Dosing information for COVID-19 booster vaccination

Marianne Eve, Medicines Information Pharmacist, Midlands and East Medicines Advice Service (East site)Published Last updated See all updates

Guidance on eligibility of individuals to receive a reinforcing dose of COVID-19 vaccine, along with the recommended choice of vaccine

Eligibility for booster

UK Health Security Agency (UKHSA – formerly known as PHE) Immunisation Against Infectious Disease (the Green Book) states that the Joint Committee for Vaccines and Immunisation (JCVI) recommends that people who received a primary course in Phase 1 of the COVID-19 vaccination programme (priority groups 1-9) should be offered a reinforcing, or “booster”, COVID-19 vaccine.

This includes:

  • those living in residential care homes for older adults
  • all adults aged 16 years or over
  • frontline health and social care workers
  • all those aged 16 to 49 years with underlying health conditions that put them at higher risk of severe COVID-19
  • all carers aged 16 years and above
  • all those aged 16 years and above who are household contacts of immunosuppressed individuals of any age

Scheduling

Reinforcing doses should not be given within three months of completion of the primary course.

Following the emergence of the Omicron variant, JCVI have now advised accelerating the booster deployment in order of age and risk status. Individuals aged over 50 years and in risk groups should now be offered booster vaccination, followed by those aged 49 years and below who are not at risk, in descending age order.

Immunosuppressed patients

A reinforcing dose should be offered from 3 months after the third primary vaccination dose, according to the UK Health Security Agency (UKHSA – formerly known as PHE) Immunisation Against Infectious Disease (the Green Book).

Those who have not yet received their third dose may be given their third dose in line with primary vaccination schedule.

A further reinforcing dose can then be given in 3 months, in line with the clinical advice on optimal timing.

Using COVID-19 vaccines in patients taking immunosuppressive medicines contains further guidance.

Children and young people

Children and young people aged 12-15 who are at higher risk from COVID-19 or those aged 12-15 years who are household contacts of immunosuppressed individuals of any age should also be offered a booster. Booster doses should not be given within three months of completion of the primary course.

Vaccine choice

UK Health Security Agency (UKHSA) Immunisation Against Infectious Disease (the Green Book) states that the Joint Committee for Vaccines and Immunisation (JCVI) recommends which vaccine should be given as first line.

The JCVI states that where mRNA vaccines are not suitable, vaccination with the AstraZeneca vaccine may be considered in those who were primed with the same vaccine.

Adults aged 18 years or over

The JCVI have advised that a full dose of Pfizer-BioNTech vaccine or a half dose of the Moderna COVID-19 vaccine should be offered as a booster dose irrespective of the vaccine used for the primary course.

Children and young people

Pfizer BioNTech is preferred for boosting individuals aged under 18 years.

Information on primary vaccination

Dosing information COVID-19 primary vaccination

Dose scheduling, actions when the intervals are longer than or less than recommended, and use of alternative brands for second doses

Use in conjunction with other material

The legal mechanisms available for giving COVID-19 vaccines and their application

A summary of the different legal mechanisms available, a priority order for the options, and advice on their application to different professional groups.

Change history

  1. Resources checked and information remains correct
  1. Information on booster doses for children and young people added
  1. Legal mechanisms wording removed as link provided to the dedicated "legal mechanisms available for giving COVID-19 vaccines and their application" webpage with more detailed guidance.
  1. Information updated to reflect new guidance from JCVI.
  1. Information on booster doses for immunosuppressed patients and children and young people added
  1. Published