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Five-month booster possible ‘in certain circumstances’: ATAGI


Jolyon Attwooll


3/12/2021 4:49:17 PM

No changes have been prompted by the Omicron variant, but the advisory group says a shortened minimum gap can be followed if specific conditions are met.

COVID-19 vaccine.
ATAGI has said providers should use their clinical judgement to determine whether it is appropriate to administer the dose early. (Image: AAP)

GPs can administer COVID-19 booster doses five months after the primary vaccination course ‘in certain circumstances’, the Australian Technical Advisory Group on Immunisation (ATAGI) has advised.
 
In an announcement on Friday, the group said the recommended six-month gap could be shortened to five months ‘for logistical reasons’, citing the following examples:

  • For patients with a greater risk of severe COVID-19 in outbreak settings
  • If an individual is travelling overseas and will be away when their booster dose is due
  • In outreach vaccination programs where access is limited
‘Providers should use their clinical judgement to determine whether it is appropriate to administer the dose early,’ ATAGI stated.
 
Last month, some GPs called for clarification on whether the interval between the primary course and booster could be shortened.
 
UNSW epidemiologist Professor Mary-Louise McLaws has also called for a shorter gap, following reports of vaccines having to be thrown out as demand for the primary two-dose course tailed off.
 
The advisory group had not previously issued any specific advice on circumstances where shortening the minimum gap for a booster would be possible.
 
However, the new Omicron variant has not prompted any immediate changes to the booster program, ATAGI said, with the group indicating there is not yet any clinical proof that shortening the gap between doses will be beneficial.
 
‘At this stage, there is no evidence to suggest that earlier booster doses of current COVID-19 vaccines will augment protection against the Omicron variant,’ ATAGI said.
 
‘ATAGI will continue to closely monitor the epidemiology and emerging data on the likely impact of vaccination on this variant and update recommendations in the near future.’
 
It also said there is little clinical evidence more broadly on the effect of giving booster doses less than 20 weeks after a second dose.
 
Earlier this week, outgoing Federal Health Minister Greg Hunt said that ATAGI was looking into whether the gap between primary course and boosters should be shortened following a decision by the UK to halve the minimum gap from six months to three.
 
While Omicron has not caused any changes to the booster program, Australia’s Chief Medical Officer Professor Paul Kelly said the emergence of the new variant of concern underlines the importance of getting the booster.
 
‘Once people have reached a six-month stage since their second dose … they should have that booster,’ he told reporters on Friday.
 
‘It’s really important now with the emergence of the Omicron variant that we do go ahead and get that booster when people are due.’
 
There have been 495,252 third doses administered in Australia as part of the COVID-19 vaccination program, according to the latest government figures.
 
These do not distinguish between people who have had a third dose due to immunosuppression and those who have taken a further dose as a booster.
 
A Department of Health spokesperson told newsGP the data is not separated as immunocompromised status is not recorded in the Australian Immunisation Register (AIR).
 
In October, access to a third dose for the severely immunocompromised was opened as part of a primary vaccination course, with a recommended gap of at least two months between a second and a third dose.
 
According to ATAGI, there will be more than four million people over the age of 18 who will be eligible for a booster dose by the end of January 2022.
 
Meanwhile, Professor Kelly said he remains ‘cautiously optimistic’ about Omicron but that gaps in the scientific community’s understanding of the variant need to be filled before any firm conclusions can be drawn. He said he had some good discussions with his South African counterparts.
 
‘Is it transmissible? They are in no doubt that it is. It is definitely replacing Delta in South Africa as the main COVID-19 virus,’ he said.
 
‘They have no real evidence at the moment of an increase in severity. They are seeing a rise in hospitalisations in one of their provinces – in Gauteng province, which is Pretoria and Johannesburg, [a] large population, [a] dense population.
 
‘But even hospitalisations they are seeing with the Omicron variant are not any more severe than … in previous waves.
 
‘I would stress that it’s very early days. It is only in the last few weeks this has been circulating in South Africa and elsewhere, and there is that delay from cases to hospitalisations and deaths.
 
‘So … I remain cautiously optimistic, but we need further information.’
 
ATAGI said studies of virus transmission, age-specific case-hospitalisation, case-fatality ratios, and breakthrough infections, including after vaccination, are underway both overseas and in Australia, and that more evidence will emerge in the coming weeks.
 
Further funding
On Friday, Minister Hunt also announced $540 million of extra funding to bolster the response to the COVID-19 pandemic in Australia.
 
The funding includes $492 million for measures to support aged care and testing, the National Incident Centre, COVID-19 test fees and to continue the Indigenous and Remote Response.
 
There was also $48 million for further research into COVID-19. This includes $15 million for university research projects monitoring the long-term health impacts of COVID-19, as well as clinical trials to improve vaccination planning for the immunocompromised and to evaluate the efficacy of combining different vaccines.
 
The other $33 million will be released as part of a competitive grant process to investigate different new treatments for COVID-19, and to study immune responses, as well as airborne transmission of SARS-CoV-2. The funding includes $3 million that will go towards a new national data platform ‘to strengthen evidence-based public health and health system planning and management’.
 
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RM   4/12/2021 9:26:23 AM

We are about to throw out 200+ doses of Pfizer so have already been giving some of our elderly patients their booster a bit earlier at 5+ months. Also many will be attending large indoor family gatherings for Xmas with children/grandchildren so gives them that added protection ahead of Xmas


Dr Neeraja Sambasivam   4/12/2021 2:46:33 PM

Eligibility criteria for Aztrazeneca vaccine as booster dose ?