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Oxford Vaccine Group Director advises against widespread fourth jabs

Yan Chen reports.

Upcoming COVID-19 vaccine shots should target the most vulnerable in the UK and low-income countries worldwide, instead of becoming a regular occurrence for the general population once every few months, says Professor Sir Andrew Pollard, Chair of the Joint Committee on Vaccination and Immunisation (JCVI), which advises UK health departments on immunisation. 

“It’s just not, from a global perspective, affordable, sustainable, or deliverable to give fourth doses to everyone on the planet every six months.” The Oxford Vaccine Group Director and Professor of Pediatric Infection and Immunity told Sky News on 4th January 2022. 

The UK Government’s deliberations on a possible fourth dose came after Israel announced its plan to roll out a fourth jab for over-60s and healthcare workers, which Israeli Prime Minister Naftali Bennett has said increases antibodies fivefold. Some scientists on the Israeli Government’s advisory board, however, have warned that decisions to administer a fourth jab may be premature, and that too many shots could fatigue the immune system. On 10 January 2022, Chile also began rolling out a fourth shot for the immunocompromised, to be expanded to over-55s in February. 

The remark came as the UK marked one year since the deployment of the Oxford-AstraZeneca vaccine, for which Sir Pollard served as chief investigator in the clinical trials in 2020. The UK Government estimates that 2.5 billion doses of the Oxford-AstraZeneca vaccine have been distributed at-cost worldwide. 

Sir Pollard called attention to the imbalance in current global vaccine distribution. 

Less than ten percent of people in low-income countries have even had their first dose,” he stressed, “so the whole idea of regular fourth doses globally is just not sensible.”

The WHO has set a target of vaccinating 70% of the world’s population–in all countries–against COVID-19 by the end of June 2022, which has already been met on average by upper middle and high income countries. Meanwhile, the vaccination rate of lower middle income countries hovers around 50%, and that of low income countries, a mere 9.5%. 

Sir Pollard went on to suggest that “the most vulnerable”, rather than society at large, should be the target for future boosters. In an interview with the Telegraph, he acknowledges that more data will be needed to decide the necessity, timing, and frequency of these potential next boosters for vulnerable people. He also weighs the possibility of updated vaccines each year to counter the virus’ mutations, but again underlines that no conclusion can be drawn without further data. 

As society begins to open up in countries with high immunity such as the UK, Sir Pollard adds that “working out better how to live with the virus” will be the UK’s “critical next step” in the upcoming “new period of transition”. 

Professor Lim Wei Shen, JCVI’s COVID-19 immunisation Chair, also says there is no immediate need for a fourth jab, based on UK Health Security Agency (UKHSA) figures which show the booster’s protection against hospitalisation remaining around 90% for over-65s three months post-jab, although vaccine effectiveness against symptomatic disease drops, and is lower with the Omicron variant than with Delta. 

In mid-December 2021, the UK Government launched the Get Boosted Now campaign, which offered all eligible adults in England a booster by the end of December and administered more than 8 million jabs in the same period. 

As of 10th January, 83% of the UK population above the age of 12 had received their second dose, and 62.3% had received their booster or third dose, according to the UK Government Coronavirus Dashboard. This means that 79% of those eligible for the booster had received their jab, says Vaccines Minister Maggie Throup MP

Quoted on 11th January, Minister Throup cites JCVI advice to say there is “no plan for a fourth dose” from the UK Government at the moment, and that encouraging first, second, and booster doses will continue to be the priority. 

Image: Marco Verch Professional / CC BY 2.0

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