Coronavirus vaccination programme - statement

On 2 December 2020, the Medicines and Healthcare products Regulatory Agency (MHRA) authorised the Pfizer-BioNTech vaccine for those aged 16 years and over in the UK under an emergency use authorisation. On 30 December MHRA issued an emergency use authorisation for the AstraZeneca vaccine. Advice from the Joint Committee on Vaccination and Immunisation (JCVI) to Government at this point is to directly protect those most at risk of morbidity and mortality.

Under this approach JCVI has identified a number of priority groups for the first phase of the vaccination programme.

For the paediatric workforce

JCVI has advised that those working at the frontline of health and social care are a priority group for receiving vaccination. Local implementation of the programme should seek to mitigate risks arising from health inequalities in relation to COVID-19, such as those relating to ethnicity. Anyone with concerns or queries should contact their Clinical Lead or College Tutor in the first instance.

JCVI advice is that although the available data do not indicate any safety concern or harm to pregnancy, there is insufficient evidence to recommend routine use of COVID-19 vaccines during pregnancy. However, JCVI has advised that vaccination in pregnancy should be considered where the risk of exposure to SARS-CoV2 infection is high and cannot be avoided, or where the woman has underlying conditions that put them at very high risk of serious complications of COVID-19. Therefore vaccination should be considered for pregnant healthcare workers in patient-facing roles where the risk of exposure is high.

JCVI has also advised that breastfeeding women may be offered vaccination with the Pfizer BioNTech or Astra Zeneca vaccines. Vaccination should not impact on breastfeeding.

For children and young people

Young people aged 16 years and over with specific clinical vulnerabilities are identified in the priority groups within the first phase. Those who are deemed clinically extremely vulnerable will be eligible for vaccination in priority group 4, after those aged 75 and over. Young people aged 16 and over with other clinical vulnerabilities specified by JCVI will be eligible for the vaccine in priority group 6, after those aged 65 and over.

At present there are very limited data on safety and efficacy of the vaccine in those aged under 16. JCVI has advised that only those at very high risk of exposure and serious outcomes should be offered this vaccine at present. According to the Green Book (chapter 14a, v7), older children (aged 12 years and over) with severe neuro-disabilities and recurrent respiratory tract infections who frequently spend time in specialised residential care settings for children with complex needs may be considered for vaccination (note: this would be considered unlicensed use of the vaccine).

Clinicians should discuss the benefits and risks and limited safety data with children, young people and parents/guardians before taking a decision on vaccination. 

Looking ahead

The College expects to see more safety and efficacy data gathered from clinical trials which will inform strategies for vaccination of children and young people under 16, and other groups not covered by the first phase. This research is essential to ensure paediatricians are equipped to discuss immunisation with children, young people and parents and can address any questions they may have about the vaccine. Further data on the effect of vaccines on transmission of the virus is needed to shape strategies to cocoon those who cannot be vaccinated (due to immunosuppression or immunocompromise) by vaccinating close family and household contacts.

It is essential that the COVID-19 vaccination programme is guided by evidence. Paediatricians are playing significant roles in helping to gather evidence around the safety and efficacy of individual vaccines, and in assessing data that helps to determine the vaccination strategy. The operational challenge posed by the COVID-19 vaccination programme to the NHS is considerable. As this necessary work is undertaken at pace, it will be essential to avoid any disruption to the established programme of childhood vaccinations. 

For further information see the RCPCH position statement on vaccinations (August 2020) and the below external links.

Latest updates to this page

Update in this version (29 March 2021)

  • To reflect V7 of Green Book chapter 14a. 

Update in version 13 January 2021

  • Addition of updated JCVI advice issued on 30 Dec.