Some 700,000 people in England will get a free Covid-19 vaccine this week as the country’s spring booster campaign kicks off.

Starting Monday, the elderly and those with weakened immune systems will be able to get a shot free of charge to reduce the impact of the disease.

Some 48,400 shots have already been delivered to adults in residential care homes, officials say, with vaccine teams having visited around 3,400 facilities by Thursday April 18.

Vaccines significantly reduce the chances of hospitalization and death from Covid-19. This is especially important for those most at risk of complications.

Follow-up doses help maintain existing protection against the disease, which can wane over time.

Steve Russell, who directs vaccines and immunizations at the country’s public health system, the National Health Service, said last years’ data showed “those who received the spring jab were up to 50% less likely to be admitted to hospital for three to four months afterwards.”

Officials invited eligible members of the public to book their shots last week. These individuals will also be invited to book by phone, letter or email.

Private vaccines are now also available in the U.K. for the first time ever.

Who is eligible and why?

Scientists on the U.K.’ country’s Joint Committee on Vaccines and Immunisation advise health leaders on vaccine eligibility. They compare evidence on a shot’s benefits and risks with the dangers of the disease it targets to come up with their recommendations.

In February, JCVI scientists advised giving boosters to those aged 75 or older, those living in older peoples’ care homes and those aged six months or older who are immunosupressed.

This includes people whose immune systems are weakened because of treatments like chemotherapy and radiotherapy, certain immunosupressive medications or organ transplantation. It also includes those who have particular health conditions that impact the immune system, including multiple myeloma, HIV infection, and certain genetic disorders.

A full list of relevant immunosupressive conditions can be found on page 24 of the UK’s “Green Book” on Covid-19.

Professor Wei Shen Lim, chair of Covid-19 immunization on the JCVI, said at the time that the “spring programme will continue to focus on those at greatest risk of getting seriously ill, who will benefit the most from a further vaccine dose.

“It is important that everyone who is eligible takes up the offer this spring,” he said in a statement. “Current vaccines provide good protection against severe disease, hospitalization and can protect those most vulnerable from death.”

Mary Ramsay, who directs public health programmes at the UK Health Security Agency (UKHSA), said that “ongoing surveillance” shows Covid-19 is still causing “severe illness, particularly in older age groups and those who are immunosuppressed.”

But data “clearly” show that booster campaigns in spring and fall “are effective in helping to protect those most at risk — halving the likelihood of hospitalization from the virus,” she added.

Healthcare system under strain

Minimizing the impact of Covid-19 on England’s public health system remains important as hospitals struggle to keep up with demand for services.

The country has been experiencing a crisis in emergency care for at least two years, with a lack of available hospital beds leading to lengthy waits for admission, overcrowding in emergency departments and ambulance delays.

There are many factors behind the crisis, including a lack of social care capacity for people who are medically fit to leave hospital, but who need extra support in the community to be discharged safely.

It’s likely that long waits for elective procedures, exacerbated by a pandemic which saw vast swathes of cancelled operations, have left people sicker than they would have been if they’d been seen quicker.

An ageing population and widening levels of inequality have also contributed to increased demand for services.

The true impact of Covid-19 on the country is still being unpicked by researchers. Last month, statisticians revealed the disease is thought to be a major factor in a reduction in the U.K.’s healthy life expectancy.

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