The JCVI says this third dose should be offered to people over 12 who were severely immunosuppressed at the time of their first or second dose.

Importantly, the JCVI advises they should be offered mRNA vaccines (either Moderna or Pfizer-BioNTech) for their third dose, no matter which vaccine was given as their first and second. For 12-17 year olds the only UK approved vaccine is Pfizer-BioNTech, so severely immunosuppressed individuals in this age group will be offered a third Pfizer dose. Research evidence has shown that people who are severely immunocompromised develop a better, stronger response to the mRNA vaccines.

Who does this affect?

The JCVI has provided a list of the groups of people who they advise should receive the third vaccine dose. This comprises people on immunosuppressive therapies, specifically including kidney transplant patients who have received immunosuppressive therapy in the past six months, regardless of when the transplant occurred. Therefore this will also include people whose kidney transplant may no longer work and who may be back on dialysis, provided they were on immunosuppressants in the past six months.

The immunosuppressive therapies listed include treatments used for lupus affecting the kidneys, vasculitis and some causes of nephrotic syndrome. The JCVI also specifies the timeframe these treatments must have been given in relation to vaccination for patients to be eligible for a third dose. So the good news is that many of these patients will now be eligible for this third dose scheme.

How will people be able to obtain their third dose?

The JVCI has requested that specialists provide clear advice to GPs regarding:

• each patient’s need for a third dose
• finding the optimal time in their treatment cycle to generate the best response.

What’s next?

Whilst this is reassuring for kidney transplant patients, we await further advice for those on dialysis or with advanced kidney disease who remain highly vulnerable and are currently at risk of being left behind in the vaccine programme.

The vaccine efficacy research study we are funding together with our charity partners (the National Kidney Federation, Kidney Wales, the PKD Charity and several Kidney Patient Associations) will monitor the impact of third doses for at-risk kidney patients. Further research is being carried out through the OCTAVE DUO study to establish the immune efficacy of third doses in a wider group of patients, including people on dialysis. Using the evidence from both of these studies we will continue our efforts to highlight the specific needs of the kidney community to ensure the best outcomes for patients and their families.