The guidance confirms a priority list published in September has remained unchanged, and recommends patients should be vaccinated in the following order:
- Residents in a care home for older adults and their carers
- All those 80 years of age and over; frontline health and social care workers
- All those 75 years of age and over
- All those 70 years of age and over; clinically extremely vulnerable individuals
- All those 65 years of age and over
- All individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
- All those 60 years of age and over
- All those 55 years of age and over
- All those 50 years of age and over
The JCVI guidance comes as the government confirmed that the Pfizer/BioNTech vaccine has been approved by the MHRA - making the UK the first western country to approve a coronavirus vaccine - and the committee says this version of the vaccine should be 'used in the first phase of the programme, according to the priority order' set out.
The Welsh government has said that due to practical constraints around the Pfizer/BioNTech vaccine - which must be stored at -70oC and is delivered in 975-dose packs containing 195 five-dose vials that must be diluted before use, it 'cannot deliver this vaccine to care homes'.
This suggests that in parts of the UK the highest-risk patients will have to wait for the rollout of the Oxford/Astra Zeneca vaccine, also expected to become available this year.
However, although JCVI chair Professor Wei Shen Lim confirmed at a briefing that there would be some 'flexibility in terms of operational constraints', he made clear: 'The JCVI's advice is that every effort should be made to supply vaccine and offer vaccines to care home residents.'
The government has said it expects 800,000 doses of vaccine to become available next week, with as many as 10m potentially available by the end of 2020. Patients require two doses of the vaccine administered between 21 and 28 days apart to achieve full protection.
The committee's updated advice confirms that pregnant women will not be offered the vaccine because of the lack of safety data for this group, and that only the highest-risk children aged under 16 should be considered for vaccination.
The guidance explains that despite evidence of increased risk in black, asian and minority ethnic (BAME) groups, people in these groups have not been prioritised for vaccination because there is 'no strong evidence that ethnicity by itself (or genetics) is the sole explanation for observed differences in rates of severe illness and deaths'.
The committee said evidence showed that 'certain health conditions are associated with increased risk of serious disease, and these health conditions are often overrepresented in certain BAME groups' adding that 'prioritisation of persons with underlying health conditions [as part of clinically extremely vulnerable groups] will also provide for greater vaccination of BAME communities who are disproportionately affected by such health conditions'.
The guidance comes as the RCGP today wrote to health and social care secretary Matt Hancock calling for a clear explanation for the rationale behind the decision not to prioritise BAME groups.
The JCVI has said that as further data become available on the safety and effectiveness of vaccines approved for use in the UK, rollout of vaccines could be considered for lower-risk groups.
It said: 'The committee is currently of the view that the key focus for the second phase of vaccination could be on further preventing hospitalisation. Vaccination of those at increased risk of exposure to SARS-CoV-2 due to their occupation could also be a priority in the next phase.
'This could include first responders, the military, those involved in the justice system, teachers, transport workers, and public servants essential to the pandemic response. Priority occupations for vaccination are considered an issue of policy, rather than for JCVI to advise on.'