COVID-19 Vaccination

Colleagues are advised that an update has been made following the item on vaccinating young people turning 18 within three months, included in the Clinical Bulletin on Wednesday 04 August 2021. It follows the Patient Group Direction for Pfizer BioNTech Covid-19 Vaccine which was updated on Friday and is now available on the NHSE-I website: Coronavirus » Patient Group Direction for COVID-19 mRNA vaccine BNT162b2 (Pfizer/BioNTech) (england.nhs.uk).

The below table is correct as of Monday 09 August 2021 and replaces that which was included last week. It highlights which mechanism is required to enable administration of COVID-19 vaccines to the different paediatric cohorts. This table should be read in conjunction with the JCVI recommendation and the recent operational letters issued.

Cohorts	Valid Legal Mechanism	Number of Doses
17 and 9 months (‘18’)	Current PGD (6.8.21) and current National Protocol (13.4.21) or PSD.	2 doses.
All healthy 16-17year olds	Current PGD (6.8.21) or PSD	1 dose currently (under review)
16-17-year olds clinically at risk or in the other at-risk groups (in cohorts 2, 4 and 6) as outlined in the Green Book	Current PGD (6.8.21) and National Protocol (13.4.21) or PSD	2 doses
Children 12-15 yrs old at risk and household contacts of immunosuppressed (as specified by JCVI)	Current PGD (6.8.21) or PSD	2 doses

Toolkit messaging on vaccinating children

Please find attached a toolkit that includes some key messaging to use across your social media profiles, which support the latest JCVI guidance on vaccinating under 18-year-olds.

Updated JCVI guidance for the vaccination of children and young people

Following the Joint Committee on Vaccination and Immunisation (JCVI) guidance on COVID-19 vaccinations for children and young people, and outlined in our letter, individuals within 3 months of their 18th birthday will shortly be invited to book their vaccination appointment via the National Booking System (NBS). We will confirm as soon as possible the specific timing for when this change will be live in the NBS.

Vaccination centres, community pharmacies and Hospital Hubs can vaccinate individuals within 3 months of their 18th birthday subject to completing the clinical criteria, in the attached checklist, as a self-assessment process. PCN-led sites are not required to complete the checklist but are strongly encouraged to review it and ensure their sites remain compliant.

Meeting these criteria is also a precondition for vaccinating individuals within 3 months of their 18th birthday arriving as ‘walk-ins’ at vaccination sites.

These criteria (attached) have been developed to help providers identify the minimum requirements for vaccinating children. All providers must meet the requirements regardless of the delivery model. They cover the following:

Safeguarding
Consent
Staffing
Environment and processes
Emergency Preparedness
Legal Framework.

When planning the operational implementation of this guidance, sites must ensure there are appropriate mechanisms for patients aged less than 18 years to be identified on check-in and routed so they are seen by appropriate, competent and trained staff.

Staff working with individuals under the age of 18 must have an appropriate level of disclosure and barring service check. The full details, including how to obtain a fast track check, is here.

Children under the age of 16 must not be vaccinated in a vaccination centre or community pharmacy setting. This guidance is also not intended to cover vaccinating children under 16 years in PCN-led settings or Hospital Hubs.

The criteria in the attached supersede previously issued guidance from 22 July 2021 (‘Guidance on ‘walk-in’ appointments for people aged 12-17’).

In line with JCVI guidance and as currently set out in the Green Book, young people aged 16 and 17 years who are at higher risk of serious COVID-19 (cohort 6) or are health and social care workers (cohort 2) are also eligible for COVID-19 vaccination and could also attend any delivery model. Sites must meet the criteria outlined in the self-assessment checklist, prior to vaccinating these individuals.

Referrals for 12–15-year-old CEV Children

We are expecting the national protocols and indemnity arrangements to be in place week commencing on Monday 23 August which will allow PCNs to vaccinate the new Clinically Vulnerable group of 12–15-year-olds, including those who live in a household with immunocompromised adults. Currently PCN sites cannot vaccinate this group.

The Joint Committee on Vaccination and Immunisation (JCVI) issued recommendations for COVID-19 vaccinations in children and young people (12-17years) on Thursday 15 July 2021. The JCVI advise that the following children and young people should be offered a vaccine:

Children 12 to 15 years of age with severe neuro-disabilities, Down’s syndrome, underlying conditions resulting in immunosuppression, and those with profound and multiple learning disabilities (PMLD), severe learning disabilities or who are on the learning disability register
Children and young people aged 12 years and over who are household contacts of persons (adults or children) who are immunosuppressed should be offered COVID-19 vaccination on the understanding that the main benefits from vaccination are related to the potential for indirect protection of their household contact who is immunosuppressed.

In the interim period a weekly clinic is being set up at the Kingston Centre in Stafford by MPFT to vaccinate these children should they present to you in practice and you are unable to vaccinate them yourself. A referral can be made directly to the Kingston Centre alongside the attached PSD form. Please note, GPs do not have to send patients to this clinic, but if they want MPFT’s help in vaccinating the children now then they have to provide a PSD.

Please send any referrals, along with the PSD, to kingstonvc@mpft.nhs.uk

Please see attached C1375 – Enhanced Service Specification: COVID-19 vaccination programme 2020/21 – version 10 and C1377 – Enhanced Service Specification: COVID-19 vaccination programme: phase 3 2021/22 – version 2.1

Further to the JCVI’s recent announcements on 15 July and 4 August about the vaccination of children and young people, we have updated the COVID-19 enhanced service specification for phases 1 and 2 and the enhanced service specification for phase 3 to include the new eligible patients.

Practices delivering COVID-19 vaccinations under the phases 1 and 2 Enhanced Service (ES) can start vaccinating eligible children and younger people immediately subject to meeting the requirements of the ES. That includes eligible 12–15-year-olds and all 16- and 17-year-olds.

Until Public Health England (PHE) update the national protocol and Patient Group Direction (PGD), sites will need to use a Patient Specific Direction (PSD).

Regional Vaccine clinical update newsletter (14 June)

Please find attached issue 14 of the COVID vaccination support bulletin.

Advice

COVID Vaccine Advice Line for GPs and other vaccinators and prescribers

UHNM has agreed to provide a COVID Vaccine Advice Line for GPs and other vaccinators and prescribers across Staffordshire and Stoke-on-Trent to help answer some concerns regarding allergies and reactions. Please can you share the comms below with GPs, vaccinators and prescribers and not to wider staff.

COVID Vaccine Advice Line (via Consultant Connect) and vaccineeligibility@uhnm.nhs.uk email

There have been some concerns about giving COVID vaccines to people with allergies and reactions. The green book is now updated and very few people cannot have the Pfizer or Moderna vaccines and many of those will be able to have one of the other vaccines e.g. Vaxzevria. If you have concerns about whether it is safe to vaccinate someone you can use the Consultant Connect COVID Vaccine Advice Line or UHNM email address above to contact the adult allergy/ immunology team.

To access Consultant Connect download the app, via the App Store or Google Play, and follow the account set up instructions. Any issues contact Consultant Connect via email at hello@consultantconnect.org.uk