DO I REALLY NEED THE AUTUMN COVID BOOSTER?
Covid is still officially a pandemic, but many experts would now describe it as endemic (something that's constantly present in the population).
People are testing positive for the virus, but thousands more are likely to have it as many people don't have symptoms.
While cases are much lower than at their peak, they are expected to rise in the coming months as we spend more time indoors. (The virus is mainly spread in close proximity, in tiny droplets when we speak.)
In Northern Ireland, two-thirds of the population (65.4 per cent) aged 12-plus have had three doses of Covid vaccine (the two-part initial course, plus a booster), according to the NI Covid-19 Vaccinations Dashboard.
Just under 85 per cent elected to have only the first two doses.
"For many, Covid is now a relatively mild respiratory disease," says Andrew Preston, a professor of microbial pathogenesis at the University of Bath.
"That's largely due to most of us being able to mount a robust immune response to the virus, having now been vaccinated, infected or both.
"Protection against SARS-CoV-2 [which causes Covid] is associated with high levels of antibodies. These levels are greatly boosted by vaccination, but they drop over time, meaning we can become susceptible to infection once the levels drop."
BUT I'VE ALREADY HAD THE OTHER THREE JABS?
Professor Preston says: "As many people have experienced, three jabs haven't prevented infection with one of the Omicron strains, but they have kept it to a generally tolerable mild infection.
"The problem is that we don't know how long that protection will last, particularly if new variants arise.
"Vaccines stimulate greater magnitude immune responses than even natural infection, so provide greater levels of protection. Boosters reduce your chances of suffering from any type of disease, at least for a while.
"And the more people who are protected, the less Covid will circulate. The theory is that this reduces the risk of new strains developing.
"Boosters are also important for those who've never tested positive for Covid. Given the levels of infection over the past year, if you've never had Covid, then it's very likely down to the protection you've got from vaccination."
But others have questioned the benefits of the booster campaign. Last month, Pascal Soriot, chief executive of AstraZeneca, said boosting healthy people again was not "good use of money" as vaccines protect healthy people for a "long time". (AstraZeneca's jab will not be used in the campaign.)
Will Irving, a professor of virology at Nottingham University, said: "Many people have now had three doses of vaccine, as well as two or three bouts of real infection, and you would imagine that would provide them with enough immune memory to protect them for a while.
"The issue is we don't know how long the immune memory lasts, so a top-up dose is a good idea for those advised to have one."
SO AM I ELIGIBLE FOR THE NEW JAB?
The Northern Ireland winter vaccination campaign, which began this week, will see flu and Covid-19 vaccines offered to over 1 million people within eligible groups over coming months.
They are: adults aged 50 and over; those aged five to 49 with underlying health problems such as auto-immune conditions that put them at risk; those aged 16 to 49 who are carers or who live with someone who is immuno-suppressed; pregnant women; care home residents; care home workers; social care workers and frontline health workers.
Healthy children and adults under the age of 50 "continue to have good protection from their first two vaccinations and their first booster jab,"' says the UK Health Security Agency (UKHSA).
WHICH VACCINES ARE BEING USED FOR THE BOOSTER?
The jabs will be one of the mRNA vaccines: the new bivalent version of the Moderna (Spikevax) and Pfizer jabs, which protect against two strains of Covid, the Delta variant and Omicron; the original single-strain Moderna jab (Spikevax); and the Pfizer vaccine (Comirnaty).
The Novavax (Nuvaxovid) jab, which works differently, will be offered to those for whom the mRNA vaccine is unsuitable.
"These mRNA vaccines are a new type of vaccine which deliver the genetic code for the SARS-CoV-2 spike protein directly into our cells," explains Professor Preston. The spike protein binds the virus to our cells to start infection.
"The natural protein-making machinery in the cell interprets this [spike protein] code, produces the spike protein and presents it to our immune cells to stimulate the immune response, which will help your body fight off Covid if you come into contact with the virus."
In very rare circumstances, such as a severe allergy, none of the approved mRNA vaccines will be suitable, says the UKHSA. In these circumstances, the Nuvaxovid vaccine should be offered. For some, such as many immunosuppressed people, vaccination is not possible at all.
Last month, the government decided not to buy Evusheld, a potentially life-saving treatment for the 500,000 high-risk patients who are not able to have a vaccine because they have weakened immune systems.
Evusheld, which costs £1,500 per person a year, is taken as a preventative treatment. Data from Israel shows immunocompromised people who get it are half as likely to become infected with Covid and 92 per cent less likely to be hospitalised and/or die.
WHY AREN'T WE GETTING THE ASTRAZENECA VACCINE?
"The concern over the very rare clotting disorders observed with the AstraZeneca jab led to the decision to use the Moderna/Pfizer RNA vaccines for boosters," Professor Preston says.
The UKHSA points to evidence from a trial of seven different vaccines given as a third dose by University Hospital Southampton NHS Foundation Trust, which found mRNA vaccines were "the most effective".
HOW GOOD IS THE NEW VACCINE?
Vaccines are very effective at preventing people from dying or becoming seriously ill with Covid; a booster of the Pfizer or Moderna mRNA vaccines is still more than 85 per cent effective at preventing death three months after being administered, and around 60 per cent effective at preventing hospitalisation.
However, this wanes and by six months, protection against symptomatic infection drops to zero. How long booster protection lasts is as yet unclear.
Last month, Dame Kate Bingham, the architect of Britain's successful vaccination campaign, accused civil servants of "taking their foot off the gas" in finding new jabs.
She said the current jabs are "not good enough" because they "don't block transmission, they don't protect for very long".
She is concerned that the government drive to find new vaccines has fallen away.
Scientists are working on new Covid vaccines, the ultimate goal being a universal version that protects against all variants.
DOES IT MATTER WHICH VACCINES I'VE HAD BEFORE?
No, says Professor Irving: "There have been a number of studies that show using combinations of the different vaccines approved in the UK poses no additional safety concerns, and in fact produces a better response than using the same version of the vaccine, because different vaccines present slightly different antigens [molecules capable of stimulating an immune response] to the immune system."
ARE THERE SIDE-EFFECTS TO THE BOOSTER?
These are the same as with previous Covid jabs: a sore arm and flu-like symptoms. Headache, chills, fatigue, nausea, fever, dizziness, weakness, aching muscles and a rapid heartbeat are the most commonly reported side-effects.
"This is your immune response to the vaccination kicking in," says Professor Preston.
IF ONLY THE MRNA TYPE OF VACCINE IS BEING USED, IS THERE ENOUGH TO GO ROUND?
The UKHSA insists there will be enough doses of the booster vaccines for everyone who is eligible.
CAN I GET A BOOSTER VACCINE PRIVATELY?
The simple answer is no, it's only available on the NHS.
HOW QUICKLY WILL THE BOOSTER WORK?
"Boosters start to work very quickly," says Professor Preston.
"Antibody levels will start to rise within a few days, at most."
WHAT'S THE BEST TIME TO HAVE THE JAB?
"In the autumn, just before Covid might be expected to rise more sharply, is a good idea to give you the best protection," says Professor Irving. The plan is to have rolled out the vaccine to all those eligible over three months.
"Waiting until Covid cases start to increase to have your booster is risky, as cases can rise very steeply," adds Professor Preston.
"The recommendation is to receive it once you are offered it."
WILL THE AUTUMN BOOSTER PROTECT AGAINST NEW STRAINS?
"Very likely, yes," says Professor Preston. "That's because many aspects of the virus remain the same even when the strain changes."
However, he adds that we may well need boosters every year, depending on new variants.
SHOULD I STILL HAVE THE FLU JAB?
Yes. The flu jab will not protect you from Covid, and the Covid booster will not protect you from flu. Everyone eligible for a Covid booster this autumn is also eligible for a flu jab - and the jabs can be given at the same time.
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