Suspension of the 15-minute wait for vaccination with mRNA vaccine for COVID-19: UK CMOs’ opinion

The Chief Medical Officers (CMOs) of the UK and lead Deputy Chief Medical Officers (DCMOs) for vaccines have considered whether, in the light of the very considerable need to speed up vaccination and boosting in response to Omicron variant, the 15-minute wait for some mRNA COVID-19 vaccines should be suspended.

Their view, having considered the views of the COVID-19 Vaccine Benefit-Risk Expert Working Group (EWG), NHS planners and others is that with the low rates of anaphylaxis, in the context of the considerable need for people to be boosted or vaccinated, the 15-minute wait after a vaccination with mRNA vaccine will cause more harm than it can avert because it will significantly reduce the number of people who can be vaccinated over a short period of time. The 15-minute wait should therefore be suspended for first, second and homologous or heterologous boost vaccinations with mRNA vaccine given the current situation, with this operationalised in line with the needs in each of the 4 nations.

The long-term decisions on the 15-minute wait, when the current need for extreme speed of vaccination and boosting is over, should rest with the Commission on Human Medicines (CHM), the Medicines and Healthcare products Regulatory Agency (MHRA) and the Joint Committee on Vaccination and Immunisation (JCVI). If Ministers agree then this should be a temporary measure on the grounds of public health need to protect as many citizens as possible over a short period of time. How the 15-minute suspension is operationally implemented should be determined by each nation.

The CMOs recognise that this will lead to a marginal increase in risk for a very small number of people, but substantially fewer than would be harmed by a slower vaccine rollout in the current public health emergency leading to some citizens not getting boosted or vaccinated prior to exposure to Omicron. This includes a consideration that any prior vaccination and particularly boosting is likely to lessen the likelihood of severe disease arising from Omicron variant infection.

Those with a history of allergic reactions should be managed in line with Green Book advice and everyone who is vaccinated should be given verbal and written advice on allergic reactions including what actions to take if they become unwell.

The background to this decision is laid out below.

We will copy this to the Chair of CHM and JCVI for information.