New focus on vaccine boosters

Israel has become the first nation to officially launch a booster shot of the Pfizer COVID-19 vaccine, with a third dose already being issued to people aged over 60.
 
In an official announcement published on the weekend, the Israeli Ministry of Health’s Director, General Professor Nachman Ash, said the program has begun and called upon all those eligible to get the booster shot.
 
‘The vaccine operation for administering a third dose to those aged 60 and older is underway,’ he said.
 
‘This is an important measure that we take in the State of Israel, aimed at protecting the older adult population from infection with coronavirus and from serious illness.’
 
While other countries such as the UK have already signalled their intention to run booster campaigns, Israel is the first to put it into action.
 
The Israeli newspaper Haaretz reported that appointments for the booster shot are being scheduled ‘at a fast pace’.
 
The Israeli President Isaac Herzog is among those to have received a third dose.
 
The country’s health officials previously announced they would offer Pfizer boosters for immune-compromised adults but said last month they were still weighing up whether it should be released to the general population.
 
Israel’s vaccine rollout, which has one of the highest take-up rates in the world, has been dominated by the Pfizer vaccine.
 
In Australia, there is a strong likelihood of booster shots being administered, although the format for further vaccination is yet to be confirmed.
 
Prime Minster Scott Morrison last month announced 85 million doses of Pfizer had been ordered for booster shots. Federal Health Minister Greg Hunt said last week that 60 million of those doses are due to arrive in 2022, with the remaining 25 million scheduled for the following year.
 
Minister Hunt also indicated that booster clinics are highly probable but gave no further detail on the shape they are likely to take. At a press conference in Melbourne last Thursday, he said COVID-19 vaccination will ‘remain, in all likelihood, an ongoing feature of life in Australia in just the same way as flu vaccination is.’
 
Dr Emil Djakic, a member of RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), previously told newsGP he believes COVID-19 booster vaccinations should be worked into the primary care system.
 
‘I would see this as something that would become integrated into what was the normal vaccine process,’ he said last month.
 
Dr Djakic said that while state-run COVID-19 vaccination clinics are useful for ‘surge capacity’ in the current vaccination program, he does not think they will be needed beyond the initial push.
 
‘There is absolutely no need to create an alternative chain of supply systems and pop-up clinics if it’s organised in collaboration with our industry, which is clearly the biggest provider of this sort of service in the country,’ he said.
 
Dr Djakic also said the business case for GPs to be part of any future vaccination booster program ‘has to stack up’. 
 
In England, Pfizer boosters are due to be introduced for the immunocompromised from next month. Regulators in the US are understood to be assessing whether to recommend a booster program and, if so, to which sections of the population.
 
However, in a sign of the likely ongoing demand for its vaccine, Pfizer announced last month it had reached a deal to supply a further 200 million further doses to the US government to be delivered from October this year until April 2022.
 
The company cited data in its second-quarter teleconference last week which suggests the level of antibodies created by a third dose could be up to the five times the level produced after two doses, and potentially even higher in older patient cohorts.
 
In the meantime, there was widespread public discussion of boosters in Australia on Monday.
 
AstraZeneca’s Australian/NZ president Liz Chatwin told the ABC the company is currently testing a variation to its vaccine, which she said would be available later this year ‘if it is going to be needed as a booster shot’.
 
‘All the variants to date, the current vaccine is equipped to deal with those,’ she stressed. 
 
Ms Chatwin said earlier in the interview she has been surprised by the amount of debate about the AstraZeneca vaccine and disappointed more people in Australia had not yet been vaccinated with it – although she said attitudes appear to be changing.
 
Also speaking on Monday, University of Melbourne epidemiologist Tony Blakely said that overseas data suggested booster shots using mRNA vaccines could be particularly effective. He believes a boosting program should be in place in Australia by early next year.
 
‘Let’s think ahead a bit more. We want to get everybody fully dosed, or as many people as possible with AstraZeneca or Pfizer,’ he told 3AW.
 
‘But then we are going to need to boost. This Delta virus is really quite something. We are going to want to boost first of all those people who have had AstraZeneca and top them up with mRNA, and we are also going to want to vaccinate the children.
 
‘Those two things would be happening, I hope, early next year so we are in good shape then for opening up to the rest of the world somewhere around March or Easter next year.’
 
In addition to the further Pfizer doses, Australia is expecting 51 million doses of the Novavax vaccine to start arriving by the end of this year. Minister Hunt said last Thursday the Novavax vaccine doses would be ‘ready to be used as a booster as well’.
 
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