FAQs on Covid-19 vaccines for children

10 mins read

Here you’ll find answers to your questions about the Joint Committee on Vaccination and Immunisation (JCVI) and government guidance issued on 19 July 2021 and further updates since.

JCVI advice applies to England and Wales. The Scotland and Northern Ireland governments have confirmed they will follow JCVI advice too.

Read the latest NHS information on the Covid-19 vaccine.

In this article

Questions about the guidance

What is the JCVI currently saying?

Children aged 12 to 15 in clinical risk groups are eligible for a Pfizer vaccine. The JCVI also recommends that children and young people aged 12 to 17 who live with an immunosuppressed person (adult or child) should be offered the vaccine.

Read the latest JCVI update in full.

What is the government doing in response to the JCVI advice?

All UK governments are following the JCVI guidance and have issued further guidance on how they will offer eligible children a Pfizer vaccine.

The government has updated its guidance (called the Green Book). See page 17 for the relevant section: COVID-19: the green book, chapter 14a – GOV.UK (www.gov.uk)

The Patient Group Protocol has been updated which means GPs and local vaccination centres can now  administer the Pfizer vaccine to children. 

Does the JCVI guidance apply to Wales, Scotland and Northern Ireland too?

JCVI advice applies to England and Wales, and the Scotland and Northern Ireland governments have confirmed they will follow JCVI’s advice too.

Questions about eligibility

Which children can get the Pfizer vaccine now?

No. The JCVI has only recommended that children aged 12 to 15 in clinical risk groups should be offered the vaccine. The Green Book used by health professionals and immunisation practitioners provides more detail (see page 17).

The JCVI also recommends that children and young people aged 12 to 17 who live with an immunosuppressed person (adult or child) should be offered the vaccine.

The JCVI is not recommending routine vaccination outside of these age or risk groups.

So this does leave some gaps in eligibility for disabled children, and under-12s still can’t access the vaccine.

The clinical risk groups are:

Chronic respiratory disease

Including those with poorly controlled asthma that requires continuous or repeated use of systemic steroids or with previous exacerbations requiring hospital admission, cystic fibrosis, ciliary dyskinesias and bronchopulmonary dysplasia.

Chronic heart conditions

Haemodynamically significant congenital and acquired heart disease, or milder heart disease with other co-morbidity.

Chronic conditions of the kidney, liver or digestive system

Including those associated with congenital malformations of the organs, metabolic disorders and neoplasms, and conditions such severe gastro-oesophageal reflux that may predispose to respiratory infection.

Chronic neurological disease

This includes those with:

  • neuro-disability and/or neuromuscular disease including cerebral palsy, autism, epilepsy and muscular dystrophy
  • hereditary and degenerative disease of the nervous system or muscles. or other conditions associated with hypoventilation
  • severe or profound and multiple learning disabilities (PMLD), Down’s syndrome, those on the learning disability register, neoplasm of the brain

Endocrine disorders

Including diabetes mellitus, Addison’s and hypopituitary syndrome.

Immunosuppression

Immunosuppression due to disease or treatment, including:

  • those undergoing chemotherapy or radiotherapy, solid organ transplant recipients, bone marrow or stem cell transplant recipients
  • genetic disorders affecting the immune system (for example deficiencies of IRAK-4 or NEMO, complement disorder, SCID)
  • those with haematological malignancy, including leukaemia and lymphoma
  • those receiving immunosuppressive or immunomodulating biological therapy
  • those treated with or likely to be treated with high or moderate dose corticosteroids
  • those receiving any dose of non-biological oral immune modulating drugs, for example methotrexate, azathioprine, 6-mercaptopurine or mycophenolate
  • those with auto-immune diseases who may require long term immunosuppressive treatments

Asplenia or dysfunction of the spleen

Including hereditary spherocytosis, homozygous sickle cell disease and thalassemia major.

Serious genetic abnormalities that affect a number of systems

Including mitochondrial disease and chromosomal abnormalities.

Are they using the same definition of clinically extremely vulnerable for children who were asked to shield?

No, but there may be some crossover with this list.

I’m not sure if my child falls into those categories.

Your child’s doctor, paediatrician or neurologist will play a part in interpreting Green Book (Chapter 14a) guidance.

What happens if I want the vaccine for my child but they don’t fall into those categories?

Speak to your GP or clinician about this. They will be able to clarify the categories and whether or not your child falls into them. They can also use their clinical judgement to interpret the Green Book guidance.

If child’s doctor thinks your child would benefit from a Covid vaccine but they fall outside the categories in the Green Book, they can still arrange for your child to be vaccinated ‘off label’. The doctor will need to sign a Specific Patient Direction. The direction enables the doctor to take responsibility for prescribing the vaccine even if another clinician administers it to your child.

Further advice on the getting a vaccine of-label: Steps you can take to secure a Covid vaccine for your child

Further information about prescribing off-label: Off-label vaccines – an introductory guide for healthcare professionals (publishing.service.gov.uk)

Off-label or unlicensed use of medicines: prescribers’ responsibilities – GOV.UK (www.gov.uk)

How did the JCVI decide which children are eligible? 

The JCVI looked at a range of evidence, particularly from the United States and Israel. They will be keeping decisions under constant review based on new data from the UK and abroad, especially in the context of the Delta variant. 

Here are some of the studies used by the JCVI to decide which children are eligible for a vaccine: 

My child is under 12. Can they get a vaccine?

No. The Pfizer-BioNTech vaccine has been authorised for children aged 12 or older in the UK. This followed a US clinical trial of around 1,000 children aged 12 to 15 that found side effects in this group were generally short-lived and mild to moderate.

Until more safety data is available and has been evaluated, children under 12 will not be offered the vaccine.

Can 16 and 17 year olds get a vaccine?

All young people aged 16-17 are now being offered a first dose of the Pfizer vaccine.

The NHS will contact you when it’s your turn to get the vaccine. You’ll be invited to a local NHS service such as a GP surgery.

What about children living in household with a clinically vulnerable person?

The JCVI advice is that children aged 12-17 that live in same household as an immunosuppressed person (adult or child) should have the Pfizer vaccine.

The government agrees, but we are unsure how these children will be identified and offered the vaccine. You should speak to their GP until we know more.


Questions about getting the vaccine

How and when will my child get offered a vaccine?

Vulnerable children aged 12-15 eligible for a Covid vaccine should have received an invitation for their first appointment by Monday 23 August.

GPs and vaccination centres have been told to prioritise eligible children. Guidance reported in the GP press makes it clear that GPs who signed up to deliver the Covid vaccines for earlier phases of the vaccine roll-out can now vaccinate eligible children. If you haven’t heard anything by now, you should contact your GP or clinician and ask them to arrange a vaccine for your child – what you can do if you haven’t received an invite.

This latest letter from the National Director for the COVID Vaccine Programme at NHS England to all GPs sets out how children should be offered the vaccine.

All eligible children should have received their first Covid vaccination before the start of the new school year.

Some Primary Care Network groups have opted out of vaccinating children, but they are still responsible for identifying eligible children and passing this information on to commissioners to arrange appointments.

In some areas, like Hammersmith and Fulham, public health doctors have worked with special schools, short breaks teams, parent forums and the local authority to set up special vaccination centres for eligible children and young people, taking into account any reasonable adjustments they may need.

Children in contact with hospital services may also receive ‘opportunist’ vaccination in a specialist
settings where children and their parents/carers can discuss their individual needs, as long as hospital have completed their readiness check before vaccinating.

This letter sets out draft plans in Scotland COVID-19 vaccination programme: JCVI advice for vaccination of children and young people aged 12 to 17 years (scot.nhs.uk)

Read the latest NHS FAQ document on vaccinating children against COVID.

Should I contact my child’s GP/clinician now?

Eligible children should have received a vaccine invitation from the NHS by 23 August. However, the NHS has acknowledged that local searches of GP records may not identify all eligible children. If you are worried your child will be missed, or you are unsure if they are eligible, contact your GP to ask.

If you haven’t heard anything by now, you should definitely contact your GP or clinician.

No child aged 12-15 year olds can book an appointment via the NHS. Appointments will need to be made via a local booking system.

We understand that further delays will be frustrating and worrying for families. Please be assured that we will continue to press government for further information.

Will I have to prove my child needs a vaccine?

No. We understand that the NHS will identify eligible children from data available on their health records, and health and social care services are encouraged to proactively flag eligible children in their database

How do I get my son or daughter on the learning disability register in England?

Anyone with a learning disability can be added to the register even if they do not have a formal diagnosis.  If it is unclear whether your son or daughter has a learning disability, the GP can assess them using this simple Learning Disability Register Inclusion Tool.

Our Annual Health Check factsheet has information on GP learning disability registers and annual health checks, why they are important and how you can support your child or young person to access the services they are entitled to.

Will accessible vaccine centres be available for my child?

NHS England has issued guidance to clinicians on making reasonable adjustments when giving Covid vaccination to people with learning disabilities. 

There are also vaccine clinics for people with learning disabilities, led by learning disability nurses. 

What should I do if my GP/clinicians refuses my child a vaccine?

Please email una.summerson@contact.org.uk.  We will collect issues and raise them with government officials.

You can also get in touch with our helpline on 0808 808 35555 or by emailing helpline@contact.org.uk.