Updated: 1 June 2023
Who will be offered COVID-19 vaccinations?
Since July 2021, the Joint Committee on Vaccination and Immunisation (JCVI) and the UK Chief Medical Officers (CMOs) have been advising on how the COVID-19 vaccination programme may be applied to children and young people. This advice covers primary doses and booster doses.
COVID-19 vaccinations for babies and children aged 6 months - 4 years.
On the 6 April 2023 the UK Health Security Agency (UKHSA) announced the advice of the JCVI to offer COVID-19 vaccinations to babies and children aged 6 months to 4 years who are in a clinical risk group (as defined in the Green Book). Those eligible should be offered two doses of the 3-microgram Pfizer-BioNTech COVID-19 vaccine, with an interval of 8 to 12 weeks between the first and second doses. Further advice regarding a potential third 3-microgram dose of the Pfizer-BioNTech COVID-19 vaccine will be issued in due course; for children who are immunosuppressed and are eligible for a third primary dose, please refer to the Green Book for more details.
Over one million children aged 6 months to 4 years in the US have received at least one dose of the Pfizer-BioNTech COVID-19 vaccine since June 2022 with side effects being similar to other vaccines given in this age group.
The JCVI does not currently advise COVID-19 vaccination of children aged 6 months to 4 years who are not in a clinical risk group.
NHS England has confirmed it will begin offering vaccinations in England from mid-June. In Scotland the programme will launch from 29 May although some Boards may not commence appointments until June. In Wales vaccinations may start to be offered from May. Information regarding arrangements in Northern Ireland will follow soon. Parents should wait to be contacted before coming forward.
What is the advice on primary doses?
The JCVI’s advice on primary doses is as follows.
| 6 months - 4 year year olds at higher clinical risk* | Two 3mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 5-11 year olds at higher clinical risk* | Two 10mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 5-11 year olds who are household contacts of someone who is immunosuppressed | Two 10mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 5-11 year olds who are severely immunosuppressed** | Three 10mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 5-11 year olds not in groups specified above. This one-off programme includes children who turn 5 years old before the end of August 2022.*** | Two 10 mcg doses of Pfizer BioNTech, at least 12 weeks apart |
| Note: For 5-11 year olds above, JCVI advise that there should be a minimum four-week interval between any vaccine dose and recent COVID-19 infection | |
| 12-15 year olds at higher clinical risk* | Two 30mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 12-17 year olds who are household contacts of someone who is immunosuppressed | Two 30mcg doses of Pfizer-BioNTech, at least 12 weeks apart |
| 12-17 year olds who are severely immunosuppressed** |
Three 30mcg doses of Pfizer-BioNTech, at least 8 weeks apart |
| 12-17 year olds not in groups specified above*** | Two 30 mcg doses of Pfizer-BioNTech, at least 12 weeks apart |
| Note: The Green Book provides advice on dosing intervals following recent COVID-19 infection | |
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* clinical risk as defined in Table 4 of the Green Book chapter on COVID-19 ** criteria for a third primary dose are listed in Box 1 and Box 2 in the Green Book chapter on COVID-19 ***From the end of the spring 2023 campaign, primary course COVID-19 vaccination will become a targeted offer during seasonal campaigns to those at higher risk of severe COVID-19 only i.e. risk groups stated in the Green Book chapter. Note: 5-11 year olds who are severely immunosuppressed should be considered for primary immunisation regardless of the time of year based on clinical judgement. |
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What about booster doses for children and young people?
JCVI advised on 27 January 2023 that booster doses for persons aged 16 to 49 years who are not in a clinical risk group will end in alignment with the close of the Autumn 2022 vaccination booster campaign. In England this ended on 12 February 2023 and in Wales it is due to end on 31 March 2023.
Spring Booster 2023 - JCVI also advised that an extra booster dose could be offered in spring 2023 to individuals aged 5 years and over who are immunosuppressed, as defined in the Green Book, chapter 14a (tables 3 and 4).
Autumn Booster - Booster doses will continue to be offered in the Autumn to the groups below during the seasonal booster campaign or sooner on the advice of a clinician:
- 5-17 year olds in a clinical risk group. Clinical risk groups are defined Tables 3 and 4 of chapter 14a of the Green Book.
- 5-17 year olds who are household contacts of people with immunosuppression
- Carers who are aged 16 and over, as defined by Table 3 of chapter 14a of the Green Book.
Children and young people who become severely immunosuppressed - Vaccinated individuals aged five years and above who become or have recently become severely immunosuppressed should be considered for an additional dose of COVID-19 vaccine, regardless of the time of year. This would represent either a third primary dose or an additional booster. Clinical judgement should be used to decide which individuals
should be given an additional booster dose soon after their diagnosis rather than waiting for the next campaign and thus getting extra protection during the season and at the same time as other high risk groups.
How will those who are eligible be able to get their vaccinations?
The four health services across the UK will provide details of how and when those who are eligible will be able to get their vaccinations.
The Governments and NHS vaccine programmes should provide clear and consistent information for children and young people, families and clinicians with regards to the vaccination programme.
In England further information has been published on nhs.uk.
In Scotland, further information has been provided by NHS Inform.
Further details of the Welsh Government’s vaccination programme is available on the GOV.WALES website.
What information will be provided to children, young people and their families about this?
The JCVI and CMOs have noted that the risks and benefits around COVID-19 vaccination for children and young people are more finely balanced than for older age groups. Information provided should cover all the details needed to ensure informed consent can be given by the 12-17 year old. For those aged 5-11, a parent or carer will need to provide that informed consent
For those who are household contacts of a person who is immunosuppressed - vaccination should be offered on the understanding that the main benefits are related to the potential for indirect protection of that household contact.
Information about the vaccine, its safety and side effects has been published by the UK Health Security Agency.
What information will be available to support healthcare professionals?
The Green Book details the clinical criteria, the evidence base, potential safety and side effects, and recommended dosing intervals (which vary according to age, risk profile and time since a confirmed COVID-19 infection). This information should support clinicians discuss risks and benefits of vaccination with children, young people and their families.
Product information about individual vaccines is available from the MHRA. Two formulations of the Pfizer BioNTech vaccine have been authorised for use: a paediatric formulation for 5-11 year olds and an adult formulation for those aged 12 and over. The Moderna vaccine are authorised for use in 12-17 year olds. Other vaccines have yet to be authorised for under 18s in the UK.
Is the paediatric formulation available in the UK?
Yes, the paediatric formulation is available in the UK.
What’s the College’s view on myocarditis?
We don’t know the long-term issues from vaccination, but nor do we have a full understanding of the long-term issues from COVID-19. All suspected side effects to COVID-19 vaccines should be reported to the MHRA through the Yellow Card Scheme. The College looks to JCVI to review the evidence and data and provide advice on risk.
What about other routine childhood vaccinations?
JCVI has stressed the importance of ensuring that other routine immunisations for children and young people are maintained given the benefits they offer. National immunisation programmes are proven to be highly effective at preventing disease, reducing serious and sometimes life-threatening diseases such as meningitis and measles.
As we note in our position statement on vaccinations, paediatricians and child health professionals can support national vaccination programmes through their work by making every contact count. Some groups are at greater risk of low vaccine uptake, including children in large families, children in lone parent families, looked after children, children in mobile families including the travelling community, children in some ethnic minority groups, children with chronic conditions or disability. Children’s immunisation status should form part of any assessment. If vaccines are not up to date, the reason should be established. Parents may have delayed or refused vaccines for a variety of reasons and parents should be offered the opportunity to discuss their concerns.
Latest updates to this page
- Update in this version (1 June 2023) to add expected dates for commencement of vaccination offer in Scotland and Wales for babies and children aged 6 months to 4 years in clinical risk groups
- Update in version (6 April 2023) to reflect JCVI advice offering COVID-19 vaccination to babies and children aged 6 months to 4 years
- Update in version (20 February 2023) to reflect statement from the Welsh Government on the cessation of the universal primary and booster COVID-19 vaccinations.
- Update in version (3rd February 2023) to reflect the JCVI interim statement on the COVID-19 vaccination programme for 2023.