Summary of JCVI advice

Adults (≥18 years)

• Booster vaccination should be offered to all adults 18-39 years.
• Booster vaccination priority should be given to older adults and those in a COVID-19 at-risk group which includes congenital heart disease in those >16 years– see tables 2 and 3 in Green book information on vaccines 30 Nov 21.
• Boosters should be offered at an interval of at least 3 months of completion of the primary course.
• Severely immunosuppressed individuals who have completed their primary course (3 doses) should be offered a booster dose with a minimum of 3 months between the third primary and booster dose. Those who have not yet received their third dose may be given the third dose now to avoid further delay. A further booster dose can be given in 3 months, in line with the clinical advice on optimal timing.
• Both the Moderna (50 microgram) and Pfizer-BioNTech (30 microgram) vaccines should be used with equal preference in the COVID-19 booster programme. Both vaccines have been shown to substantially increase antibody levels when offered as a booster dose.

Young adults (16-17 years)

• 16 to 17-year-olds may also be offered their second dose of vaccine at least 8 weeks from the first dose
• 16 to 17-year-olds in higher-risk groups, which includes congenital heart disease should be offered a third dose (booster vaccination) at an interval of at least 3 months of completion of the primary course.

Children (12-15 years)

• 12 to 15-year-olds should now be offered a second dose (30 micrograms) of the Pfizer-BioNTech COVID-19 vaccine at an interval of at least 12 weeks from the first dose
• Interval could be shortened to 8 weeks “in periods of high incidence or where there was concern about vaccine effectiveness (for example a new variant)”- presumably at the present time
• Interval of at least 8 weeks for those in recognised higher risk groups (which includes haemodynamically significant congenital and acquired heart disease, or less severe heart disease with other co-morbidity– see Table 4 in Green book information on vaccines 30 Nov 21).
• Such haemodynamically significant congenital and acquired heart disease categories in 12 to 15-year-olds  have been previously considered and published by the BCCA

Children (5-11 years)

• No vaccine currently authorised in the UK for use for 5 to 11-year-olds. JCVI will continue to review data on the potential benefits and risks of vaccination of children aged 5 to 11 years and will issue separate advice in due course.

Vaccination following COVID infection
Vaccination of individuals who may be infected or asymptomatic or incubating COVID-19 infection is unlikely to have a detrimental effect on the illness. Vaccination should be deferred in those with confirmed infection- see P30 and 31 in Green book information on vaccines 30 Nov 21 :
Adults and high-risk children

• Deferred until 4 weeks after onset of symptoms or 4 weeks from the first confirmed positive specimen in those who are asymptomatic.

Children and young people <18 years not in high-risk groups

• Deferred until 12 weeks from onset (or sample date)
• Deferred until 8 weeks during periods of high incidence or where there is concern about vaccine effectiveness (for example a new variant). Both are currently the case.

PIMS-TS cases

• Deferred until 12 weeks, although earlier administration can be considered in those at risk of infection and/ or who are fully recovered.

British Congenital Cardiac Association