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ATAGI expands fourth COVID vaccine dose eligibility


Jolyon Attwooll


25/05/2022 4:10:52 PM

The immunisation advisory group is now recommending a fourth COVID-19 vaccine dose for people with a range of immunocompromising conditions.

COVID-19 vaccine.
An expanded group of people is now eligible for a fourth dose, to be given four months after the initial booster. (Image: AAP)

The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended that more people be given a fourth ‘winter’ dose of COVID-19 vaccine.
 
In an announcement released on Wednesday afternoon, the group said an extra winter booster is now advised for an expanded group of people, to be given four months after an initial booster.
 
Under the new guidance, people with a medical condition that increases the risk of severe illness (see list below) are now eligible, as are those with a disability who have significant or complex health needs, or multiple comorbidities that increase the risk of poor outcomes from COVID-19.
 
People within the new expanded group are those aged 16–64 with conditions including:  

  • Cancer, with examples as follows: Non-haematological cancer including those diagnosed within the past five years or on chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy (active treatment or recently completed) or with advanced disease regardless of treatment. Survivors of childhood cancer
  • Chronic inflammatory conditions requiring medical treatment with disease modifying antirheumatic drugs (DMARDs) or immunesuppressive or immunomodulatory therapies with examples as follows: Systemic lupus erythematosus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and similar who are being treated
  • Chronic lung disease with examples as follows: Chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease and severe asthma (defined as requiring frequent hospital visits or the use of multiple medications).
  • Chronic liver disease with examples as follows: Cirrhosis, autoimmune hepatitis, nonalcoholic fatty liver disease, alcoholic liver disease
  • Severe chronic kidney disease (stage 4 or 5)
  • Chronic neurological disease with examples as follows: Stroke, neurodegenerative disease (eg dementia, motor neurone disease, Parkinson’s disease), myasthenia gravis, multiple sclerosis, cerebral palsy, myopathies, paralytic syndromes, epilepsy
  • Diabetes mellitus requiring medication
  • Chronic cardiac disease with examples as follows: Ischaemic heart disease, valvular heart disease, congestive cardiac failure, cardiomyopathies, poorly controlled hypertension, pulmonary hypertension, complex congenital heart disease
  • People with disability with significant or complex health needs or multiple comorbidities which increase the risk of poor outcome from COVID-19, particularly those with trisomy 21 (Down Syndrome) or complex multisystem disorders
  • Severe obesity with BMI ≥ 40 kg/m2
  • Severe underweight with BMI < 16.5 kg/m2
ATAGI said the list is not exhaustive, and that ‘providers may include individuals with conditions similar to those listed below, based on clinical judgment’.
 
The group also reiterated that the additional winter doses should be delayed three months after a confirmed COVID-19 infection has cleared.
 
In March, ATAGI recommended a fourth dose for all over-65s, as well as all residents of aged and disability care facilities, regardless of age. Those aged 16 and above with severe immunocompromise and Aboriginal and Torres Strait Islander people aged 50 and older were also included in that recommendation.
 
RACGP President Adjunct Professor Karen Price welcomed the announced.
 
‘The pandemic is far from over and this winter booster expansion is a positive step forward,’ she said.
 
‘Winter is fast approaching, and we have high community transmission of COVID-19 in all corners of the country.’
 
However, Professor Price also warned the extra dose would place an increasing burden on a primary care system struggling with COVID-19 cases, influenza vaccines, and a day-to-day patient caseload with significant backlogs due to the pandemic.
 
‘Some practices are still very much struggling to absorb the cost of taking part in the COVID-19 vaccine rollout,’ she said.
 
‘The new [Federal] Government has a great opportunity to get behind the nation’s general practices and make sure we have the resources we need.
 
‘We need greater funding and support for general practice teams and it’s important to keep in mind that this will enable more practices to run after-hours and weekend vaccination clinics.
 
‘This would be a fantastic start for the Government and a clear demonstration that they have GPs and their hardworking general practice teams front of mind.’
 
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ATAGI COVID-19 immunocompromised vaccination winter booster


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Dr Lisa Mary Skrebels   26/05/2022 6:41:10 AM

Will health workers , including GPS who do not fall into these categories, be offered a 4th dose? I would think that was important.


Dr Ian   26/05/2022 11:20:33 AM

Many General Practice Clinics feel poorly prepared for the expected Respiratory Tract Infection Surge in terms of PPE and well ventilated spaces so a booster dose 2 would increase safety hopefully .
The question is what is happening in hospitals and respiratory clinics .