The primary course of the Covid-19 vaccine doses creates the immune response. For most people, two doses is enough to create an immune response but, for people who are immunosuppressed, a third primary dose is needed.  

Third primary doses are given as a full dose of either the Pfizer vaccine or Moderna vaccine from eight weeks after the second dose. AstraZeneca can be used as an option for patients who received it previously where this would facilitate delivery.

A booster dose is given to prolong the protection already created by the primary course. Booster doses are given as either a full dose of Pfizer or a half dose of Moderna from three months after the second dose. 

Booster doses are available to everyone aged 16+ from three months after their second dose. 

GP practices should text all patients aged 16+ to invite them to book a booster dose two months after they received their second dose. All walk-in vaccination sites in NCL are also offering booster doses. 

All sites in NCL have been asked to allow health and social care workers, those who are vulnerable, and those receiving a first or second dose to bypass the main queue.

The eligibility criteria for a third primary dose are set out in Appendices A B and C of the Clinical Framework for assessing patients presenting for additional doses due to immunosuppression (see Useful Resources).

Individuals can self-identify as potentially eligible for a third primary dose on the basis of severe immunosuppression by booking an appointment on the National Booking System or by attending a walk-in centre.

Usually, these individuals would present a letter from their GP or hospital consultant stating their eligibility for receipt of the third dose. In the absence of this letter, these individuals will require an assessment of their clinical eligibility.

A third primary dose should be administered eight weeks after their second dose.

NCL trusts have written to eligible patients in their care, copying their GP, to confirm that the individual is eligible for a third dose and to specify the optimal timing. GPs should follow up with these patients to invite them to book their third primary dose in line with the consultant’s advice. Patients aged 18+ who have a letter from a GP or hospital consultant confirming their eligibility for a third dose can also go to a walk-in vaccination site.

GP teams should also identify their eligible patients. If you have eligible patients who have not received a third dose recommendation letter from their consultant, please contact the consultant to check that they have not been overlooked.