7 September 2021

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended that people with severely weakened immune systems should have a third vaccine dose as part of their primary Covid-19 vaccination schedule.

This is intended to lift immune response to similar to that of the rest of the vaccinated population.

This advice is for individuals aged 12 and over who had severely weakened immune systems at the time of their first or second Covid-19 vaccination doses in the primary schedule. Those who were receiving, or had received in the previous 6 months, immunosuppressive chemotherapy or radiotherapy are eligible under this guidance.

The JCVI guidance has a full list of those eligible for a third dose as part of their primary Covid-19 vaccination schedule.

Primary and secondary care teams are being asked to identify patients within their care who are eligible for a third primary dose.

Eligible patients should receive a letter from their GP or hospital team advising them of this recommendation. If you think you are eligible and don’t receive a letter, please contact your GP.

The JCVI recommends eligible adults over 18 should have the Pfizer or Moderna vaccines for their third primary dose. The AstraZeneca vaccine may be offered following a decision by a healthcare professional on an individualised basis. The Pfizer vaccine is recommended for those aged 12 to 17.

Primary and secondary care teams are also being asked to consider the best timing to administer the third dose.

In general, vaccines administered during periods of minimum immunosuppression are more likely to generate better immune responses. Therefore where possible, the third primary dose should be given 2 weeks after the period of immunosuppression or during a treatment break.

The third dose should be at least 8 weeks after the second dose.

It is important to note this third dose forms part of the individual’s primary vaccination schedule and is separate to advice on a booster vaccination programme. Individuals who receive a third primary dose will be eligible for booster doses in future. 

The JCVI is currently reviewing the evidence for a booster vaccination programme.