Coronavirus (COVID-19): Scotland's autumn/winter vaccination strategy 2021

Strategy outlining our progress on COVID-19 vaccinations and plans for COVID-19 and seasonal influenza (flu) vaccinations in autumn and winter 2021 to 2022 in Scotland.

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5. Third primary doses of the COVID-19 vaccine for those who are severely immunosuppressed

Emerging data suggests that some individuals with severely suppressed immune systems will not mount a full immune response to COVID-19 vaccination, and therefore may be less protected than the wider population. People with severe immunosuppression are more likely to be severely ill if they catch COVID-19.

On 1 September 2021, the JCVI advised that individuals aged 12 and over who were severely immunosuppressed at the time of their first or second dose should be offered a third primary dose of the vaccine, as it may increase their protection. This offer is separate to any potential booster programme. A third primary dose is an extra 'top-up' dose for those who may not have generated a full immune response to the first two doses. The JCVI will review whether those identified as severely immunosuppressed require a further booster at a later date, following completion of their 3-dose primary course.

Those with lower levels of immunosuppression, alongside most individuals whose immunosuppression commenced at least two weeks after the second dose of vaccination, do not require a third primary dose at this stage. Initial letters will be issued inviting individuals to a scheduled appointment at community based clinics from week beginning 27 September 2021, with work ongoing with specialist clinicians to identify and invite other severely immunosuppressed patients in due course.

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