Your questions answered
Last updated: February 2024
Since the summer of 2023, the UK's COVID-19 programme has changed.
Studies suggest that most of the population now have some degree of immunity – either from previous vaccination or from previous infection, or both. It was therefore decided that the future vaccination programme:
- will focus on those who are at greater risk of severe illness if they catch COVID-19
- will take the form of seasonal campaigns – in much the same way as flu vaccinations.
The groups to be targeted may vary from one campaign to the next, based on the recommendations of the Joint Committee on Vaccination and Immunisation (JCVI). These arrangements will apply unless there is a significant surge in COVID-19 cases or a new variant emerges that means a different approach is needed.
For most people, COVID-19 vaccinations will only be available during the seasonal campaigns. However, if you are newly diagnosed with a condition or start a new treatment that puts you into a clinical risk group, then your healthcare team may offer vaccination outside of the seasonal campaigns. This may be either:
- primary doses if you have not previously been vaccinated, or
- a booster dose if you have previously been vaccinated and it's at least 3 months since your last dose.
Spring 2024 vaccination programme
The JCVI has recommended that doses of COVID-19 vaccine should be offered to the following groups during Spring 2024:
- residents of care homes for older adults
- all adults aged 75 and over
- anyone aged over 6 months who is considered to be in a clinical risk group.
Booster doses should normally be given around 6 months after your previous dose of COVID-19 vaccine. There is some flexibility in this, but there should at least 3 months between doses.
How do you book your COVID-19 vaccination?
In England, you can access the online national booking system to make an appointment or call 119 free of charge. Or you can use the NHS search tool to find a pharmacy offering walk-in vaccination services.
In Scotland, you can use the online portal to book or call the National Helpline on 0800 030 8013. If you live in the Western Isles, Orkney or Shetland you will not need to use the online portal as you should receive an appointment through the post.
In Wales, if you are eligible you should receive an appointment invitation from your local health board.
In Northern Ireland, you should check your GP surgery's or community pharmacist's vaccination arrangements.
Which vaccines are being used for the Spring 2024 campaign?
Most people will be given vaccines made by Pfizer or Moderna. You can find out more about these vaccines by following the links below:
You will not be able to choose which vaccine you have, but a very small number of people may be offered a different vaccine from those listed above.
Why is it important for me to have the vaccine?
There are some types of arthritis which are caused by the body’s immune system, which usually protects us from infection. When the immune system is affected by arthritis or drugs to treat the condition, the risk from COVID-19 is increased.
People who catch COVID-19 can become very unwell. Many people will need hospital treatment even if they don’t have a health condition.
Vaccines are a good way for people with rheumatology conditions to stay safe. Vaccines teach the immune system to recognise infections, stopping people becoming unwell.
When vaccines for COVID-19 first became available, the Joint Committee on Vaccination and Immunisation (JCVI) issued guidance on priority groups to receive the vaccines.
The JCVI continues to advise the four governments of the UK on who should receive the vaccines, including booster doses, and when.
Read the NHS open letter to people with a weakened immune system (PDF, 771 KB) which explains why it's important to have the COVID-19 vaccination and to keep up to date with your booster doses.
Who will receive a third dose of the vaccine?
People who had severely suppressed immune systems at the time of their first and second doses of the vaccine may be offered a third dose. It's recommended that this is given at least eight weeks after the second dose.
This is not a booster dose, but an additional ‘top-up’ dose to increase protection from COVID-19 for people who may not have not had a good response from the first two doses.
Based on the guidance put out by the JCVI, the British Society of Rheumatology (BSR) has recommended that most people who were taking the following treatments during the time of their first two doses should be offered a third dose of the vaccine:
- Conventional DMARDs, such as methotrexate, azathioprine, mycophenolate mofetil.
- Anti-TNF biologics, such as infliximab, adalimumab, etanercept, golimumab, certolizumab pegol.
- Other biologics, such as rituximab, tocilizumab, abatacept, ustekinumab, secukinumab, belimumab.
- JAK inhibitors, such as baricitinib, tofacitinib, upadacitinib, filgotinib.
- Prednisolone (steroid tablets) at doses of at least 10mg per day.
Not all people who have or are currently taking these treatments need to receive a third dose. Your doctor should be able to tell you whether you should receive a third dose based on your medical history.
If you have not been invited to receive a third dose, but you think you should have been, you should contact your GP or rheumatology team.
If the medications you take have changed over time or if you get your prescriptions from different doctors, it might be harder for doctors to correctly identify you as eligible for a third dose. It may be helpful to confirm your status as a severely immunosuppressed person with your GP in order to arrange getting a third COVID-19 vaccine.
What is the difference between a third dose and a booster dose of the vaccine?
Third primary doses of the COVID-19 vaccine may be offered to people who have a severely suppressed immune system, either because of a health condition or treatment.
This is because research has found that people in this group are less likely to have received a good level of protection from their first two doses of the vaccine. A third primary dose is aimed at increasing their initial levels of protection.
Seasonal booster doses are offered from time to time after completion of a primary course of vaccinations. This is because the effectiveness of the vaccines in preventing COVID-19 infection has been shown to tail off after a time.
Could my medication or condition mean I can’t have the COVID-19 vaccine?
People with some types of arthritis take medicines to suppress the immune system. In general people on these treatments need to avoid live vaccines. You can find out more about live vaccines and how they can affect people taking drugs to suppress the immune system on our vaccinations webpage.
All of the COVID-19 vaccines available in the UK are safe for people with arthritis and people taking drugs that suppress the immune system, even if your condition is active.
Is one vaccine more suitable than another for people who are on drugs that suppress the immune system?
There is no good evidence that one vaccine is more suitable than another for people who are on drugs that suppress the immune system, and you will not be able to choose which vaccine you have.
Some people are only offered certain vaccines. For example, there are specific guidelines on which vaccines can be offered if you are under 18 or if you are pregnant.
Very rarely, if you have previously had a severe allergic reaction to a particular vaccine you may be offered an alternative vaccine or may be referred to a specialist clinic.
Clinical trials have shown that mixing vaccine types is safe and does not lower the level of protection from COVID-19.
Should I delay or stop my treatment, and will my treatment affect how the vaccine works?
People with severely suppressed immune systems generally get a much lower level of protection after just one dose of the vaccine, so it is especially important to get all recommended doses of the vaccine.
The OCTAVE study is exploring the effectiveness of the vaccine after two doses in people with autoimmune conditions. Read more about the OCTAVE study and its initial results.
The VROOM study, published in June 2022, showed that stopping methotrexate for two weeks after a COVID-19 vaccination doubled people’s antibody response for at least three months without causing major flare-ups of arthritis. While pausing methotrexate after vaccination may be a good idea for many people, we don’t recommend pausing any of your treatments without checking first with your healthcare team.
If you haven’t yet started treatment with medicines that suppress the immune system, or if you’re about to have a repeat course of treatment to suppress the immune system, it might be a good idea to delay this for a period after you have had a dose of the vaccine. But you should only think about doing this if your rheumatology team say that it is safe to delay your treatment.
Can I have the vaccine if I am taking steroids?
It’s fine for you to have the vaccine while you’re taking steroids. There’s no reason to delay the vaccine if you’re taking steroids, or have recently had a steroid injection or finished a course of steroid treatment.
Taking steroids as tablets, liquids, injections or drips might mean that your immune system doesn’t respond as well to the vaccine as someone who isn’t taking these drugs. This means that you may be advised to follow advice on shielding and social distancing guidance after you have had it and if you may need a third dose of the vaccine as part of your initial course. Steroid creams or eye drops should not affect your immune system or response to the vaccine.
Your healthcare team might want to discuss delaying a dose of steroids or a steroid injection with you, especially if there is a high risk of getting COVID-19. It’s important that you don’t stop taking your steroid medication without speaking to a healthcare professional, as this can leave you at risk of having a flare-up, which can increase your risk of COVID-19.
Do children need to have the vaccine?
It’s known that most children and young people are at a very low risk of severe illness from COVID-19.
However, during 2021 and 2022, primary vaccination was offered initially to children and young people in higher risk groups or who shared living accommodation with people in higher risk groups. This was gradually extended to all children and young people aged 5 to 17 years. And in early 2023 children aged 6 months to 4 years in clinical risk groups became eligible for primary vaccination.
Currently, children and young people are not eligible for booster doses unless they are in higher risk groups themselves or they live with or care for people who are in higher risk groups.
Can I have the vaccine if I am pregnant?
Clinical evidence so far does not suggest that COVID-19 vaccinations are harmful while pregnant or breastfeeding.
Based on the evidence we have so far, catching COVID-19 while pregnant appears to carry a higher risk than having the vaccine. For this reason, the JCVI advises that pregnancy should be included in the eligibility criteria for seasonal booster doses.
Your doctor or midwife should be able to advise and discuss the possible risks and benefits with you if you're concerned.
Can I have the vaccine if I am waiting for surgery?
Guidelines recommend people do not have major surgery and vaccines within one week of each other. This is because both surgery and the vaccine can cause a fever.
Are there any side effects?
The person giving you the vaccine will be able to let you know about any side effects that you can expect, and these may differ depending on which of the vaccines you have. It’s common to have some pain at the injection site following a vaccination.
As well as pain at the site of the injection, you may other side effects that include feeling tired, achy, feverish or sick, or have a headache. If you do have side effects, they usually come on shortly after the vaccination and are not linked with more serious or lasting illness.
If you have any adverse reactions to the vaccine, it’s important to tell a healthcare professional so they can report it to the Yellow Card Scheme. Anyone is free to use the scheme to report adverse reactions, but it’s still important to tell a healthcare professional if this happens to you.
How long will the vaccine take to work?
All of the available vaccines are thought to offer short-term protection from around 10–14 days after the first dose. A second dose offers longer-term protection from COVID-19.
A third primary dose of the vaccine may be recommended for people who have severely suppressed immune systems as they may have a weaker response to the first two doses.
The effectiveness of vaccines does start to tail off after a time, so seasonal booster doses are offered in order to extend protection from COVID-19.
Do you still need the vaccine if you have had COVID-19?
It’s possible for people who have already had COVID-19 to have the vaccine for it. It’s not known yet how long the antibodies made by your body in response to COVID-19 last, so a vaccine could offer more protection or boost any antibodies your body has already made.