Keeping up to date: Things to know in practice currently:

• 28th August: Ooooh look what's been updated! COVID-19: the green book chapter.

• 16th July: Departmental minute on the COVID-19 autumn 2025 vaccination programme AND 26/27 advice is here! Vaccination will be offered in England in autumn 2025 to adults aged 75 years and over, residents in a care home for older adults, individuals aged 6 months and over who are immunosuppressed, as defined in tables 3 and 4 of the COVID-19 Green Book chapter. The same groups look likely for autumn 2026 and spring 2027 too. The vaccines that will be supplied for the autumn 2025 programme are the Pfizer-BioNTech mRNA (Comirnaty) vaccines, dose-dependent on age.

I like this line from the June JCVI minutes: "Internationally, similarly low levels of COVID-19 activity had been seen across the winter. It was suggested that the stability of the recent epidemiology might reflect the slowing in viral evolution of SARS-CoV-2". Phew! COVID-19 seems to be losing momentum! (a bit like me towards the end of the school holidays). Another important thing mentioned in those minutes was that the two most recent vaccination campaigns had taken place after significant peaks in hospitalisations, as such indicating a possible misalignment of timing of vaccination with peaks in disease. HEADS UP: It was proposed that year-round vaccination, with individuals receiving a dose of COVID-19 vaccine twice a year, every six months, might be an alternative model for vaccine delivery. Benefits of a year-round delivery model were highlighted as;

• Regular supply of vaccine which could change as a new product, such as an updated variant vaccine, became available

• More outreach work could be undertaken to improve uptake in population groups with lower vaccine coverage throughout the year

• Less disruption on routine healthcare services

• The potential to vary or extend the interval between vaccination, depending on vaccine effectiveness estimates and cost-effectiveness analysis.

• A year-round delivery model might facilitate more frequent vaccination for immunosuppressed individuals.

Well they are some good arguments, but they are undecided as of yet.

• 7th July 2025: New Covid strain spreads across UK with unique symptom. The XFG and XFG.3 variants currently account for around 30 percent of Covid-19 cases in England. Feeling hoarse? Could it be stratus?...

• 4th June: Cumulative uptake for the spring 2025 vaccination campaign, as of the 4th June 2025, was 55% in adults 75 years of age and over, and 23% in individuals under 75 years (including individuals who were immunosuppressed). Most campaigns plateaued in uptake between eight and twelve weeks after beginning.

• 6th Feb 2025: Updated resources: Safety of COVID-19 vaccines when given in pregnancy - Guidance for health professionals to share with pregnant women immunised with COVID-19 vaccines.

• 8th October 2024: Vaccine update landed! In there it highlighted that last year’s data shows that those who received a COVID-19 vaccine were around 45% less likely to be admitted to hospital with COVID-19, compared to those who did not receive one. But protection wanes 3 to 6 months following vaccination. That is why for those who are most vulnerable, we must keep going with those booster doses for the most vulnerable groups.

Other useful links and further reading:

Reminders:

Current COVID-19 mRNA vaccines available in the UK:

Comirnaty LP.8.1 This is the Pfizer–BioNTech paediatric variant vaccine:

• 10 µg dose for children aged 5–11 years

• 3 µg dose for infants aged 6 months to 4 years

Comirnaty KP.2 A monovalent vaccine adapted to the KP.2 ("FLiRT") subvariant:

• 30 µg in pre‑filled syringe (and multidose vial) for individuals aged 12 and over

Comirnaty JN.1. A vaccine targeting the JN.1 subvariant, available in several age formulations:

• 30 µg for adults and children 12+

• 10 µg for children 5–11 years

• 3 µg for infants 6 months – 4 years

Spikevax JN.1 Moderna's adapted mRNA vaccine targeting JN.1 subvariant:

• Approved for adults and children aged 6 months and over

• Primary course no longer routinely offered except in high-risk groups or unvaccinated

• Booster campaigns run autumn and spring (depending on age/risk)

• Administered IM, usually deltoid

• May be co-administered with flu vaccine

• Store at 2–8°C after thawing (check SPC—shelf life varies by product)

• Administer under PSD or PGD or National Protocol

Want to geek out? Go deeper here:

• 15th May 2025: If you want to learn more about the pipeline for COVID-19 vaccines and hear a REALLY GOOD explanation of all the different platforms and how to handle explaining this to the public then THIS IS THE (recording of a) WEBINAR FOR YOU! I really enjoyed it.

  7th May 2025: I was wondering what the latest was on the combined flu and COVID vaccine, and then Fray very kindly sent me this: Moderna's combo Covid and flu mRNA shot outperforms current vaccines in large trial

• 5th Feb 2025: Nasal COVID-19 vaccine to enter US clinical trials. The new trial will evaluate the safety and efficacy of the vaccine administered via two routes: inhaled into the lungs and sprayed into the nose. I absolutely love seeing developments in vaccine administration technology.

• Check out this intriguing headline: Administering the BCG vaccine during the active phase of COVID-19 may help protect against the development of long COVID.

• SIREN study: The SIREN study has been investigating SARS-CoV-2 infections and acute respiratory illness in healthcare workers since 2020, and providing vital research into the immune response to infection and vaccination.

What Is COVID-19 Anyway?

COVID-19 is caused by the SARS-CoV-2 virus, a novel coronavirus first identified in 2019. It rapidly led to a global pandemic, causing widespread illness, disruption, and over 6 million deaths worldwide (WHO, 2024). While milder in many people today, COVID-19 still poses a significant risk to certain populations—particularly the elderly and immunocompromised.

What Happens If You Catch It?

• COVID-19 affects people very differently. Symptoms can range from mild cold-like illness to life-threatening pneumonia, sepsis, and long COVID:

• Common symptoms: cough, fever, fatigue, loss of taste or smell, headache, sore throat

• Severe illness: difficulty breathing, chest pain, confusion, low oxygen levels

• Long COVID: fatigue, brain fog, breathlessness, and other symptoms persisting for months

• As of mid-2025, most severe cases occur in unvaccinated individuals or those with reduced immune response.

How Does It Spread?

Primarily via respiratory droplets and aerosols—talking, coughing, sneezing, and even just breathing in close quarters. Also spreads via contaminated hands and surfaces, especially in indoor or poorly ventilated environments.

Does Getting It Make You Immune?

Infection does provide some immunity, but this wanes over time, and new variants can bypass earlier protection. Vaccination boosts both infection and severe disease protection, especially against newer variants.

Can It Be Treated?

Yes—for higher-risk cases. Options include:

• Antivirals: e.g. nirmatrelvir/ritonavir (Paxlovid®), remdesivir

• Monoclonal antibodies: limited use as resistance patterns change

• Supportive care: oxygen, fluids, anticoagulants, ICU if needed

• Treatment is most effective when started early after symptom onset.

Who’s Most at Risk?

• Adults aged 65+

• People with chronic conditions (diabetes, heart disease, respiratory disease)

• Immunocompromised individuals

Bits and bobs to casually drop into conversation

Did you know....

About 40% of people with COVID-19 have moderate symptoms and non-severe pneumonia, 15% have significant disease including severe pneumonia, and 5% experience critical disease with life-threatening complications.

So far, no-one has been able to identify the animal which led to human infection with the 2019 coronavirus -but there are reports that SARS-CoV-2 is most similar to that of bat coronaviruses.

The European Centre for Disease Control estimates that 1 in 1000 people die prematurely when infected with influenza. For COVID-19 the current estimates suggest that 10 in 1000 infected people will die from the disease in high-income countries. Handy statistic to know for those who say "I'll have my Flu jab but not that COVID-19 one".