ATAGI announces COVID booster program for some adolescents

Matt Woodley

9/06/2022 11:39:36 AM

The advisory group has said 12–15-year-olds with specified underlying conditions should receive an additional vaccine dose.

Adolescent receiving COVID-19 vaccination.
The booster will be the fourth dose for severely immunocompromised adolescents. (Image: AAP)

Around 120,000 teenagers are now eligible to receive a first booster dose of Pfizer’s COVID-19 vaccine, following a new recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI).
According to ATAGI, adolescents aged 12–15 who have completed a primary course of vaccination three months or more ago may receive an additional vaccine, provided they fall into one of the following groups:

  • Those who are severely immunocompromised
  • Those who have a disability with significant or complex health needs
  • Those who have complex and/or multiple health conditions that increase the risk of severe COVID-19
At this stage, only Pfizer can be administered to this cohort, as neither Moderna nor Novavax’s vaccines are licenced for use as a first booster dose in this age group.
The booster will be the fourth dose for severely immunocompromised adolescents, as a third primary dose has already been recommended for this cohort.
While the effectiveness and safety of a fourth dose in this age group is unknown, ATAGI states the benefits are ‘likely to outweigh the risks’ as there have been no safety concerns in severely immunocompromised people in older age groups.
However, there does not appear to be any plans to expand eligibility to the general adolescent population.
Early evidence suggests two doses protects against severe disease, including admission to an intensive care unit and development of multisystem inflammatory syndrome in children, and this protection persists for at least several months after a primary course of vaccination in adolescents aged 12–18 years,’ the ATAGI release states.
‘This is supported by Australian data that shows unvaccinated adolescents aged 12–15 years are more likely to be admitted to an intensive care unit compared to those who have received a primary series of COVID-19 vaccination.
‘The current primary aim of the Australian COVID-19 vaccination program is to prevent severe disease, including hospitalisation and death … [and] there is currently insufficient evidence that a first booster dose provides additional protection against severe disease for most children and adolescents in this age group.’
There have been no confirmed deaths from COVID-19 in Australian adolescents aged 12–15 years during the period of Omicron predominance, while most European and North American countries have also recorded no deaths, except for England (one), Denmark (five), and the US (17).
Additionally, ATAGI states that these data reflect deaths in adolescents aged 12–15 years with concurrent SARS-CoV-2 since 1 February 2022, and do not necessarily attribute cause of death to COVID-19.
Aside from assessing evidence of increased protection, ATAGI also considered the very rare risk of vaccine-induced myocarditis when deciding which cohorts should be eligible for a booster.
‘Data from the United States and Israel suggest the risk of myocarditis following a third dose of the Pfizer COVID-19 vaccine in male adolescents aged 12–15 years ranges from one in 11,000–58,000 doses,’ the release states.
The advisory group pointed out that this rate is ‘probably lower’ than the rate after dose two, but higher than the rate after dose one. There are also no existing reports of myocarditis following a first booster dose in female adolescents aged 12–15 years.
While the overall 12–15 population is still not eligible for a booster dose, ATAGI has said this advice ‘may change’ as new evidence or vaccines emerge, or the aims of the vaccination program respond to local epidemiology, such as a new variant of SARS-CoV-2 becoming predominant.
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adolescents ATAGI COVID-19 immunocompromised Omicron Pfizer vaccination


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