Israel became the first country in the world to start administering third doses of the Pfizer vaccine this week to tackle the spread of the Delta variant. Nitzan Horowitz, Israel’s health minister, has confirmed that booster jabs will be available to adults with pre-existing medical conditions immediately.
This move begs the question: what’s the UK government’s plan for the autumn?
On 21 June, a number of NHS leaders penned a letter to the government urging it to put concrete plans in place. If a winter booster programme is to go ahead, then the NHS needs ample time to prepare, they warned. The letter demanded clarity on crucial questions – for instance, which Covid vaccines will be used as boosters and whether it is safe to administer Covid boosters and winter flu jabs simultaneously. They pointed out that given the annual flu vaccine roll-out starts in September, time is of the essence.
Matt Hancock, then health secretary, responded that these much-needed answers would come soon, pointing out that the UK’s £20 million Cov-Boost trial is still underway. This vital study is using seven different vaccines to give booster jabs to over 3,000 fully-vaccinated volunteers. He said: “In the next few weeks, when we get the clinical data through on what’s the most effective combinations to have… then we’ll set out all the details for the booster programme for the autumn.”
Just over a week later, the government published interim advice that a booster programme for the elderly, medically vulnerable and health and social care workers should begin in September. According to this most up-to-date guidance, the final advice “will be published before September” and it will “take into account the latest epidemiological situation and additional scientific data from trials such as Cov-Boost”.
But there appears to be an inconsistency in timeframes. Today, a spokesperson from the Cov-Boost study confirmed that the initial findings of this major trial are not expected “until September.”
Waiting for trial data to make informed public health decisions is undoubtedly crucial. But the muddled timings undermine confidence that the government is giving NHS leaders the time they need to prepare for a booster roll-out. And the questions raised in the letter on 21 June – such as whether it’s safe to administer flu and Covid simultaneously – remain unanswered.
The next few weeks will be a nerve-wracking time for ministers, including Sajid Javid, the new health secretary. They’re watching the case numbers, and data from across Europe, and waiting to see if vaccines have a sufficiently powerful effect to keep deaths really low. Or is the connection between case numbers and deaths still strong enough to create a bigger death toll that fuels media and public panic in mid-August? Government simply doesn’t know. And then it is only six or so weeks until schools are due to return, and the country finds out if – and this is whispered behind the scenes – the government has to start tightening restrictions again going into the autumn.
Of course, another even more glaring unknown is that we still don’t how vital booster jabs are.
There is good evidence that two doses of any Covid vaccine used in the UK will provide strong protection against severe disease for at least six months. After this, it’s unclear just how rapidly levels of immunity fade.
Pfizer is suggesting that a third jab is beneficial within six to 12 months after a second dose to “maintain the highest levels of protection”.
But Dr Soumya Swaminathan, the chief WHO scientist, has offered a cutting rebuke to the pharma giant. The WHO, she insists, will make recommendations on booster shots “based on the science and data, not on individual companies declaring that the vaccines should now be administered as a booster dose”.
According to Swaminathan, who is urging countries to forego third jabs and focus on vaccinating those in poorer countries, “there is no scientific evidence to suggest that boosters are definitely needed.”
What does Israel – the world’s real-life coronavirus laboratory – imply about the necessity of a booster jab?
After the country’s impressive inoculation efforts prompted a return to near-normality, the Delta variant is now causing infection rates to spike. Case numbers have risen to over 400 a day, after weeks of single-digit daily infections.
Yet only 47 out of the 4,000 active coronavirus cases nationally are thought to involve serious illness. And health workers in the country are insisting that a double dose of the Pfizer jab is continuing to act as a strong shield against hospitalisation and death.
The evidence, then, is mixed. But with cases already surging and time quickly running out to put the full logistics and public messaging in place for an autumn booster programme, there is a need for a more coherent plan that can be communicated clearly. While the decisions are fraught with difficulty, soon the government must assess the data, incorporate it into its strategy, and act.
Let’s spend again, like we did last summer
Warm weather, domestic holidays and Euro 2020 lay behind the strongest quarter of retail growth on record, according to the British Retail Consortium.
Sales for April to June were up by 10.4 per cent compared to the same period in 2019 with pent up demand fuelling a surge in consumer spending as the country unlocked.
Separate figures from Barclaycard showed that spending on fuel, hotels, resorts and accommodation all grew for the first time since the pandemic began. Pubs and bars enjoyed a 38.1 per cent jump, as lockdown-weary Brits flocked to watch the football and tennis in sunny beer gardens.