This summer has seen a large 鈥� one which is showing potential to be bigger than the 2023 winter wave was.
The current wave has largely been driven by the so-called variants, which have acquired greater immune evasion and ability to enter our cells. The rise in COVID cases has also been a .
COVID is not seasonal, as this current wave is stark evidence of. This is why vulnerable people are given . Nonetheless, most respiratory infections (COVID included) are at . Having access to a COVID booster in the autumn is of great importance, as it protects those who are most vulnerable from severe COVID infections.
The Joint Committee for Vaccination and Immunisation (JCVI) have just published their recommendations for the . Unfortunately, the recommendations they鈥檝e made mean even fewer people will have access to vaccines for free on the NHS this autumn. And, the vaccines that will be made available may not be as effective against the current variants as newer formulations would be. This could leave more patients at risk of potentially serious infection.
The JCVI use a number of considerations in costing their recommendations for vaccine campaigns (although they have not fully released details of their costing model). What is clear is that the main concern is the cost of buying and delivering vaccines to prevent severe disease and deaths.
This year sees even fewer people able to access the vaccine for free on the NHS. The boosters will be offered to those over the age of 65, residents in old-age care homes and people who are at greater risk of catching COVID due to a compromised immune system. The JCVI haven鈥檛 advised offering the vaccine to frontline health and social care workers, staff in care homes and unpaid carers or household contacts of immunosuppressed people. Fortunately, the government has agreed to maintain the vaccine this year for .
Reduced vaccine coverage leaves those with regular, close access to vulnerable people unable to reduce their own risk of catching or spreading COVID. Although, it鈥檚 possible to purchase vaccines from many pharmacies, this is not cheap 鈥� with doses . Many people may not have the resources to pay for one.
Vaccines don鈥檛 just lower the risk of severe infection. They may also lower the risk of developing long COVID after an infection . Recent data shows that the risk of developing long COVID from an infection . The most recent Office for National Statistics data also shows are still being reported in the UK. Although fewer new cases are emerging, it鈥檚 still a significant number.
Despite the benefit of vaccination on reducing long COVID risk, the JCVI say there鈥檚 not enough evidence showing boosters reduce the risk of the condition. This is why they did not into their cost-benefit analysis.
The autumn vaccine campaign will also provide eligible patients with from the Autumn 2023 campaign instead of purchasing new vaccines.
Although using pre-procured doses means less money will be spent on the autumn booster programme, research shows older formulations of vaccines are less effective against variants which emerged after they were developed (such as the ). Modelling suggests they鈥檒l be up to a against severe disease.
Indeed, the , in line with , have recommended boosters be updated to target the JN.1 variants. Several manufacturers have begun preparing updated formulas for . The US鈥檚 Food and Drug Administration noted the and requested a modification to vaccines in order to as well.
But even with vaccine modifications being made to it may still be too late, given FLiRT variants are . Recent data suggests the virus is even evolving away from the FLiRT variants with even more .
The fact we鈥檙e in a position where we鈥檙e using vaccines that may be less effective against current variants is enormously frustrating. Ideally we would be looking to develop or acquire more durable vaccines that confer longer-lasting immunity 鈥� such as or that may be more resilient against the ever-evolving virus.
These could potentially have been developed in the UK鈥檚 vaccine manufacturing production centre. However, was in 2022. This leaves us lagging well behind other countries, such as , and , which are continuing to invest in developing the next generation of vaccines.
Vaccines, of course, aren鈥檛 the only tool we have. We can reduce the impact of infection by widening access to anti-viral COVID drugs (such as Paxlovid). Access to Paxlovid was to be expanded to cover who aren鈥檛 eligible for the vaccine (such as people who are obese or have diabetes). But the reality is there aren鈥檛 enough supplies and funding to cover the 15 million people that could become eligible 鈥� so these plans . Patients currently eligible to access the drug have described difficulty getting hold of this .
Public health measures such as and in buildings could also help lower risk of infection. But again, no money is being invested into making these measures more accessible.
COVID is not just another cold. It still has the potential to cause serious disease 鈥� and this threat is not going away anytime soon. Ignoring it isn鈥檛 an option, which is why ensuring people still have access to the latest, most effective vaccines is so important.
, Professor in Biomedical Sciences,
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