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Extra booster dose recommended by ATAGI


Jolyon Attwooll


25/03/2022 2:31:36 PM

The rollout of additional COVID-19 vaccine doses for those ‘at greatest risk of severe illness’ will commence ahead of winter to tie in with flu vaccination.

Elderly woman receiving COVID-1booster vaccination
Booster doses have proved an effective way of reducing severe disease outcomes caused by the pandemic. (Picture: AAP Photos)

The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended a second booster COVID-19 vaccine dose among the most vulnerable sections of the population.
 
In a widely anticipated announcement on Friday 25 March, the Federal Minister for Health and Aged Care, Greg Hunt, confirmed a fourth dose of a COVID-19 vaccine is now recommended four months after an initial booster dose for the following groups:

  • All over-65s
  • All residents of aged and disability care facilities, regardless of age
  • Those aged 16 and above with severe immunocompromise
  • Aboriginal and Torres Strait Islander people aged 50 and older
For people in those categories who had a confirmed COVID-19 infection after receiving a first booster dose, the follow-up booster is recommended with a gap of four months after infection.
 
The first doses are expected to be administered in April.
 
Dr Khayyam Altaf, Chair of RACGP Specific Interests Aged Care, said he is ‘absolutely supportive’ of the ATAGI announcement.
 
‘The key point is the winter challenges that we’re going to face and [the likelihood] that the viral numbers are going to increase,’ Dr Altaf told newsGP.
 
‘The benefits have already been evident with the first booster.’
 
Widespread studies have suggested the efficacy of booster doses in preventing severe outcomes, and Dr Altaf said his own experience reflected those findings.
 
‘I look after a lot of patients in aged care in facilities where there have still been outbreaks,’ he said.
 
‘But the adverse outcomes or deaths have been much, much less [since boosters were put in place].
 
‘There’s clear evidence to me, just by looking at that, that the boosters have been effective, and the initial doses have been effective.’
 
Dr Altaf has also noticed some improvements with the booster rollout compared with a fraught primary dose rollout.
 
‘It has gone a lot better than the initial rollout, so I’ve been pleased with that,’ he said.
 
‘Part of it is because the booster is just one dose as opposed to two, so logistically it has been easier. And I think that there will be further improvements with the second booster dose.
 
‘The feedback that I get from the aged care facilities that I work with is that there has been more support from the private providers. It’s still not ideal, but it’s definitely better than it was.’
 
According to the latest COVID-19 vaccine rollout figures, 93% of eligible residents within aged care facilities around the country – stated at 174,344 people in total – have had more than two vaccine doses.
 
ATAGI has recommended that the rollout of extra booster doses begin next month to coincide with the start of the influenza vaccination program.
 
‘The age cut-off of 65 years aligns with eligibility for receiving [the] influenza vaccine under the National Immunisation Program, which may facilitate implementation and uptake of the additional booster dose,’ the ATAGI statement reads.
 
A recent Department of Health (DoH) webinar once again confirmed GPs are able to co-claim COVID and influenza vaccinations, provided the COVID vaccination is clearly bulk billed. The department has also indicated that it will release a new fact sheet on this process soon.
 
ATAGI advises that the flu vaccine can still be given ahead of the additional booster for patients not yet eligible for a fourth dose.
 
It also says that some patients can be vaccinated at a shorter interval than four months, giving the example of outreach programs to aged and disability care facilities, remote communities and in response to natural disasters ‘where some flexibility of the minimum interval may facilitate vaccination of a larger proportion of individuals’.
 
However, it says the additional booster dose should not be given with a gap of less than three months from a previous booster dose or COVID-19 infection.
 
The existing booster rollout has slowed down significantly over the past several weeks, prompting the Federal Government to announce a $13 million campaign to improve uptake.
 
ATAGI states that the mRNA vaccines Pfizer and Moderna remain the preferred vaccines for the further winter booster dose.
 
Other recommendations also remain the same, with AstraZeneca advised when mRNA vaccines are contraindicated or declined, while Novavax is suggested ‘if no other COVID-19 vaccine is considered suitable for that person’.
 
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