RCN position on changes to the COVID-19 vaccination programme

RCN members have raised concerns regarding the changes in the COVID-19 vaccination schedule following the announcement of the authorisation of the second vaccine for use in the UK from AstraZeneca.

In the context of the serious public health emergency, the details of a vaccine programme will inevitably change in response to the evolving epidemiology of the disease and scientific evidence. 

As a general principle, the RCN support the decisions of the Joint Committee on Vaccination and Immunisation (JCVI) as the independent expert group responsible for advising the UK vaccination and immunisation programme.

The decisions must be taken by independent experts and on the basis of all the available evidence and such decisions must be taken without pressure from government or other pressure groups. There must be detailed responses when concerns are raised and other solutions proposed. 

The WHO acknowledges the recommended dosing interval but have also advised that countries have to make decisions according to their own epidemiological situations. 

The Green Book sets out the policy for all immunisation and vaccination policy across the UK and this is the guidance to which staff should work to. It has been updated to reflect the COVID-19 vaccine programme delivery process and the rationale for it. Any members following the guidance in the Green Book – even if it is at odds with manufacturer recommendations – will be practising within the NMC Code. 

Members can be reassured that a change to the plan for the vaccine recipient does not invalidate the earlier consent. Consent for administration of any vaccine is required before each dose. 

It is essential that people receive their second dose to provide longer term protection and there must be robust recall and follow up plans in place to ensure every second dose is administered. 

The announcement of the AstraZeneca vaccine authorisation and changes to the scheduling mean that more of the priority groups can be vaccinated as soon as possible, which is welcomed by the RCN.

The advice in the Green Book on health and social care staff is that this should include all front-line staff including agency, support staff and students. This is applicable across all health and care settings. We are aware of local variations on the implementation of this policy and would support local and regional officers in promoting the JCVI guidance.

The disease trajectory is changing for the worse and our members, patients and health and care services must be protected. The RCN is monitoring the situation and updating guidance daily.