Scotland's autumn and winter vaccination strategy: progress report and accelerated delivery plans - December 2021

5. Our acceleration plans in response to the Omicron variant – December 2021

The First Minister set out as part of a statement to Parliament on Tuesday 14 December 2021 our aim to ensure everyone over 18 in Scotland is able to book a booster appointment by 31 December 2021. This includes a commitment to reach as close as possible to 80% uptake of booster and third dose vaccinations by those eligible by 31 December, with the balance of appointments taking place in January 2022.

Latest progress on the vaccination programme is published by PHS on their COVID-19 Daily Dashboard and from 23 December, this will include a headline figure on % coverage of the eligible population aged 18+ who have received their COVID-19 booster or third dose. The definition of ‘eligible’ (for this measure) includes individuals aged 18+ who have completed their first and second course 12 weeks or more prior to the 31 December 2021.

There are still a number of important characteristics which remain incompletely understood in terms of the Omicron variant. Evidence is still emerging about disease severity, degree of increased transmissibility and the effect of the viral mutations on currently available COVID-19 treatments or vaccine effectiveness. However, there are some early data from the UKHSA indicating that a booster dose of currently available mRNA vaccines provides increased protection (when compared to 2 doses of mRNA or adenovirus vector vaccines) which is important as Omicron has now replaced Delta as the dominant strain circulating in Scotland.

Until more is known, we will continue to take a precautionary approach and do everything we can to minimise the risk of spreading infection from Omicron, while making sure people have the greatest possible protection against severe illness caused by the virus. We must continue to assume that older age groups, and those who are clinically at risk for other reasons, are likely to remain at higher risk from the serious effects of SARS-CoV-2 infection. This was supported by the Scottish Flu Vaccination and COVID-19 Vaccination Programme Clinical Governance Group who also advised even greater acceleration and flexibility in terms of the delivery of COVID-19 vaccines in Scotland, as is noted below in the section on ‘Creating Additional Capacity’.

Given the most recent advice from the JCVI, we are committed to providing as much protection as possible through vaccination, in an attempt to reduce the impact of the Omicron variant on the people of Scotland.

In response to the risks of COVID-19 this autumn and winter, and the emergence of the Omicron variant, we have accelerated in the following ways:

• Increased our bookable appointment capacity significantly in December 2021;
• Increased our staffing in clinics;
• Added new larger venues;
• Worked with the Ministry of Defence to extend and double the military support vaccinators;
• Deployed more drop in activity for those eligible for boosters;
• Brought forward the opening of the online vaccination booking portal and helpline for 30-39 year olds from Monday 13 December 2021, and from Wednesday 15 December 2021 for 18-29 year olds;
• Sending blue envelope letter reminders to everyone in these cohorts who have not yet been vaccinated on the same basis as we did for both 50-59 and the 40-49 year olds. This has been accompanied by follow up texts or emails to those for whom we have appropriate contact details, with a link to online portal;
• We also continue to monitor vaccination uptake and capacity closely across cohorts and to advance appointments and vaccination if and where there is capacity to do so.

We have accepted the recent JCVI advice to include pregnant woman in the “at risk” group. This does not require a revision of the updated booster delivery programme, as all those aged 18 and above can already now book a booster appointment. Our key priority, however, for this group remains to increase coverage of the primary course in pregnant women. To do this we will work with the midwifery community and other professionals to coordinate our response to reduce inequalities in vaccine uptake in pregnant woman.

We will continue to review the clinical evidence on Omicron as it emerges and adapt our delivery model as required and advised, alongside the consideration of other public health measures.