Guidance

COVID-19: the green book, chapter 14a

Coronavirus (COVID-19) vaccination information for public health professionals.

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COVID-19: the green book, chapter 14a

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Details

This chapter includes information on:

  • the COVID-19 vaccines
  • the dosage and schedule for the UK
  • recommendations for the use of the vaccine
Published 27 November 2020
Last updated 21 February 2024 + show all updates
  1. Updated to correct minor typing errors in HIPRA section; additional clarification in dosing advice for under 5 year olds, repeating advice on second doses.

  2. Error in 2024 advice corrected.

  3. Updated to include eligibility for Spring 2024 campaign, including choice of vaccine type; vaccines being marketed outside of the NHS and more flexibility on schedules for individuals with immunosuppression.

  4. Updated to include recent information on circulating variants and vaccines. Simplified advice for individuals with severe immunosuppression to align with the changes in primary doses.

  5. Updated mention of a table.

  6. Updated to include JCVI advice on vaccination for children aged 6 months to 4 years in a clinical risk group.

  7. Updated storage information for VidPrevtyn.

  8. Updated to include shortened background, separation between the historical pandemic response and the ongoing programme, spring booster campaign, explanation of the end of universal primary and booster offers, and describing the move to only offer vaccine during seasonal campaigns.

  9. Updated to include approval of Pfizer bivalent vaccine and further clarification around vaccination of under 12 year olds.

  10. Updated to include information on the autumn programme and variant vaccines, and further clarification of information on revaccination and capillary leak syndrome.

  11. Updated to include: approval of Novavax, clarification around deferral after COVID-19 infection, one-off programme for 5 to 11 year olds who are not in clinical risk groups, advice on use of the paediatric formulation in those aged 12 years, spring booster recommendations (including flexibility around timing) and expectations for an autumn booster, clarification of the management of individuals with a history of allergic reactions, updated advice on management of people who have ITP following vaccination.

  12. Updated background to include latest data on vaccine effectiveness and booster safety; clarified and corrected chronology of booster advice. Clarified clinical advice about vaccination of 5 to 11 year olds at high risk: interchangeability of adult, fractional and paediatric doses; management of 5 to 11s who are about to become immunosuppressed; advice on third primary doses for severe immunosuppression, including updated definitions for severe immunosuppression for younger children.

  13. Updated to include JCVI advice on boosters for 16 and 17 and at risk 12 to 15 year olds, and primary immunisation for 5 to 11 year olds. Information on the paediatric product and advice about fractional doses. Updated risk for pregnancy and added reference to guidance on monitoring patients with a history of immune thrombocytopenia.

  14. Updates on 15 minute wait after mRNA vaccines and advice on heterologous primary courses.

  15. Updated to include more background on variants and clinical trials in younger children, advice on offering boosters to 18 to 39 year olds, advice on boosters for severely immunosuppressed after a third dose, advice on second doses of vaccine for children aged 12 to 15 years and potential flexibility around schedules in under 18s in a changing epidemiological situation.

  16. Updated to include second doses for 16 to 17 year olds and booster doses for 40 to 49 year olds; further clarification on booster timing flexibility; guidance on deferral after COVID-19 infection in under 18s and other minor edits for clarification.

  17. Updated to improve consistency of wording in the allergy and immunosuppressed sections; updated definitions of clinically vulnerable, advice on further doses for those who have suspected myocarditis or Guillain-Barré Syndrome after vaccination, clarifying flexibility around the booster timing and supply, additional evidence on booster dose effectiveness and on vaccination after monoclonal antibody products.

  18. Updated to include new recommendations on boosters and children and young people. Minor updates to guidance on managing allergies and giving additional doses after rare side effects. Clarification of clinical risk groups for children and adults and the use of the clinically extremely vulnerable definition.

  19. Updated to include third dose primary vaccination for severely immunosuppressed patients and revised risk groups for children, PEG allergy advice, background information and regulatory information.

  20. Updated to include vaccinating at-risk children section, information and references on vaccines and evidence on vaccine effectiveness, cautions on rare conditions reported after vaccination, advice on schedules and emerging evidence on protection of immunosuppressed people.

  21. Updated with clarification around the schedule following the emergence of Delta variant, advice on cautions and contraindications, and co-administration advice. More evidence also added on vaccine effectiveness and mixed schedules.

  22. Updated to include additional information on the eligibility and safety of the AstraZeneca vaccine.

  23. Updated to incorporate recommendations for phase 2 of the programme and additional information on the safety of the AstraZeneca vaccine.

  24. Replaced with previous version.

  25. Updated to incorporate recommendations for phase 2 of the programme and additional information on the safety of the AstraZeneca vaccine.

  26. Updated to include information on the Moderna mRNa vaccine, further changes to the advice on managing allergic history and allergies after dose 1 and updated information and clarification of advice on pregnancy.

  27. Updated clarification around allergies.

  28. Updated to include changes to the advice on timing of vaccine in those being given immunosuppressive treatments and further detail on history of previous allergies.

  29. Added revised green book chapter 14a - additional information to reflect the MHRA approval of the Astra-Zeneca vaccine and to reflect updated advice on pregnancy and allergies for the Pfizer BioNTech vaccine, and the updated statement from the JCVI on scheduling.

  30. Added revised green book chapter 14a.

  31. Added revised green book chapter 14a.

  32. First published.