ATAGI releases clinical information for teen boosters

The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended adolescents aged 16 and older receive a COVID-19 booster dose, days after the Therapeutic Goods Administration (TGA) provisionally approved Pfizer’s vaccine for this cohort.
 
ATAGI states the decision to recommend boosters for 16–17-year-olds is based on a review of COVID-19 epidemiology, disease burden, health benefits directly to individuals and indirectly to the community, and safety considerations in this age group.
 
The vaccine is recommended for all people in this cohort who have previously received any TGA approved or recognised vaccines for their primary vaccine schedule, from three months after receiving their last primary dose.
 
This includes adolescents aged under 16 when they received their last primary dose who are now over the age cut-off, and 16–17-year-olds who are severely immunocompromised and have already received a third primary dose.
 
Following the confirmation, RACGP President Dr Karen Price welcomed ATAGI’s decision but warned that practices delivering COVID-19 vaccines still need more assistance.
 
‘This latest booster announcement for 16–17-year-olds is great news, but it will add another layer of work for the nation’s GPs and general practice teams,’ she said.
 
‘We are flat out delivering kid’s vaccines, which is more time intensive and complicated compared to adults, as well as boosters and taking care of our day-to-day patient case load.
 
‘Some people avoided or delayed screenings and consultations during the pandemic and others have had to delay elective surgery, so helping those people is also a high priority.’
 
Dr Price says more Federal Government support is needed if general practice is to continue as the ‘backbone’ of Australia’s vaccine rollout.
 
‘Many practices are having enormous difficulty absorbing the cost of taking part in the rollout,’ she said.
 
‘We didn’t sign up to make money but at the end of the day we must make ends meet because no one benefits when a practice has to shut up shop.’
 
As of 3 February, 93.5% of people aged over 16 had received two doses, while around 40% of this population has received a third dose. According to ATAGI, given ‘a large proportion’ of 16–17-year-olds were vaccinated in the first three months of becoming eligible, approximately 65% are now due for a booster.
 
However, adolescents who have previously developed myocarditis or pericarditis after a primary dose of Pfizer or Moderna have been advised to discuss the benefits and risks of a booster with their cardiologist and/or GP to determine whether they should defer vaccination.
 
Preliminary evidence from Israel’s booster program, which includes people 12 years and older, indicates that post-booster myocarditis rates in 16–19-year-olds were similar in females and lower in males than after a second primary dose, but higher than that seen after the first dose in this age group.
 
No additional safety concerns have been reported following booster doses and there is no indication that myocarditis or pericarditis events have been more serious after boosters.
 
However, people with previous anaphylaxis to an mRNA vaccine are contraindicated to receive a Pfizer COVID-19 vaccine booster dose and unlike the adult population, cannot receive AstraZeneca as a booster.
 
While no Australian deaths were recorded due to COVID-19 in 16–17-year-olds between 1 January and 21 November 2021, 3.2% of cases required hospitalisation. Meanwhile, approximately 6.3% of cases among Aboriginal and Torres Strait Islander people in this age group required hospitalisation, which indicates a higher rate of severe disease, ATAGI suggested.
 
Aside from offering enhanced protection against the Omicron variant, ATAGI also anticipates that boosters will help reduce transmission by preventing infection in these individuals, as well as by potentially reducing onward transmission from infected people who are vaccinated.
 
Adolescents who have recently had COVID and are now eligible for a booster are still recommended to receive their booster dose, which ATAGI says can be administered immediately after recovery from acute illness or deferred for up to four months.
 
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ATAGI boosters COVID-19 Pfizer teenagers vaccination