Order of priority for COVID-19 vaccine booster dose
The Public Health Agency of Sweden recommends offering booster doses of the COVID-19 vaccine to the groups whose protection has started to decline.
The approved COVID-19 vaccines protect against serious illness. The Public Health Agency carefully monitors the effect of the vaccines and recommends that booster doses are given to the groups whose protection has started to decline.
A person’s age has shown to be a key factor when determining how long the vaccine will protect them against serious illness. The older a person is, the faster their protection will decline.
Therefore, the Public Health Agency recommends that the oldest age groups receive their booster doses first. Like many other illnesses, COVID-19 is more common among people with lower socioeconomic status. Special consideration should therefore be given to these groups when conducting the booster vaccination programme.
Booster dose for different target groups
The following groups will be offered booster doses, in order of priority.
People aged 80 or above who live in care comes or receive home help services
On 28 September, the Public Health Agency took the decision to recommend booster doses for the following groups, in order of priority:
- people aged 80 and above (born 1941 or earlier)
- people who live in care homes for older people
- people whose municipality has granted them home help care, and people who receive medical care in the home
People aged 65–79, care home staff, home help workers and those who provide medical care in the home
As of 1 November, booster doses are recommended for the following groups:
- people aged 65–79 (born 1956–1942)
- care home staff, home help workers and those who provide medical care in the home.
A regional vaccine uptake of 80 per cent should have been achieved in the 65–79 age group before the next group (medically at-risk groups) and 50–64 year olds are offered a booster dose.
People with illnesses or medical conditions that create an increased risk of becoming seriously ill with COVID-19
- People aged 18 and above who receive support in accordance with the Support and Service for Person with Certain Functional Impairments Act (1993:387) (LSS).
- People aged 18 and above who have been granted assistance allowance as per the Social Insurance Code (2010:110) (15:22).
- People aged 18–64 who are medically at-risk due to:
- chronic cardiovascular disease, including stroke and high blood pressure (hypertension)
- chronic lung disease such as COPD, and brittle asthma
- other conditions that impair lung function or the ability to cough and clear mucus (for example, extreme obesity, neuromuscular disorders or multiple disabilities)
- chronic liver and kidney failure
- diabetes types 1 and 2
- conditions that severely weaken the immune system as a result of illness or treatment
- Down’s syndrome
- those who are pregnant with pregnancy-related risk factors such as being older than 35, high blood pressure (hypertension), diabetes, a BMI over 30 or other factor following individual assessment.
People aged 50–64
Regional vaccine uptake of at least 60 per cent in the 50–64 age group should be achieved before the next group (18–49 year olds) are offered their booster dose.
People aged 18–49
The oldest people should be vaccinated first. Socioeconomic status should also be taken into account.
Healthcare and social care staff
Healthcare and social care staff, including care home staff, can be offered their booster dose sooner if they risk spreading the virus to people who could become seriously ill with COVID-19. However, the region must first assess whether this is possible without the risk of preventing other groups from receiving booster doses. Each region will arrange vaccination of these staff groups.
Regions must monitor vaccine uptake
The regions are responsible for establishing vaccine uptake targets for each group, and following up on them. They will also decide when the next group can receive their booster dose, once good vaccine uptake has been achieved among the previous group. As previously, this work may differ across the country based on the population’s age distribution and other factors.
1177.se contains information about the groups currently being offered the booster dose in each region.
The recommended booster dose
An mRNA vaccine is recommended for the booster; one dose of Pfizer’s Comirnaty or half a dose of Moderna’s Spikevax. The booster dose is to be given to people aged 65 or above no earlier than five months after their first two initial doses.
People younger than 65 should receive their booster dose no earlier than six months after their first two initial doses.
The Comirnaty vaccine is recommended for those aged 30 and younger (born 1991 and later).
The seasonal flu vaccination can be given at the same time as the booster dose. However, if a person has received the high-dose flu vaccine they must wait seven days before receiving their COVID-19 vaccine booster dose.
Protection by a third and fourth dose of vaccine against COVID-19 among persons aged 65 years and older – Based on Swedish data from February to August 2022
This report presents an analysis of COVID-19 vaccine effectiveness (VE) after a fourth dose in relation to SARS-CoV-2 infection and severe outcomes due to the omicron variant among persons aged 65 years and older in Sweden.