Future Covid-19 vaccination programmes may only offer the jab to those at highest risk of severe disease, a former Government adviser has said.

A future programme could fall in line with the current flu jab scheme and only see those at highest risk offered a vaccine, Professor David Salisbury said.

The former director of immunisation at the Department of Health also said that people shouldn’t expert a vaccine “menu” and should accept whichever Covid-19 jab they are offered.

The Chatham House Covid-19 briefing heard that it was difficult to predict when social distancing might end and that people will “have to come to terms with some social distancing” for the foreseeable future.

Prof Salisbury said there might be “multivalent coronavirus vaccines” which protect against different variants of the virus which would be delivered in an inoculation programme like the season flu jab scheme.

So we may be in a position where, just as we do with seasonal flu in most countries in the world that have seasonal flu programmes. We vaccinate the risk groups.

“I would be surprised if we continue to depend on a single coronavirus vaccine,” he said.

“I think that we will be forever chasing our tails as each variant then starts to spread and we’re having to then think: ‘Oh my goodness, got to reformulate the vaccine – start all over again’.

“So my vision is that we will be looking at multivalent coronavirus vaccines that will now have – one, may have two, may have three, may have four – different viruses. And that will depend on whether these very different vaccines can be adapted from monovalent to multivalent.

“And if they can be adapted to multivalent – someone will have to do the sort of forecasting that we currently do for seasonal flu about what we’re going to put in this year’s mix.

“And then (the question is) who we’re going to vaccinate.

“I think that the first order of choice there is – we vaccinate the risk groups.

“And the reason that we’ve actually had the risk groups is that they’re the most likely to get seriously ill and die. And that’s mapping very nicely on to our seasonal flu vaccine programme.

“We will have some political, moral, ethical considerations about what do we do with people who are not in the risk groups – they’re much less likely to die, but they may get long Covid

“But in terms of the economic impact and in terms of the health system impact, that’s much less.

“So we may be in a position where, just as we do with seasonal flu in most countries in the world that have seasonal flu programmes, we vaccinate the risk groups.

“And we say to the others – ‘Well, it is pretty mild disease for most people’.

“And we don’t have routine vaccination for the whole population every year, against whichever coronavirus is circulating. And if we do that, we protect our health services.”

When asked whether people will request a certain Covid vaccine over another, he said: “I can’t think of circumstances where we’ve had a menu of different vaccines and we choose the one for our first course and we choose the one for our second course, and we choose the one for our dessert based on our own interpretation of what will give us the best response.

“I’m asked this question. And my answer is the same. Take whichever vaccine you are being offered. Because the one thing that has been common to all of the vaccine results is that they protect against severe disease and death.”

He added: “In the short term, I think we must be grateful for any offer for a vaccine and take that, because they protect against severe disease and death.

I think people will be much more cautious about standing nose-to-nose with someone (on the Underground) who you have no idea whether they are infectious with coronavirus

On social distancing, he said: “Given that we don’t know what this virus is going to do it is of course very difficult to make predictions.

“I think that there will be behaviour changes – we will have a much lower threshold to putting a mask on.

“I think people will be much more cautious about standing nose-to-nose with someone (on the Underground) who you have no idea whether they are infectious with coronavirus.

“So I think that our behaviour is highly likely to change.

“And we will have to come to terms with – with some social distancing, some different aspects of the way in which we work. We may not feel every day we have to go to work if we can actually work effectively from home.”