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Information and resources on vaccination are regularly updated to reflect the most recent scientific data and evidence.

The Joint Committee on Vaccination and Immunisation (JCVI) advice for those at risk, including those with a weakened immune system, is that protection from the COVID-19 vaccines is best during the first three months after vaccination. Protection from the COVID-19 vaccines does not stop after three months, but slowly begins to fade. This is why those at risk are invited forward for their booster vaccinations during seasonal programmes. These messages are reflected in our winter vaccine resources. The “Don’t let your protection fade” public marketing campaign also focuses on the importance of revaccination.

Individuals who develop severe immunosuppression may be at high risk of COVID-19 and less able to sustain any protection from previous vaccination or exposure. These individuals can be considered for additional doses of vaccination, outside of seasonal campaigns, based on clinical judgement.

This year’s COVID-19 vaccine marketing and communication plan utilises a number of communication channels to reach those with a weakened immune system, under the “Don’t let your protection fade” campaign. The accompanying marketing toolkit includes a range of assets directed at those who are at higher risk of COVID-19. This toolkit has been shared with Health Boards and stakeholders for them to promote via their own communication channels. The national campaign has also promoted vaccination for those at clinical risk.

All those eligible for winter vaccination have been sent an invitation letter with either a scheduled appointment or instructions on how to book an appointment. Included with this is a leaflet which includes information around why those eligible are being offered a COVID-19 vaccine this winter.

Specific leaflets have been produced for the clinical at risk child and infant groups. These leaflets are designed to help parents/carers make an informed decision about getting their child vaccinated.

All programme patient leaflets can be viewed on NHS Inform.

Winter vaccines briefings for professionals working with people at higher risk are available on the Public Health Scotland website. These explain the importance of the winter vaccines and encourage healthcare professionals to speak to their patients about being vaccinated.

The Scottish Government is aware that there was a UK-wide supply issue with the availability of Antabuse® (disulfiram) tablets earlier this year. The supply disruption has now been stabilised and supplies of Antabuse® (disulfiram) tablets are returning to normal levels.

The pricing and the supply of medicines is currently reserved matter for the UK Government. We continue to engage with the Department for Health and Social Care (DHSC) and we will continue to monitor the situation.

In the event of a medicine shortage, the NHS in Scotland has robust processes in place to manage supply issues when they do arise. Normally there are alternative products which can be prescribed and dispensed.

Letters were issued to individuals at higher risk from COVID-19 in December 2021 and April 2022, notifying them of their potential eligibility for COVID-19 treatments. Registered care home providers also received letters advising them on access arrangements in January 2022 and July 2022. In addition, general information on the arrangements for direct access to COVID-19 treatments in Scotland can be found on NHS Inform .

The Scottish Government also encourages individuals to speak to their GP or specialist clinician about managing their COVID-19 risk, as they are best placed to provide advice on an individuals’ condition and potential eligibility for treatments. The final decision on whether to prescribe a COVID-19 treatment, and which treatment to prescribe, is entirely for a clinician to make.

The winter 2023 programme was always due to start on 4 September, so there was no need to bring that date forward. Our original plan was to start vaccination with those at lower risk and call those at highest risk slightly later in the programme, from mid-October. This was in line with JCVI advice, as protection is highest in the first three months following COVID-19 vaccination, so by vaccinating those who are at highest risk later, we would give them greater protection over winter and into the new year .

Although there is currently insufficient data to assess the potential severity or increase in transmissibility of new variant BA.2.86 (Pirola), in light of its emergence, along with the other nations across the UK, we took the precautionary measure to bring forward vaccination of care home residents, people aged 75 and over and people with weakened immune system aged 12 and over, where possible for Boards.

Our scheduling team has provided technical support to Boards to help them bring forward and re-order their scheduling plans. The Scottish Ambulance Service has also provided support to some Boards in vaccinating these groups. Public Health Scotland and Scottish Government have provided support in communicating these changes to the general public. The Flu & Covid-19 Vaccination team, including Scottish Government officials, has provided individual guidance and support to Boards where required.

No additional funding has been provided to Boards by Scottish Government, as we did not ask Boards to increase the numbers they are vaccinating, or to vaccinate all those eligible any quicker than the original plans. We have asked them to re-order and re-prioritise where possible, within their current planning and financial models.

In Scotland, respiratory infection levels, including those of COVID-19, and their impact are monitored using various sources of data, including microbiological sampling and laboratory test results from community and hospital settings, NHS 24 calls, primary care consultations, and hospital admissions. The intelligence generated from these different data sources provide a comprehensive picture of current respiratory illness in Scotland. In addition, COVID-19 outbreaks and general trends can be estimated by measuring concentrations of the virus in wastewater.

Surveillance of respiratory infections is a critical part of our approach to monitoring and managing the spread and prevalence of COVID-19 and other respiratory viruses. It helps us to determine the right public health strategies and timing, to manage transmission in the community. Public Health Scotland (PHS) are responsible for delivering Scotland’s National Respiratory Surveillance Plan with the support of the Scottish Government.

Our successful vaccination programme means many people previously considered at highest risk, and the wider population, are now far less likely to become seriously ill from Covid-19. However, people with a weakened immune system might not develop the same level of immunity from the vaccination as others. This means that some people with a weakened immune system may still be at higher risk from COVID-19, although many do get some protection from the vaccine. These people should continue to follow the advice of their GP or specialist clinician, who best know their health condition and circumstances. This may include accessing to antiviral treatment where required. The advice across respiratory diseases remains to get your booster when we invite you for vaccination and if you feel unwell with a respiratory infection to try to stay at home.

The MAT Implementation Support Team (MIST) was established to work with and support local areas to build improvement-based capacity and capability so that they would be able to implement and sustain the MAT standards locally.

MIST support is provided through networking and regular support visits with a range of stakeholders including ADPs and local Health Boards to facilitate improvement work such as the sharing of good practice. Ministers have commissioned Healthcare Improvement Scotland (HIS) to run a national learning system for implementing the standards which is mainly aimed at providing support to ADPs and Health Boards by sharing best practice.

So, MIST and HIS work together on this to support local areas. The HIS learning system includes networking and webinars as well as providing insights and materials such as case studies, resources and news stories which are shared across ADPs and Health Boards.

Local areas report regularly to Ministers on progress towards implementation of the MAT standards. Public Health Scotland publishes progress in an annual National Benchmarking Report each June based on the work of MIST, and in the second annual Report published in June this year included good practice case studies provided through the HIS learning system.

MIST are also holding thematic groups for each of the standards to bring stakeholders together, and there is a planned in person work shop for MAT Standard 3 – Assertive Outreach taking place in the Autumn.