The Joint Committee on Vaccination and Immunisation’s (JCVI) interim advice is that COVID-19 booster vaccinations should first be offered to the most vulnerable.

The JCVI’s interim advice recommends a two-staged approach, with individuals in stage one offered a booster vaccine as well as a flu vaccine, as soon as possible from September 2021. Individuals in stage two offered a booster vaccine as soon as practicable after stage one, with equal emphasis on deployment of the flu vaccine where eligible. The JCVI advises that unpaid carers and the adult household contacts of immunosuppressed individuals should be offered a COVID-19 booster vaccine.

Final decisions on the timing and scope and cohort eligibility of any COVID-19 vaccine booster programme will be confirmed once the JCVI has provided their final advice.

The Joint Committee on Vaccination and Immunisation (JCVI) published interim advice on a potential COVID-19 booster vaccination programme on 30 June, which is available at the following link:

https://www.gov.uk/government/publications/jcvi-interim-advice-on-a-potential-coronavirus-covid-19-booster-vaccine-programme-for-winter-2021-to-2022

The JCVI advises a two staged approach, with individuals in stage one offered a booster vaccine and flu vaccine as soon as possible from September. Individuals in stage two should be offered a booster vaccine as soon as practicable after stage one, with equal emphasis on deployment of the flu vaccine where eligible. The JCVI suggests those aged 16 to 49 years old who are in an influenza or COVID-19 at risk group which includes some sufferers of chronic respiratory disease and asthma, are currently included in stage two.

Based on the JCVI’s interim advice, those eligible in phase one of the COVID-19 vaccination programme are likely to be offered a booster which includes unpaid carers. Final decisions on the timing, scope and cohort eligibility, of any booster programme will be confirmed once the JCVI has provided their final advice.

The Joint Committee on Vaccination and Immunisation (JCVI) is the independent body made up of scientific and clinical experts who advise Government on COVID-19 vaccine prioritisation at a population level.

The JCVI has assessed and reviewed data to understand the association between occupation and the risk of exposure to COVID-19, the risk of COVID-19 disease and the risk of COVID-19 related severe outcomes. Based on their assessments, the JCVI concluded that frontline health and social care staff and adult carers should both be prioritised for vaccination in Phase One of the COVID-19 vaccination programme as they are at high risk of exposure to COVID-19 and may also expose vulnerable individuals and other staff members whilst providing care. This includes both paid professionals and unpaid carers, who provide care in people’s own homes, and are prioritised in cohorts two and six respectively.

The Government has accepted this advice. Priority cohorts two and six have both been called forward for vaccination earlier this year.

Unpaid carers are not required to prove their eligibility for COVID-19 vaccinations. This is made clear in the COVID-19 vaccine deployment programme unpaid carers Standard Operating Procedure which states that “A person may be asked to prove their identity for the purpose of vaccination but not to prove their status as an unpaid carer. For example, unpaid carers will not be required to provide proof of receipt or entitlement to a carer’s allowance”.

Eligible unpaid carers have been invited for vaccination as a part of cohort six of phase one of the COVID-19 vaccination programme. This follows the advice the Joint Committee on Immunisation and Vaccination (JCVI).

There is no distinction in NHS England and NHS Improvement’s standard operations procedure (SOP) between eligibility of those who are and are not, in receipt of carers allowance. The SOP is available at the following link:

www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2021/03/C1182-sop-covid-19-vaccine-deployment-programme-unpaid-carers-jcvi-priority-cohort-6.pdf

The SOP sets out a number of existing sources used by the National Health Service to identify unpaid carers as follows:

- Those in receipt of or entitled to a carer’s allowance;

- Those known to general practitioners who have a ‘carer’s flag’ on their primary care record;

- Those known to local authorities who are in receipt of support following a carer’s assessment; and

- Those known to local carers organisations to be actively receiving care and support.

The JCVI’s definition of an unpaid carer has been clarified in Public Health England’s Green Book for COVID-19 as “carers who are eligible for carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable”.

The Joint Committee on Vaccination and Immunisation (JCVI) has determined that those with severe mental illnesses (SMI) are within cohort 6 for the vaccine rollout, and we are encouraging General Practitioners (GPs) to take a similar approach for this group of people to that being proposed for people with learning disabilities, working in partnership with secondary care mental health services and Voluntary, Community and Social Enterprise partners to ensure appropriate outreach mechanisms are in place.

People with SMI (including people who are severely unwell with an eating disorder, who have a high or low body mass index) and their carers should receive an invitation from their GP to get their COVID-19 vaccine. This might be by letter, text message or phone, or a combination of all three. If someone is unsure if they have an SMI which falls within the official definition above, they are encouraged to contact their GP, or mental health team. GP teams are encouraged to keep prioritising people with severe mental illness, applying a flexible approach to defining SMI.

There are no plans to do so.

Based on current evidence, complex disabilities are not considered by the Joint Committee on Vaccination and Immunisation to mean an automatically increased risk for serious outcomes from COVID-19. However, many people with complex disabilities will have other conditions which mean they do meet the criteria for either priority group four for those who are clinically extremely vulnerable or priority group six for those who have underlying conditions which create a heightened risk. Anyone in either of those groups or who are aged 50 years old or over have now been offered vaccination.

Adult carers, defined as those aged 16 years old or over, are being prioritised for vaccination alongside priority group six. This includes unpaid and family carers. Criteria include eligibility for a carer’s allowance, being the sole or primary carer for an elderly person or person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable.

Prioritisation for COVID-19 vaccination in phase one of the programme is based on reducing mortality, morbidity and protecting the health and social care system. Phase two, which started on 13 April, has been based on risk of serious health outcomes from COVID-19 therefore individuals have not been prioritised on the basis of factors such as responsibility for child-care. There are currently no plans to prioritise on this basis.

The Joint Committee on Vaccination and Immunisation (JCVI) is the independent body made up of scientists and clinical experts who advise the Government on prioritisation of vaccines at a population level. At present, there is very limited data on vaccination in adolescents, with no data on vaccination in younger children. The JCVI advises that only those children at very high risk of exposure and serious outcomes, such as older children with severe neuro-disabilities that require residential care, should be offered vaccination as part of phase one.

The Public Health England Green Book, which provides guidance for health professionals and immunisation practitioners, also sets out that children under 16 years of age, even if they are clinically extremely vulnerable (CEV), are at low risk of serious morbidity and mortality, and given the absence of safety and efficacy data on the vaccine, are not recommended for vaccination.

Parents and carers of children who are CEV will be prioritised for vaccination if they are frontline health or social care workers, or if they are an unpaid carer who is in receipt of carers allowance or are the sole or primary carer for a child who is particularly vulnerable to COVID-19. All other parents and carers will be vaccinated alongside other adults of the same age, or earlier if they have an underlying health condition themselves which makes them particularly vulnerable to COVID-19.

The Standard Operating Procedure (SOP) for unpaid carers was published on 8 March. It outlines the numbers of existing sources that will be drawn from to identify unpaid carers. They are:

- those in receipt of or entitled to a carer’s allowance;

- those known to GPs who have a ‘carer’s flag’ on their primary care record;

- those known to Local Authorities who are in receipt of support following a carer’s assessment; and

- those known to local carers organisations to be actively receiving care and support.

The SOP is available at the following link:

https://www.england.nhs.uk/coronavirus/publication/sop-covid-19-vaccine-deployment-programme-unpaid-carers-jcvi-priority-cohort-6/

The Department has established an extensive communications programme to target public health messages and tackle vaccine misinformation to improve the take-up of the COVID-19 vaccine among carers. This includes bespoke communications materials shared on the CARE Workforce App; a weekly newsletter and via social media channels; a paid advertising campaign targeting social care workers with digital advertising to build vaccine confidence and encourage booking vaccine appointments; a stakeholder toolkit with resources for distribution by care providers and representative bodies; and positive messaging using influencers, health experts, faith leaders and social care workers who have already been vaccinated to boost confidence and tackle misinformation. We have also held briefings with faith groups, charities and care providers who have expressed interest in co-creating vaccine content and acting as ambassadors.

NHS England’s Standard Operating Procedure sets out how unpaid carers are being identified. NHS England estimates that there are approximately two million unpaid carers in England. This is based on the number of people either eligible for a carer’s allowance, identified through general pracitioner records, receiving support following a carer’s assessment by their local council or from a local carer’s organisation, or who are the sole or primary carer of an elderly or disabled person who is clinically vulnerable to COVID-19.

A bespoke process is being developed for any eligible but unknown unpaid carers so they can self-declare and still apply for priority vaccination.

At present, there is very limited data on vaccination in adolescents, with no data on vaccination in younger children. The Joint Committee on Vaccination and Immunisation advises that only those children at very high risk of exposure and serious outcomes, such as older children with severe neuro-disabilities that require residential care, should be offered vaccination as part of phase one. The Green Book also sets out that children under 16 years of age, even if they are clinically extremely vulnerable, are at low risk of serious morbidity and mortality and given the absence of safety and efficacy data on the vaccine, are not recommended for vaccination.

Clinicians should discuss the risks and benefits of vaccination with a person with parental responsibility, who should be told about the paucity of safety data for the vaccine in children aged under 16 years old. However, the matter of whether to vaccinate a child should always be ultimately a decision to be made by the physician responsible for the patient.

As part of the booking process, providers are advised to check whether eligible patients require any reasonable adjustments for having their vaccination and this might include having an appointment alongside their carer if the carer is also eligible.

We recognise the vital role unpaid carers play in caring for vulnerable individuals. Unpaid carers are included in the Joint Committee on Vaccination and Immunisation’s priority group six - all individuals aged 16 to 64 years old with underlying health conditions which put them at higher risk of serious disease and mortality. This also includes those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.

Frontline social care workers, who provide care in people’s homes, are prioritised for vaccination in group two. In addition, unpaid carers are included in priority group six which comprises of all individuals aged 16 to 64 years old with underlying health conditions which put them at higher risk of serious disease and mortality. This also includes those who are in receipt of a carer’s allowance, or those who are the main carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.

We have published bespoke guidance for unpaid carers set out in a Standard Operating Procedure, which has been co-produced with Carers UK, the Carers Trust, the Association of Directors of Adult Social Services and the Local Government Association, in order to help ensure that all eligible unpaid carers are offered a vaccine.

Unpaid carers are included in the Joint Committee on Vaccination and Immunisation’s priority group six. This also includes those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable.

The Standard Operating Procedure (SOP) for unpaid carers has now been published. The SOP draws on national and local sources for known carers, to help identify and enable them to be invited quickly for a vaccination, as well as making provision for those unpaid carers who may not already be known to the health and social care system to come forward.

The SOP is available at the following link:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2021/03/C1182-sop-covid-19-vaccine-deployment-programme-unpaid-carers-jcvi-priority-cohort-6.pdf

Unpaid carers are included in the Joint Committee on Vaccination and Immunisation’s priority group six. This also includes those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable.

The Standard Operating Procedure (SOP) for unpaid carers has now been published. The SOP draws on national and local sources for known carers, to help identify and enable them to be invited quickly for a vaccination, as well as making provision for those unpaid carers who may not already be known to the health and social care system to come forward. The SOP is available at the following link:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2021/03/C1182-sop-covid-19-vaccine-deployment-programme-unpaid-carers-jcvi-priority-cohort-6.pdf

Unpaid carers are included in the Joint Committee on Vaccination and Immunisation’s priority group six. This also includes those who are eligible for a carer’s allowance, or those who are the sole or primary carer of an elderly or disabled person who is at increased risk of COVID-19 mortality and therefore clinically vulnerable.

The Standard Operating Procedure (SOP) for unpaid carers has now been published. The SOP draws on national and local sources for known carers, to help identify and enable them to be invited quickly for a vaccination, as well as making provision for those unpaid carers who may not already be known to the health and social care system to come forward. The SOP is available at the following link:

https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2021/03/C1182-sop-covid-19-vaccine-deployment-programme-unpaid-carers-jcvi-priority-cohort-6.pdf