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Expert Comment - Flu and COVID-19 vaccine programmes brought forward

LSHTM experts respond to the announcement that England’s flu and COVID-19 vaccine programmes will start earlier than planned this autumn
"It should help protect the most vulnerable people in the country, as well as reducing the risk that the NHS becomes overstretched." Mark Jit, Professor of Vaccine Epidemiology, LSHTM

This year’s flu and COVID-19 vaccine programmes will start earlier than planned as a precautionary measure, following the identification of a new COVID-19 variant, according to an announcement by the UK Government’s Department of Health and Social Care (DHSC).

The decision means those most at risk from winter illness – including people in care homes for older people, the clinically vulnerable, those aged 65 and over, health and social care staff and carers – will be offered a vaccine in England from September. 

The precautionary measure is being taken as scientists examine the variant BA.2.86, which is not currently classified as a variant of concern.

Mark Jit, Professor of Vaccine Epidemiology at the London School of Hygiene & Tropical Medicine (LSHTM), said:

“COVID-19 hasn’t gone away, but fortunately fewer people are dying or getting severe disease from it nowadays because of our successful vaccination programme, as well as the immunity we’ve built up from previous infections. 

“This new variant – BA.2.86 or ‘Pirola’ – looks genetically very different from previous variants of the virus we’ve seen recently but we do know that COVID-19 vaccines provide good protection against severe disease, with the strongest protection in the months just after a new dose is given. 

“Bringing forward this autumn’s COVID-19 and flu vaccination programmes is a precautionary measure to provide protection as early as possible. It should help protect the most vulnerable people in the country, as well as reducing the risk that the NHS becomes overstretched.”

John Edmunds, Professor of Mathematical Modelling of Infectious Diseases at LSHTM, said:

“BA.2.86 is characterised by a large number of mutations, many of which might be expected to help the virus evade existing immune responses. It makes sense, therefore, to bring forward the planned autumn vaccination campaign to ensure that those at highest risk of COVID-19 have their protection topped up. 

“It should be said, however, that this is a precautionary measure. Our genomic surveillance suggests that BA.2.86 is still at low prevalence, and although this strain has been identified in a number of different countries, it is not yet clear whether it is replacing existing strains in any of these settings.”

Punam Mangtani, Professor of Epidemiology at LSHTM, said:

“Influenza vaccines are a well-established way to provide some protection against illness in those who are particularly at risk in the influenza season. An intra-muscular vaccine is given to older adults, those with underlying illness at younger ages, healthcare workers and pregnant women. Children from the age of two are offered an intranasal version.  

“It requires many months to produce vaccines from seed strains, which are chosen by an international expert assessment at the World Health Organization (WHO), of what variants are likely to be circulating each upcoming season. 

“The start of the influenza season can vary a lot, from September to the spring of the new year. Bringing forward this seasonal vaccination programme a little and offering a COVID-19 booster vaccine at the same time makes a lot of sense.  

“COVID-19 is different from influenza in that it is more of a problem in older adults and those with underlying illness than in younger people. Making both vaccines more easily available for people at higher risk of infection and for health and social care workers will provide timely protection as well as help support healthcare services.”

Shereen Hussein, Professor of Health and Social Care Policy at LSHTM, said:

“One of the main problems encountered during the peak of COVID-19 infection was the spread among individuals in care homes. It’s promising to see that care home residents are now being prioritised, as we know that this group was neglected in the early days of the pandemic. 

“A particular area of concern was people being discharged from hospitals to care homes without being tested for COVID-19. From the recent announcement, it’s unclear whether this group of individuals will now be offered routine testing or access to the vaccine.

“Optional access to the vaccine for social care staff and informal carers is also reassuring to see and our hope is that this will be extended to include NHS staff. These are all individuals who work closely together and with vulnerable patients on a day-to-day basis, so focussing on only vaccinating social care staff could create uncertainty.”

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