No 35/36 - 2022

Vaccination against COVID-19, influenza and pneumococcal disease

As part of the vaccination measures introduced this autumn, it is possible to receive COVID-19 and influenza vaccination as these measures aim to protect persons at an increased risk of running a serious disease course. Vaccines updated for the relevant variants are used for COVID-19 booster vaccination. Target group persons will receive an invitation for vaccination.

Persons who fall within the target group for pneumococcal disease vaccination or booster vaccination will also be invited for vaccination. Thus, citizens will be receiving invitations for one or more vaccinations this autumn. Several vaccinations may be given concurrently, either in the regional vaccination centres, general practice or via drop in or no-transport vaccination services (provided in the patient’s home or in a local, temporary vaccination site).

The vaccination offer comprises different vaccines for different target groups, see Table 1.

Table 1. Overview of the vaccination scheme, by target groups and vaccine types

*) The full details about the target groups will be provided in the Danish Health Authority’s guideline

Ordering and distribution of the vaccines

This year, the five Danish regions hold overall responsibility for establishing and handling the vaccination offers and a considerable share of the vaccination services will be provided in regional vaccination centres. However, the regions may make agreements with general practice and other private providers to ensure that vaccination is available near the target group citizens and to supplement the vaccination services provided by the regional vaccination centres. General practice and the other private stakeholders need to order vaccines for use in the public vaccination scheme via the regions. The vaccines may not be ordered via the SSI for use in the free vaccination scheme. The general practitioners are responsible for providing advice to and answering questions that their patients may have about the vaccinations.

Invitation for vaccination

Persons who form part of a free vaccination target group based on their age will be allocated vaccination according to their civil registration number (CPR); and in the course of September 2022, they will receive an invitation for one or more vaccinations either in the Danish public communication systems e-Boks/mit.dk or by surface mail. Initially, citizens aged 85 years or more and nursing home residents will receive their invitations. This group may receive COVID-19 vaccination as from 15 September 2022. Subsequently, influenza vaccinations will be available to this group as from 1 October 2022. Vaccination against pneumococcal disease may be administered concurrently as from 15 September 2022. The remaining age groups will receive one or more invitations in the course of September 2022 and may receive the vaccinations if they form part of the target group as from 1 October 2022.

As the centrally organised selection of people for the target groups is based on age, persons below 50 years (COVID-19), below 65 years (influenza and pneumococcal disease) and persons not comprised by the 2-6-year interval (influenza) will not automatically be invited for vaccination. Rather, persons who form part of the target groups will be informed through targeted campaigns promoted through healthcare employees, employers, patient and user associations, etc. Persons who fall within a target group may access their vaccination(s) by signing a sworn statement, e.g., when self-referring via vacciner.dk or directly at the vaccination site.

Vaccination scheduling

Vaccination at a vaccination centre may be booked at www.vacciner.dk (in Danish). Once logged in, you will see the vaccinations offered to you and may then book a time slot for vaccination using a calendar system. If you are exempted from use of digital systems, you may book vaccination by calling the region in which you reside. The phone number appears in the invitation letter sent out by surface mail. Furthermore, it is possible to be vaccinated in general practice, by dropping in at a vaccination centre or by making use of a no-transport vaccination service. Get an overview of vaccination sites at the website of the Danish Health Authority. Nursing home residents will be vaccinated at their residence by the no-transport vaccination services. Read more about the vaccination offers in Organisation of National Seasonal Vaccination Schemes 2022-2023 (Danish language version: Organisering af nationale sæsonvaccinationsprogrammer 2022-2023).

Which vaccines are offered for COVID-19 booster vaccination?

The COVID-19 vaccines offered are updated to fit relevant variants and contain the original variant and Omicron variant BA.1 The European Medicines Agency (EMA) has recommended to the EU Commission variant-updated boosters from Moderna, Spikevax bivalent Original/Omicron BA.1, and Pfizer-BioNTech, Comirnaty Original/Omicron BA.1. The two vaccines were authorised by the Commission on 2 September 2022 and will, on that basis, be used in the COVID-19 measures this autumn; for more information about the authorisation, please see here.

How are the vaccines administered?

The vaccines may be given concurrently, and you may administer several vaccination shots to the same shoulder muscle (the deltoid muscle) at a minimum distance of 2 cm. Please note that COVID-19 booster vaccine (the variant-updated boosters) is used in persons who have previously received primary vaccination (two doses) and that the minimum interval from the previous COVID-19 vaccine or COVID-19 booster vaccine is three months. Generally, citizens will be invited for vaccination with a COVID-19 vaccine from the manufacturer who produced the previously administered vaccine, but booster vaccination may also be given with a vaccine-updated booster from another vaccine manufacturer. Primary vaccination will still be possible for persons aged 18 years and above with the originally authorised mRNA vaccines.

Persons offered vaccination against pneumococcal disease should not have received this vaccine (Pneumovax^®) in the past six years, unless an individual medical assessment has been made recommending booster vaccination within this time interval.

Children who have not previously received influenza vaccination are given two doses at a minimum four-week interval, whereas children who have received one or more influenza vaccines previously, regardless or vaccine type, are given only one dose in this season.

Additional information about the vaccination schemes

The Danish Health Authority has prepared the Medical Basis and Framework for the COVID-19 Vaccination Scheme in the Autummn/winter 2022/23. Subsequently, the Danish Health Authority will publish updated guidelines specifying which persons below 50 years of age are recommended COVID-19 booster vaccination. The guideline will be available at www.sst.dk/da/corona/vaccination (in Danish). Other groups who are recommended influenza and pneumococcal disease vaccination are listed in Executive Order on Free Vaccination Against Influenza, Pneumococcal Disease and COVID-10 for Selected Groups of Persons, which will be published by Retsinformation.dk (in Danish) before the vaccination scheme becomes effective.

Statens Serum Institut has prepared information material for the new, variant-updated COVID-19 vaccines, which includes information about the use, reconstitution (when needed), withdrawal, injection and storage. The information material is available here (in Danish). When published, the guideline of the Danish Health Authority will also provide this information about vaccination against COVID-19, influenza and pneumococcal disease vaccination.

Citizen-targeted information about this autumn's vaccination offers is available from the website of the Danish Health Authority (in Danish).

Additional information about the influenza vaccines of this season will be published in EPI-NEWS no. 39.

Information about vaccination against pneumococcal disease, risk groups and recommendations is available at the website of the SSI  (in Danish).

(S.B. Asmussen, B. Søborg, L. Vestergaard, F. Kristensen Lomholt, Department of Infectious Disease Epidemiology and Prevention)

7 September 2022