Professor Lim, how can boosters protect others?

where is the logic or indeed the ethics of the autumn booster programme?

4th September 2023

Professor Wei Shen Lim and all members, Joint Committee of Vaccination and Immunisation

 Rt Hon Stephen Barclay MP, Secretary of State, Department of Health and Social Care

cc Dr Camilla Kingdon, President, Royal College of Paediatrics and Child Health

Dear Professor Lim and Mr Barclay,

re: JCVI advice for Covid-19 vaccination of healthy young adults if living with an immunocompromised household member

I, and many of my co-signatories, have written to you on several occasions since May 2021[i], when you were first deliberating over whether to recommend Covid-19 gene-based vaccines for healthy children, given the lack of any robust safety data on these new mRNA technologies and the acknowledged low impact of SARS-CoV-2 on children.

It is very gratifying to see that this autumn’s booster programme [ii] has now been dropped for almost all healthy under-65s. However, there is one group still being offered a booster that causes us serious concern, namely the offer of a booster to healthy over-12s if they have an immunocompromised household member. We set out our reasons below.

1.   It is clear that Covid-19 vaccines are failing to prevent infection by or transmission of SARS-CoV-2. 

2.   There is now good evidence that multiple boosters actually increase the likelihood of a SARS-CoV-2 infection [iii].

3.   There is good evidence of a specific rise in infection risk in the first 7-10 days after vaccination, thus putting family members at increased rather than reduced risk [iv],[v].

4.   The more recent omicron variants are poorly covered by the original vaccines, but even the newer bivalent boosters generate a much lower response against the non-Wuhan sequences in the vaccines, indicative of immune imprinting [vi].

5.   The potential benefit of vaccination now for healthy young adults is low, and for children is effectively zero, given the poor efficacy of the vaccines and the high prevalence of naturally-acquired immunity [vii].

6.   The safety profile of these vaccines is woefully inadequate for use in a healthy low-risk population, especially children, giving a poor risk : benefit balance.  The hazard of myocarditis, recognised early on as an increased risk in younger age groups [viii], has still been poorly delineated, but risks as high as 1 in 25 are reported for subclinical myocarditis in a recent study from Switzerland [ix], confirming similar findings from Thailand. Although symptoms usually resolve quickly, scarring has been demonstrated on cardiac MRI scans [x] and has been found to persist at 6-12-month follow-up [xi]. Pfizer’s own 5-year follow-up study is not due to report until 2027; likewise a large FDA-sponsored study in the US [xii].

7.   Many other adverse effects have been reported and listed in our previous letters [xiii],[xiv], perhaps the most worrying of which is the deleterious effect on the immune system [xv],[xvi]. Basic pharmacokinetics of these products are only just being reported, with a paper this week, as we write, reporting findings of vaccine-derived spike protein persisting in the circulation for many months (or longer) after vaccination [xvii],[xviii]; with serious implications for prolonged effects of any vaccine injuries. 

8.   The issue of excess all-cause deaths in younger age groups in 2022 and 2023 has yet to be properly investigated and a link to vaccines cannot be ruled out until this is done[xix].

9.   Even if there was good evidence that vaccination could protect vulnerable household contacts, there would be major ethical concerns around asking children to take a vaccine with any potential risks of harm, to protect family members. The Universal Declaration on Bioethics and Human Rights [xx] Article 4 and Article 7 make it clear that all medical interventions must be in the best interest of the individual concerned, particularly in the case of children who are not able to give consent. If a booster was in the best interests of a healthy 12-17-year-old, then surely the JCVI would be recommending it for all, but it is clear that these children are being offered the vaccine merely in a likely unsuccessful attempt to benefit other household members.

10.  Whilst it may be argued that technically these products have now been approved and are therefore no longer a research tool, these ethical principles and the precautionary principle must still apply, especially since the approval itself is still based on much less evidence than would be expected for other drugs.

Please could you urgently provide the following, under a FOI request:

  • minutes of the meetings at which these decisions were made;
  • calculations of numbers of healthy 12-17-year-olds (and of all household members aged 12-64) needed to vaccinate to prevent the hospitalisation of one vulnerable family member;
  • any legal advice taken on how these unnecessary booster doses to children comply with UK and international law.

We look forward to hearing from you as a matter of urgency before the commencement of the vaccine booster rollout to healthy 12-17-year-olds .

Yours sincerely

Dr Rosamond Jones, MD, FRCPCH, retired consultant paediatrician, convenor of CCVAC (Children’s Covid Vaccines Advisory Council) and many others….

Professor Anthony J Brookes, Professor of Genomics & Health Data Science, University of Leicester

Professor Angus Dalgleish, MD, FRCP, FRACP, FRCPath, FMedSci, Professor of Oncology, University of London; Principal, Institute for Cancer Vaccines & Immunotherapy

Professor Richard Ennos, MA, PhD. Honorary Professorial Fellow, University of Edinburgh

Professor John A Fairclough, BM BS, BMed Sci, FRCS, FFSEM(UK), Professor Emeritus, Honorary   Consultant Orthopaedic Surgeon

Professor David Livermore, BSc, PhD, retired Professor of Medical Microbiology

Professor Dennis McGonagle, PhD, FRCPI, Consultant Rheumatologist, University of Leeds

Professor Karol Sikora, MA, MBBChir, PhD, FRCR, FRCP, FFPM, Honorary Professor of Professional Practice, Buckingham University

Professor Roger Watson, FRCP Edin, FRCN, FAAN, Honorary Professor of Nursing, University of Hull

Professor Keith Willison, PhD, Professor of Chemical Biology, Imperial, London

Lord Moonie, MBChB, MRCPsych, MFCM, MSc, House of Lords, former parliamentary under-secretary of state 2001-2003, former consultant in Public Health Medicine

Dr Roland Salmon, MBBS, MRCGP, FFPH, former Director, Communicable Disease Surveillance Centre (Wales) 

Dr Najmiah K Ahmad, BM MRCA FCARCSI, Consultant AnaesthetistDr Ali Ajaz, Consultant Psychiatrist

Dr Shiraz Akram, BDS, Dental surgeon

Dr Victoria Anderson, MBChB, MRCGP, MRCPCH, DRCOG, General Practitioner 

Julie Annakin, RN, Immunisation Specialist Nurse

Wendy Armstrong, Practice Nurse

Helen Auburn, Dip ION, MBANT, NTCC, CNHC, Registered Nutritional Therapist

Dr Ancha Bala-Joof, MBChB, MRCGP, General Practitioner

Dr Michael Bazlinton, MBChB, MRCGP, DCH, General Practitioner

Dr David Bell, MBBS, PhD, FRCP(UK), Specialist in Public Health  

Dr Mark A Bell, MBChB, MRCP(UK), FRCEM, Consultant in Emergency Medicine, UK

Dr Michael D Bell, MBChB, MRCGP, retired General Practitioner

Dr Ashvy Bhardwaj, MBBS, DRCOG, MRCGP (2018)

Dr Alan Black, MBBS, MSc, DipPharmMed, Retired Pharmaceutical Physician

Dr Gillian Breese, BSc, MB ChB, DFFP, DTM&H, General Practitioner

Dr Ian Bridges, MBBS, retired General Practitioner

Dr Emma Brierly, MBBS, MRCGP, General Practitioner

Mr John Bunni, MBChB (Hons), Dip Lap Surg, FRCS [ASGBI Medal], Consultant Colorectal and General Surgeon

Dr Elizabeth Burton, MB ChB, Retired General Practitioner

Dr David Cartland, MBChB, BMedSci, General practitioner

Dr Peter Chan, BM, MRCS, MRCGP, NLP, General Practitioner, Functional Medicine Practitioner 

Dr Bernard Choi, MBBS, MRCGP, DCH, DRCOG, General Practitioner

Michael Cockayne, MSc, PGDip, SCPHNOH, BA, RN, Occupational Health Practitioner

Mr Ian F Comaish, MA, BM BCh, FRCOphth, FRANZCO, Consultant ophthalmologist

James Cook, BN, MPH, NHS Registered Nurse

Dr Clare Craig, BMBCh, FRCPath, Pathologist

Dr David Critchley, BSc, PhD, 32 years in pharmaceutical R&D as a clinical research scientist

Dr Sue de Lacy, MBBS, MRCGP, AFMCP UK, Integrative Medicine Doctor

Dr Christine Dewbury, retired General Practitioner

Mr Keith Dewbury, retired Consultant Radiologist

Dr Jayne Donegan, MBBS, DRCOG, DCH, DFFP, MRCGP, homeopathic practitioner, retired NHS GP

Dr Damien Downing, MBBS, MRSB, private physician

Dr Jonathan Eastwood, BSc, MBChB, MRCGP, General Practitioner

Dr Jonathan Engler, MBChB, LlB (hons), DipPharmMed

Dr Elizabeth Evans, MA(Cantab), MBBS, DRCOG, Director UKMFA

Dr Chris Exley, PhD FRSB, retired professor in Bioinorganic Chemistry

Dr Brian Fitzsimons, MBChB, DipOccMed, FRCGP, General Practitioner, Occupational Health Physician, Pre-Hospital Emergency Care Practitioner

Dr John Flack, BPharm, PhD. Retired Director of Safety Evaluation at Beecham Pharmaceuticals 1980-1989 and Senior Vice-president for Drug Discovery 1990-92 SmithKline Beecham  

Dr Charles Forsyth, MBBS, FFHom, Ecological and Homeopathic Physician (Retired)

Dr Sheena Fraser, MBChB, MRCGP (2003), Dip BSLM,  General Practitioner

Gayle Gerry, BSc Hons, RGN, NHS registered Nurse

Sophie Gidet, RM, Midwife

Dr Jenny Goodman, MA, MBChB, Ecological Medicine

Cheryl Grainger, BSc, Pharma Training Consultant

Dr Ali Haggett, Mental health community work, 3rd sector, former lecturer in the history of medicine 

Mr David Halpin, MBBS, FRCS, Orthopaedic and trauma surgeon, retired

Alex Hicks, MEng, MCIPS, Compliance Director (Supply Chain)

Mr Anthony Hinton, MBChB, FRCS, Consultant ENT surgeon, London

Dr Richard House, PhD, CPsychol, AFBPsS, CertCouns, Chartered Psychologist, former senior lecturer in Psychology (Roehampton) and Early Childhood (Winchester), retired psychotherapist

Dr Keith Johnson, DPhil, former patents officer

Dr Timothy Kelly, MB BCh BSc, NHS doctor

Eshani King, BSc(Hons), FCA, CTA, BFP, Evidence Based Research in Immunology and Health

Dr Tanya Klymenko, PhD, FHEA, FIBMS, Senior Lecturer in Biomedical Sciences

Dr Caroline Lapworth, MB ChB, General Practitioner

Dr Branko Latinkic, BSc, PhD, Molecular Biologist

Dr Theresa Lawrie, MBBCh, PhD, Director, Evidence-Based Medicine Consultancy Ltd

Dr Jason Lester, MRCP, FRCR, Consultant Clinical Oncologist

Dr Felicity Lillingstone, IMD DHS PhD ANP, Doctor, Urgent Care, Research Fellow 

Dr Nichola Ling, MBBS, MRCOG, Consultant obstetrician and digital advisor to NHS England

Katherine MacGilchrist, BSc (Hons) Pharmacology, MSc Epidemiology, CEO, Systematic Review Director, Epidemica Ltd

Dr C Geoffrey Maidment, MD, FRCP, retired consultant physician

Mr Ahmad K Malik, FRCS (Tr & Orth), Dip Med Sport, Consultant Trauma & Orthopaedic Surgeon

Dr Ayiesha Malik, MBChB, General Practitioner

Dr Kulvinder S. Manik MBChB, MRCGP, MA(Cantab), LLM, Gray’s Inn

Dr Fiona Martindale, MBChB, MRCGP, General Practitioner in out-of-hours

Julie Maxwell, MBBCh, MRCPCH, Associate Specialist Community Paediatrician 

Dr Fatou Mbow, MD(Italy), MRCGP, DFFP, General Practitioner

Dr Sam McBride, BSc(Hons) Medical Microbiology & Immunobiology, MBBCh BAO, MSc in Clinical Gerontology, MRCP(UK), FRCEM, FRCP(Edinburgh), NHS Emergency Medicine & geriatrics

Kaira McCallum, BSc, retired pharmacist, Director of strategy UKMFA

Mr Ian McDermott, MBBS, MS, FRCS(Tr&Orth), FFSEM(UK), Consultant Orthopaedic Surgeon

Dr Janet Menage, MA, MBChB, retired General Practitioner

Dr Franziska Meuschel, MD, ND, PhD Affiliations, IDF, BSEM, Nutritional, Environmental and Integrated Medicine

Dr Scott Mitchell, MBChB, MRCS, Associate Specialist, Emergency Medicine

Dr Alistair J Montgomery, MBChB, MRCGP, DRCOG, retired General Practitioner

Dr Alan Mordue, MBChB, FFPH, Retired Consultant in Public Health Medicine & Epidemiology

Dr David Morris, MBChB, MRCP(UK), General Practitioner  

Margaret Moss, MA(Cantab), CBiol, MRSB, Director, The Nutrition and Allergy Clinic, Cheshire

Dr Claire Mottram, BSc Hons, MBChB, Doctor in General Practice

Dr Greta Mushet, MBChB, MRCPsych, retired Consultant Psychiatrist in Psychotherapy

Dr Angela Musso, MD, MRCGP, DRCOG, FRACGP, MFPC, General Practitioner  

Dr Sarah Myhill, MBBS, Dip NM, Retired GP, Independent Naturopathic Physician

Dr Chris Newton, PhD, Biochemist

Dr Rachel Nicoll, PhD, Medical researcher

Tim Nike, Specialist Neurological Physiotherapist

Sue Parker Hall, CTA, MSc (Counselling & Supervision), MBACP, EMDR. Psychotherapist

Dr Dean Patterson, MBChB, FRCP. Consultant Cardiologist

Dr Christina Peers, MBBS, DRCOG, DFSRH, FFSRH, Menopause Specialist

Rev Dr William J U Philip MB ChB, MRCP, BD, Senior Minister The Tron Church Glasgow, formerly    physician specialising in cardiology 

Dr Angharad Powell, MBChB, BSc (hons), DFRSH, DCP (Ireland), DRCOG, DipOccMed, MRCGP, General Practitioner 

Dr Gerry Quinn, PhD, Microbiologist 

Dr Jessica Robinson, BSc(Hons), MBBS, MRCPsych, MFHom, Psychiatrist and Integrative Medicine Doctor

Dr Jon Rogers, MB ChB (Bristol), retired General Practitioner

Mr James Royle, MBChB, FRCS, MMedEd, Colorectal Surgeon 

Dr Alison Sabine, MBChB, MRCP, Consultant Rheumatologist

Dr Charlie Sayer, MBBS, FRCR, Consultant Radiologist

Sorrel Scott, Grad Dip Phys, Specialist Physiotherapist in Neurology, 30 years in NHS

Dr Rohaan Seth, BSc (Hons), MBChB (Hons), MRCGP, Retired General Practitioner

Dr Rajendra Sharma, MBBCh, BAO, LRCP&S(Ire), MFHom, Private Doctor, Medical Director, Dr Sharma Diagnostics

Natalie Stephenson, BSc (Hons) Paediatric Audiologist

Dr Noel Thomas, MA, MBChB, DObsRCOG, DTM&H, MFHom, Retired Doctor

Dr Livia Tossici-Bolt, PhD, NHS Clinical Scientist

Dr Jannah van der Pol, iBSc, MBBS, MRCGP, General Practitioner

Dr Helen Westwood, MBChB (Hons), MRCGP, DCH, DRCOG, General Practitioner

Dr Carmen Wheatley, DPhil, Orthomolecular Oncology

Dr Samuel White, MBChB, MRCGP, Functional Medicine Specialist, former General Practitioner

Dr Ruth Wilde, MBBCh, MRCEM, AFMCP, Integrative & Functional Medicine Doctor

Dr Stephanie Williams, Dermatologist

Dr AZ, MBChB, NHS Specialty doctor


[i] https://www.hartgroup.org/open-letter-to-mhra-17-05-2021/  

[ii] https://www.gov.uk/government/publications/covid-19-autumn-2023-vaccination-programme-jcvi-advice-26-may-2023/jcvi-statement-on-the-covid-19-vaccination-programme-for-autumn-2023-26-may-2023  

[iii] Shrestha NK, Burke PC, Nowacki AS et al. Effectiveness of the Coronavirus Disease 2019 Bivalent Vaccine, Open Forum Infectious Diseases 2023;10 (6):  doi.org/10.1093/ofid/ofad209 

[iv] Shrotri M, Krutikov M, Palmer T et al. Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of long-term care facilities in England (VIVALDI): a prospective cohort study. Lancet Infect Dis. 2021. doi.org/10.1016/S1473-3099(21)00289-9

[v] Bar-On YM, Goldberg Y, Micha, M et al. Protection by a Fourth Dose of BNT162b2 against Omicron in Israel, N Engl J Med 2022; 386:1712-1720. https://www.nejm.org/doi/full/10.1056/NEJMoa2201570

[vi] Fujita S, Uriu K, Pan L et al. Impact of Imprinted Immunity Induced by mRNA Vaccination in an Experimental Animal Model, The Journal of Infectious Diseases, 2023;, jiad230, https://doi.org/10.1093/infdis/jiad230

[vii]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1131409/appendix-1-of-jcvi-statement-on-2023-covid-19-vaccination-programme-8-november-2022.pdf 

[viii] Oster M, mRNA COVID-19 Vaccine-Associated Myocarditis, 2022, https://www.fda.gov/media/153514/download

[ix] Buergin N, Lopez-Ayala P, Hirsiger JR et al. Sex-specific differences in myocardial injury incidence after COVID-19 mRNA-1273 booster vaccination. European Journal of Heart Failure 2023. https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.2978

[x] Jain SS, Steele JM, Fonseca B et al. COVID-19 Vaccination–Associated Myocarditis in Adolescents. Pediatrics 2021; 148 (5): e2021053427.  doi.org/10.1542/peds.2021-053427

[xi] Yu CK, Tsao S, Ng CW et al. Cardiovascular Assessment up to One Year After COVID-19 Vaccine-Associated Myocarditis. Circulation 2023; 148(5): 436–439.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10373639/ 

[xii] https://www.nymc.edu/news-and-events/news-archives/us-fda-awards-dr-supriya-jain-19-million-to-support-research-on-covid-19-vaccine-associated-myocarditis.php

[xiii] https://www.hartgroup.org/open-letter-to-the-jcvi-pause-vaccines-for-children-pending-urgent-review/

[xiv] https://www.hartgroup.org/open-letter-to-the-jcvi-2/

[xv] Uversky VN, Redwan EM, Makis W, Rubio-Casillas A.IgG4 Antibodies Induced by mRNA Vaccines Generate Immune Tolerance to SARS-CoV-2’spike Protein by Suppressing the Immune System. Vaccines 2023; 11(5): 991.  https://doi.org/10.3390/vaccines11050991

[xvi] Noé A, Dang TD, Axelrad C et al. BNT162b2 COVID-19 vaccination in children alters cytokine responses to heterologous pathogens and Toll-like receptor agonists. Front Immunol 2023; 14:1242380. doi.org/10.3389/fimmu.2023.1242380

[xvii] Castruita JAS, Schneider UV, Mollerup S et al. SARS-CoV-2 spike mRNA vaccine sequences circulate in blood up to 28 days after COVID-19 vaccination. APMIS 2023; 131: 128-132. https://doi.org/10.1111/apm.13294

[xviii] Brogna C, Cristoni S, Marino G et al.Detection of recombinant Spike protein in the blood of individuals vaccinated against SARS-CoV-2: Possible molecular mechanisms. Proteomics Clinical Applications 2023; https://doi.org/10.1002/prca.202300048 

[xix] https://vigilantnews.com/post/excess-mortality-just-got-even-worse-ed-dowd-drops-alarming-new-data

[xx] https://www.unesco.org/en/legal-affairs/universal-declaration-bioethics-and-human-rights

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