Joint Committee On Vaccination And Immunisation Research Articles

Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection?

A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005-2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.

The impacts of SARS-CoV-2 vaccine dose separation and targeting on the COVID-19 epidemic in England

In late 2020, the JCVI (the Joint Committee on Vaccination and Immunisation, which provides advice to the Department of Health and Social Care, England) made two important recommendations for the initial roll-out of the COVID-19 vaccine. The first was that vaccines should be targeted to older and vulnerable people, with the aim of maximally preventing disease rather than infection. The second was to increase the interval between first and second doses from 3 to 12 weeks. Here, we re-examine these recommendations through a mathematical model of SARS-CoV-2 infection in England. We show that targeting the most vulnerable had the biggest immediate impact (compared to targeting younger individuals who may be more responsible for transmission). The 12-week delay was also highly beneficial, estimated to have averted between 32-72 thousand hospital admissions and 4-9 thousand deaths over the first ten months of the campaign (December 2020–September 2021) depending on the assumed interaction between dose interval and efficacy.

Government advisers recommend autumn COVID-19 boosters for people at most risk

People at a higher risk of severe COVID-19 should be offered a booster vaccine dose in autumn 2023, according to new interim advice in a report from the Joint Committee on Vaccination and Immunisation (JCVI). An extra booster vaccine dose may also be offered in spring 2023 for some smaller groups, such as those who […]

Serological responses to Anthrax Vaccine Precipitated (AVP) increase with time interval between booster doses

We undertook a Phase 4 clinical trial to assess the effect of time interval between booster doses on serological responses to AVP. The primary objective was to evaluate responses to a single booster dose in two groups of healthy adults who had previously received a complete 4-dose primary course. Group A had received doses on schedule while Group B had not had one for ≥2 years. Secondary objectives were to evaluate the safety and tolerability of AVP booster doses, and to gain information on correlates of protection to aid future anthrax vaccine development. Blood samples were taken on Day 1 before dosing, and on Days 8, 15, 29 and 120, to measure Toxin Neutralisation Assay (TNA) NF50 values and concentrations of IgG antibodies against Protective Antigen (PA), Lethal Factor (LF) and Edema Factor (EF) by ELISA.For each serological parameter, fold changes from baseline following the trial AVP dose were greater in Group B than Group A at every time-point studied. Peak responses correlated positively with time since last AVP dose (highest values being observed after intervals of ≥10 years), and negatively with number of previous doses (highest values occurring in individuals who had received a primary course only). In 2017, having reviewed these results, the Joint Committee on Vaccination and Immunisation (JCVI) updated UK anthrax vaccination guidelines, extending the interval between routine AVP boosters from one to 10 years.Booster doses of AVP induce significant IgG responses against the three anthrax toxin components, particularly PA and LF. Similarly high responses were observed in TNA, a recognised surrogate for anthrax vaccine efficacy. Analysis of the 596 TNA results showed that anti-PA and anti-LF IgG make substantial independent contributions to neutralisation of anthrax lethal toxin. AVP may therefore have advantages over anthrax vaccines that depend on generating immunity to PA alone.

Audit on COVID-19 Vaccine Uptake and Hesitancy Amongst Pregnant or Postnatal Patients Under the Care of a Perinatal Mental Health Community Team

AimsWomen with perinatal mental illness are at increased risk for severe illness with COVID-19. Vaccination against COVID-19 is strongly recommended by JCVI (Joint Committee on Vaccination and Immunisation) and RCOG guidance. Mental health professionals should proactively inform their patients about COVID-19 vaccination and also address any concerns or misinformation, should they be raised. The aim of this audit was to evaluate the rate of uptake of the COVID-19 vaccine among patients under the West Kent community perinatal mental health team. In addition, we aimed to identify factors that deter patients from taking the COVID-19 vaccine. In patients who were hesitant to take the vaccine, we offered further information to aid their decision-making process.MethodsWe identified patients under the care of the West Kent perinatal mental health community team on 27/10/2021. We excluded patients who were discharged from the team in subsequent weeks during data collection. We collected patient demographics including highest level of education, ethnicity, religion and socio-economic status. Patients’ COVID-19 vaccine status was obtained via GP records or through telephone contact.If patients had not had their COVID-19 vaccine, they were contacted to enquire whether they were planning to take the vaccine, if not, to ascertain reasons for refusal and whether they wanted additional information about the vaccine. Those women who requested additional information were offered the RCOG information sheet and decision aid.ResultsAmongst 86 patients included in the audit, 59% (n = 51) had taken both dose of the COVID-19 vaccine and 12% (n = 10) had taken a single dose. 29% (n = 25) were unvaccinated.68% (n = 17) of unvaccinated patients were pregnant and 32% (n = 8) were postnatal. All women who did not accept COVID-19 vaccine were contacted to offer further information. Following this contact, 39% (n = 9) decided to accept the vaccine, 52% (n = 12) refused the vaccine and 26% (n = 6) were uncertain but were willing to consider taking the vaccine in the future.The reasons for hesitancy in accepting the vaccine included a lack of trust in the vaccine, concerns around its development over a short period of time, concerns around close associates experiencing illness or side effects after taking the vaccine and scepticism over efficacy of the vaccine. Few women did not wish to take the vaccine during their pregnancy, but were willing to consider it after the birth of their baby.ConclusionWe identified potential areas to optimise uptake of COVID-19 vaccines by discussing the importance, safety, efficacy and providing up-to-date information regarding COVID-19 vaccine in the perinatal period.

Importance of understanding the reinfection risk of COVID-19 in children

Importance of understanding the reinfection risk of COVID-19 in children

Effectiveness of BNT162b2 against COVID-19 in adolescents

In the UK, COVID-19 vaccination for adults began in December, 2020.1 Because children and adolescents have a low risk of severe COVID-19 and due to concerns about rare but potentially severe myocarditis after mRNA vaccination—mainly after the second dose in young adult males—the UK Joint Committee on Vaccination and Immunisation (JCVI) initially recommended one dose for 16–17-year-olds from Aug 4, 2021,2 and recommended against vaccinating 12–15-year-olds because of marginal benefits versus risk.

Covid-19 Vaccine in Pregnancy: Don’t Forget Pregnant Women and People Seeking Asylum

Pregnant women and people are at an increased risk of severe disease and pregnancy complications if they contract severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). In April 2021, the Joint Committee on Vaccination and Immunisation (JCVI) advised this group to take the Pfizer/BioNTech or Moderna COVID-19 vaccines; however, recent data from Public Health England (PHE) indicate that this population are vaccine-hesitant. As midwives urge this cohort to get vaccinated, consideration should be given to pregnant women and people seeking asylum so that they are not left out. This population experience significant health and social inequities, which place them at a higher risk of developing serious illness from COVID-19. This article considers the risk factors for infection, and the barriers and facilitators for COVID-19 vaccines in pregnancy. This article uses the term ‘pregnant women and people seeking asylum’ as it focuses on the people seeking asylum and not their status.

Respiratory diseases advocate living with severe asthma

Respiratory diseases advocate living with severe asthma

Patients aged 50 years and over to be offered COVID-19 booster and flu jabs

Everyone aged 50 years and over in England will be offered a COVID-19 booster jab and flu vaccination from September 2022, the government has announced. This follows advice from the Joint Committee on Vaccination and Immunisation (JCVI), published on 15 July 2022, which also recommended a COVID-19 booster jab for frontline health and care workers; […]

COV-BOOST: evidence to support rapid booster deployment

With accruing evidence that the effectiveness of COVID-19 vaccines wanes over time,1–4 and the recent emergence of the omicron (B.1.1.529) variant,5 some countries are rapidly deploying vaccine boosters.6 In the UK, the COVID-19 vaccination campaign launched in December, 2020, and began with prioritised population groups, including people most likely to be at higher risk for severe outcomes or those providing health services or care for these individuals. With emerging evidence from Israel and the UK of vaccine waning, the Joint Committee on Vaccination and Immunisation (JCVI) in September, 2021, recommended boosting individuals in a phased way 6 months after completion of their primary course of COVID-19 immunisation.

COVID-19 vaccine rollout for children aged 12-15

Children aged 12 to 15 across the UK are now being offered their first dose of the Pfizer/BioNTech vaccine for COVID-19. The move follows a recommendation by the UK’s four chief medical officers (CMOs). About 3 million children are eligible for the jab, despite the Joint Committee on Vaccination and Immunisation (JCVI) deciding not to recommend mass vaccination of the age group.

The facts about the COVID-19 booster jab

Boosters are being offered to people most vulnerable to serious infection ahead of the winter months, in line with advice from the Joint Committee on Vaccination and Immunisation (JCVI).

Immunocompromised patients in the USA and UK should receive third dose of COVID-19 vaccine.

A third dose of COVID-19 vaccine should be offered to severely immunocompromised people to improve immunogenicity, the UK's Joint Committee on Vaccination and Immunisation (JCVI) advised on Sept 1, 2021. The decision followed similar announcements by the US Food and Drug Administration (FDA) and US Centers for Disease Control and Prevention (CDC) in August.

Trends and clinical characteristics of COVID-19 vaccine recipients: a federated analysis of 57.9 million patients’ primary care records in situ using OpenSAFELY.

BackgroundOn 8 December 2020 NHS England administered the first COVID-19 vaccination.AimTo describe trends and variation in vaccine coverage in different clinical and demographic groups in the first 100 days of the vaccine rollout.Design and settingWith the approval of NHS England, a cohort study was conducted of 57.9 million patient records in general practice in England, in situ and within the infrastructure of the electronic health record software vendors EMIS and TPP using OpenSAFELY.MethodVaccine coverage across various subgroups of Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts is described.ResultsA total of 20 852 692 patients (36.0%) received a vaccine between 8 December 2020 and 17 March 2021. Of patients aged ≥80 years not in a care home (JCVI group 2) 94.7% received a vaccine, but with substantial variation by ethnicity (White 96.2%, Black 68.3%) and deprivation (least deprived 96.6%, most deprived 90.7%). Patients with pre-existing medical conditions were more likely to be vaccinated with two exceptions: severe mental illness (89.5%) and learning disability (91.4%). There were 275 205 vaccine recipients who were identified as care home residents (JCVI group 1; 91.2% coverage). By 17 March, 1 257 914 (6.0%) recipients had a second dose.ConclusionThe NHS rapidly delivered mass vaccination. In this study a data-monitoring framework was deployed using publicly auditable methods and a secure in situ processing model, using linked but pseudonymised patient-level NHS data for 57.9 million patients. Targeted activity may be needed to address lower vaccination coverage observed among certain key groups.

Staff could be in line for vaccine booster jabs

Nurses and nursing students could be offered a COVID-19 booster jab with their flu vaccine from September, if interim advice from the Joint Committee on Vaccination and Immunisation (JCVI) is implemented. [ABSTRACT FROM AUTHOR] Copyright of Nursing Management - UK is the property of RNCi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Large Scale Internet-based Survey of Patients With a Myeloproliferative Neoplasm: Opinions and Experiences Regarding SARS-CoV-2 (COVID-19) Vaccination Strategies in 2021.

Supplemental Digital Content is available in the text.

Identifying UK travellers at increased risk of developing pneumococcal infection: a novel algorithm.

BackgroundIn 2016, the travel subcommittee of the UK Joint Committee on Vaccination and Immunisation (JCVI) recommended that 13-valent PCV (PCV13) could be offered to travellers aged over 65 years, visiting countries without infant PCV immunization programmes. This study aimed to identify, collate and review the available evidence to identify specific countries where UK travellers might be at an increased risk of developing pneumococcal infection. The data were then used to develop an algorithm, which could be used to facilitate implementation of the JCVI recommendation.MethodsWe conducted a systematic search of the published data available for pneumococcal disease, PCV vaccine implementation, coverage data and programme duration by country. The primary data sources used were World Health Organization databases and the International Vaccine Access Centre Vaccine Information and Epidemiology Window-hub database. Based on the algorithm, the countries were classified into ‘high overall risk’, ‘intermediate overall risk’ and ‘low overall risk’ from an adult traveller perspective. This could determine whether PCV13 should be recommended for UK adult travellers.ResultsA data search for a total of 228 countries was performed, with risk scores calculated for 188 countries. Overall, 45 countries were classified as ‘high overall risk’, 86 countries as ‘intermediate overall risk’, 57 countries as ‘low overall risk’ and 40 countries as ‘unknown’.ConclusionTo our knowledge this is the first attempt to categorize the risk to UK adult travellers of contracting pneumococcal infection in each country, globally. These findings could be used by national travel advisory bodies and providers of travel vaccines to identify travellers at increased risk of pneumococcal infection, who could be offered PCV immunization.

Estimating the Impact of Vaccination on Antimicrobial-Resistant Typhoid Fever in Gavi-73 Countries

Background: Multidrug resistance (MDR) and fluoroquinolone non-susceptibility (FQNS) are major concerns for the epidemiology and treatment of typhoid fever. The recent development and licensure of typhoid conjugate vaccines (TCVs) provide an opportunity to limit the transmission and burden of antimicrobial-resistant (AMR) typhoid fever. Methods: We combined output from mathematical models of typhoid transmission with estimates of antimicrobial resistance to predict the burden of AMR typhoid fever across Gavi-73 countries. We considered FQNS and MDR separately. The impact of vaccination was predicted based on forecasts of vaccine coverage. We explored how the potential impact of vaccination on the proportion of cases that were AMR varied depending on key model parameters. Findings: The introduction of routine immunization with TCV at 9 months of age with a catch-up campaign to 15 years of age was predicted to avert 46-74% of all typhoid fever cases in Gavi-73 countries. Vaccination was predicted to reduce the relative prevalence of AMR typhoid fever by 16% (95% prediction interval (PI): 0-49%). TCV introduction with a catch-up campaign was predicted to avert 42.5 million (95% PI: 24.8-62.8 million) cases and 506,000 (95% PI: 187,000-1.9 million) deaths due to FQNS typhoid fever and 21.2 million (95% PI: 16.4-26.5 million) cases and 342,000 (95% PI: 135,000-1.5 million) deaths from MDR typhoid fever over 10 years following introduction. Interpretation: Our results indicate the benefits of prioritizing TCV introduction for countries with a high avertable burden of FQNS and MDR typhoid fever. Funding: The Bill & Melinda Gates Foundation. Declaration of Interest: AJP chairs the UK Department of Health’s (DoH) Joint Committee on Vaccination and Immunisation (JCVI) and and is a member of the World Health Organization’s (WHO) Strategic Advisory Group of Experts. VEP has received reimbursement from Merck and Pfizer for travel expenses to Scientific Input Engagements unrelated to the subject of this manuscript and is a member of the World Health Organization’s (WHO) Immunization and Vaccine-related Implementation Research Advisory Committee. The views expressed in this manuscript are those of the authors and do not necessarily reflect the views of the JCVI, the DoH, or the WHO.

Hospital admissions due to COVID-19 in Scotland after one dose of vaccine

The BNT162b2 mRNA vaccine from Pfizer–BioNTech1 and the ChAdOx1 nCoV-19 vaccine from Oxford–AstraZeneca2 were the first two products deployed in the UK's COVID-19 vaccination programme. In accordance with the strategy set by the nation's Joint Committee on Vaccination and Immunisation (JCVI), vaccines were initially prioritised for care home residents and staff, individuals older than 80 years, and front-line health-care and social care workers. In December, 2020, in response to surging transmission of SARS-CoV-2, JCVI advised delaying the second dose of these vaccines to achieve broader population coverage with the first dose.