Teenage social patterns make boosters a ‘good idea’, expert says

The Therapeutic Goods Administration (TGA) has followed in the footsteps of regulators in Israel, the US and the UK by provisionally approving Pfizer’s COVID-19 vaccination as a booster for 16–17-year-olds.
 
The decision comes ahead of the new school term commencing as a number of states across the country continue to record new daily COVID-19 infections in the thousands.
 
Federal Health Minister Greg Hunt said the expansion of the booster program will provide ‘further protection and peace of mind’ for children and their parents.
 
‘We know that two doses of a COVID-19 vaccine provide very good protection, especially against severe disease,’ he said.
 
‘A booster dose will make sure the protection from the first two doses is even stronger and longer lasting, helping prevent the virus from spreading and new variants from emerging.’
 
The dosage for 16–17-year-olds will be the same as the adult population and can be administered after any of the COVID-19 vaccines approved for use in the age group, although the TGA notes that data on Pfizer’s use as a booster with other COVID-19 vaccines is ‘more limited’.
 
Professor Robert Booy, an infectious diseases paediatrician, welcomed the expansion of the booster program as a ‘good idea’ given the cohort’s social patterns and propensity to spread the virus.
 
‘Teenagers aged 16 and 17 behave more like adults than they do children,’ he told newsGP.
 
‘Their social mixing patterns involve crowding and often close intimate contact – and people in their late teens easily spread virus the way people in their 20s do as well.
 
‘I contend that for the last six weeks, every day has been a super spreader event for older teenagers and people in their 20s because they’ve had social events since they finished school.’
 
Chief Nursing and Midwifery Officer Professor Alison McMillan shared the sentiment.
 
Speaking during a press conference on Friday alongside Minister Hunt, she said as well as younger people being more mobile in the community, it can be a ‘challenge’ to get them to follow public health measures such as social distancing and wearing masks.
 
‘So, yes, we are seeing cases in younger people,’ she said.
 
‘And I know they are often hearing people say that “this is a mild disease and you shouldn’t worry”, but you should, and you should make sure that you do all you can to protect others so you don’t infect others.’
 
While those aged 16–17 have made up a minority of COVID-related hospital admissions and deaths in Australia to date, Professor Booy said the risk of developing severe disease is still a factor for consideration.
 
‘When it comes to being admitted to hospital for COVID, the risk of an older teenager aged 15 and above needing hospital admission is four times higher than a primary school aged child,’ he said.
 
‘So they certainly deserve being offered a booster because, as I said, they’re more akin to people in their early 20s than they are to children, and they respond very strongly to boosting.’
 
When it comes to the rare side effect of developing myocarditis post-vaccination, older teenagers, and particularly males, have been found to be at higher risk. However, data from Israel’s Ministry of Health has found that the occurrence of myocarditis in people aged 16 and older after a booster dose is half the rate observed after the second dose.
 
Professor Booy said the data is reassuring, and that it is likely to come down to the dosing interval between the second dose and the booster.
 
‘Generally that second dose was 3–4 weeks after the first dose,’ he said.
 
‘If, however, you’re having a booster dose, which is 3–4 months after your last dose, the chance of getting an inflammatory side effect, like myocarditis, does go down in Israel and other places quite a bit.’
 
The Department of Health notes that ‘follow-up time and the number of people who have received a booster dose are lower for younger people than for older age groups’ but says the Australian Technical Advisory Group on Immunisation (ATAGI) will continue to monitor and evaluate emerging evidence.
 
Meanwhile, Minister Hunt said the TGA’s advice is the ‘first step of a two-stage process’, with ATAGI expected to provide advice and further information on when the age group will be eligible to receive booster doses in the coming days, ‘if not earlier’, with doses to then be made available immediately.
 
‘They are the same doses as the adult regime [so] they’re widely available throughout the country,’ he said.
 
Australia has secured more than 151 million booster doses for delivery over the coming year. Novavax is also expected to apply for its COVID vaccine to be used as a booster dose, however Minister Hunt has advised people who are currently eligible not to wait given uncertainty around the timeline.
 
Since the TGA approved booster doses for those aged 18 and over in October, more than 7.1 million people have received a booster, and as of Monday thousands more will become eligible as the dosing schedule shortens from four to three months nationally.
 
‘Above all else, I want to say thank you for everybody coming forward,’ Minister Hunt said.
 
‘It is a challenging time, but the fact Australians are stepping forward to be vaccinated in record numbers for boosters, as well as children – we have one of the highest children vaccination rates in the world – that says what we always knew … we really are one of the leading vaccination countries.’
 
Log in below to join the conversation.

adolescents booster COVID-19 myocarditis Pfizer vaccination