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  1. The Explainer
6 January 2022

Will the UK offer everyone a fourth Covid vaccine?

The JCVI chair says a fourth dose is “not affordable, sustainable or probably even needed”.

By Freddie Hayward

Last month the UK government accelerated the vaccine booster programme as the Omicron variant hit and Covid infection rates soared. So far, 60.1 per cent of people in the UK have received their third dose, and already there is talk about a fourth vaccine.

On New Year’s Eve, Israel – which in 2021 led the world’s fastest vaccine roll-out – began administering a fourth dose of Covid vaccinations to the over-60s, health workers and immunocompromised patients. Meanwhile, Germany’s health minister has said a fourth jab will be necessary to combat the Omicron variant. 

But will the UK offer fourth vaccinations?

The UK government has already accepted advice that severely immunosuppressed people should be given a fourth vaccination three months after their booster. But, for the moment, the government has not said it will start administering fourth doses for everyone else and is focused on encouraging people to get their third dose. The Joint Committee on Vaccination and Immunisation (JCVI), which advises the government on vaccine policy, is expected to announce its recommendations on fourth doses shortly.   

The chair of the JCVI Andrew Pollard has spoken out against fourth vaccines for the general population. “It really is not affordable, sustainable or probably even needed to vaccinate everyone on the planet every four to six months,” Pollard told the BBC

“We may well need to have boosters for the vulnerable in the population but I think it’s highly unlikely that we’ll have programmes going forwards regularly of boosting everyone over the age of 12,” he added.

Pollard suggested older and more vulnerable people were most likely to need extra doses of the vaccine. Additional doses are particularly important for patients with a suppressed immune system who do not produce the typical number of antibodies in response to the vaccine. In the US there have been reports of people taking four or five vaccines, without approval, in an attempt to trigger an immune response. The Israeli Prime Minister Naftali Bennett, citing preliminary findings from an Israeli study, said on Tuesday 4 January that a fourth vaccine dose increases the number of antibodies produced after a week by five times.

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While fourth doses may be appropriate for the most vulnerable, a widespread fourth vaccination programme could use up resources required to vaccinate the global population. The G20 broke its promise to vaccinate 40 per cent of people in each African country in 2021, with only around 9 per cent of people in Africa vaccinated so far. It’s a problem the World Health Organisation recognises: it has said people worldwide should be offered their first dose before others receive boosters. 

There is also the ever-present risk of future variants jeopardising the vaccination programme. While the government may not have committed to fourth doses yet, a future variant may change the course of action.

[see also: How unvaccinated people are far more likely to be hospitalised by Covid-19]

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