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The Green Book on vaccination was recently updated, recommending COVID-19 vaccination prior to planned immunosuppression. We welcome this update but know implementation will be a challenge for many departments.


The Green Book advises that these patients should be considered for vaccination prior to starting therapy, ideally at least two weeks before, when their immune system will be better able to make a response. The second dose of vaccination should be offered at the recommended minimum (i.e. three to four weeks after the first dose). Any decision to defer immunosuppressive therapy or delay vaccination until after therapy should be made with consideration to the risks of COVID-19 and those of the patient’s underlying condition.


Members have raised concerns that this may be difficult if some vaccination centres and hubs are reluctant to stray from the current tiered roll-out of vaccination. It's important we press to ensure these patients are offered vaccination as set out in the Green Book.


Ensuring that these patients are a priority group is important for this current round of vaccination, and for the future, if boosters or new vaccines for SARS-CoV-2 variants resistant to the current vaccines are needed.


We offer our support to departments experiencing difficulties, so please reach out to us, and we'll do what we can to help facilitate implementation of this guidance.