited" information available at present, so the potential impact of this particular variant was "difficult to estimate".
The DHSC pointed out that while BA.2.86 was "not currently classified as a variant of concern", advice from UKHSA suggested that speeding up the autumn vaccine programme would deliver greater protection, support those at greatest risk of severe illness, and reduce the potential impact on the NHS.
"There's currently no publicly available data to suggest that BA.2.86 is able to overwhelm present levels of immunity to the most serious, life-threatening forms of COVID-19," underlined Dr Simon Clarke, associate professor in cellular microbiology at the University of Reading. However, he cautioned there remained "a lot of unanswered questions".
John Edmunds, professor in the Centre for the Mathematical Modelling of Infectious Diseases at the London School of Hygiene and Tropical Medicine, said that the "newly identified variant and its large number of mutations, might help the virus evade existing immune responses". He believed it made sense to bring forward the planned autumn vaccination campaign to ensure that those at highest risk of COVID had their protection "topped up".
Support for the Accelerated Programme
Dame Jenny Harries emphasised that the "precautionary measure" to bring forward the autumn programme would ensure vulnerable people had protection against any "potential wave this winter".
Residents of older adult care homes and those most at risk — including those who are immunosuppressed — would receive their COVID vaccine first, NHS England clarified. Steve Russell, NHS England chief delivery officer and national director for vaccinations, said that the new variant presented a "greater risk now".
Vaccine providers would receive an additional payment of £10 — in addition to the Item of Service (IOS) fee — for each COVID-19 vaccination administered to care home residents between Monday 11 September and Sunday 22 October 2023 inclusive; and a separate one-off additional payment of £200 for each Completed Care Home by the end of the day on Sunday 22 October, explained NHS England.
From 18 September, the NHS would start inviting people in priority order of risk, and those eligible would be able to book an appointment on the National Booking Service. NHS England stressed that eligible people should wait to receive an invite from their local provider.
For these eligible groups, vaccine providers would receive an additional £5 acceleration payment — in addition to the IoS fee — made available for each COVID-19 vaccination administered to eligible people between 11 September and 31 October.
"Wherever possible, vaccinations for flu and COVID-19 should still be offered at the same time, making it easier and more convenient for people," advised NHS England.
Dr Clarke agreed that "operationally it just makes sense to get the ball rolling and to not do it at the same time as the flu jab would be folly". He warned: "People might not bother going for the second jab or mistakenly assume that one jab protects against two very different viruses."
Protection Against "Nasty" Viruses
Claire Steves, professor of ageing and health at King's College London, welcomed the decision and believed it made "logical sense". She said that immunity from vaccines "wanes the more time since the vaccination", which meant "topping up" was needed if a new wave of the pandemic was suspected.
Professor Steves explained: "Whilst it was not known for sure yet, it's likely that broader immunity — for example to new variants like this BA.2.86 — is better with higher levels of circulating antibodies, which means it's likely that even though this vaccine is not designed for this particular variant, it is a good chance it will help to reduce risk, especially in the first 3 months after vaccination."
Professor Sir Stephen Powis, NHS England medical director, promised that the NHS would "work quickly to offer people protection against these nasty viruses as soon as possible".
However, some healthcare bodies were not so pleased with the decision. Director of the Royal Pharmaceutical Society in England, Ms Tase Oputu, expressed that the "short notice" changes to the start date for the winter vaccination programme had created "confusion" for pharmacy teams trying to make plans, and for the public.
"The Government must plan ahead more decisively next year to avoid such uncertainty," she demanded.
NHS England promised to announce full details of the accelerated roll-out soon.