‘The virus has evolved’: Fifth COVID dose available soon

As Australia prepares to enter its fourth year of tackling COVID-19, the Federal Government has announced an update to the strategy, with adults eligible to receive a fifth vaccination later this month. 

The move follows the latest advice from the Australian Technical Advisory Group on Immunisation (ATAGI). 

‘From February 20, all adults who haven’t had a booster or an infection in the past six months can go out and get a booster shot, to give them additional protection against severe illness from COVID,’ Federal Health and Aged Care Minister Mark Butler said.

While all people over the age of 18 will be eligible, ATAGI has emphasised that the recommendation is particularly important for those who are at risk of severe illness. This includes everyone aged 65 and over, and younger adults who have comorbidities, disability, or complex health needs.

At this stage, the advisory group is not advising people under the age of 18 receive an additional booster, due to the low incidence of severe illness among the cohort. 

Associate Professor Paul Griffin, an infectious diseases physician at the University of Queensland, told newsGP the announcement is welcome and timely. 

‘It’s clear that we did a fantastic job with our first two doses, but then with our boosters, a lot of people had those some time ago, and the situation has clearly changed; the virus has evolved,’ he said.

‘So we need to update that protection and an additional dose, particularly with an updated vaccine, will accomplish that.’

Until now, fifth doses have only been available to adults who are severely immunocompromised.

However, uptake of booster doses has largely been lagging, despite them first being made available in November 2021. 

The data shows that in January, 72.4% of the eligible population had received a third dose and 44.6% had received a fourth. The numbers are even lower among eligible Aboriginal and Torres Strait Islander people, with just 56.6% having received a third dose.

At this stage, Associate Professor Griffin says it is clear that a strong education campaign is needed – one that addresses both misinformation and underappreciation of the risk that COVID infection poses. 

‘Glossy ads showing people smiling, receiving a vaccine, probably isn’t sufficient,’ he said. 

‘It needs to be backed up with really good information for people that are unsure of why they should get this vaccine, or if it’s safe or effective; they’re the things that need to be really clearly communicated. 

‘I’d like to see a really robust campaign that gets that out there.’

But the infectious diseases expert says education needs to go one step further.

While ATAGI has said that all available COVID-19 vaccines are beneficial, the Omicron-specific mRNA booster vaccines are preferred. 

Associate Griffin says the options need to be effectively communicated to the public to avoid confusion.

‘It’s really clear that we’re going to recommend an updated vaccine, and ideally a BA.4 and BA.5 updated vaccine, if people have that available,’ he said. 

‘But, if they don’t, any booster they can get is significantly better than not being up to date – we need people to understand that. 

‘There are additional options like Novavax, for example, which is a very good option for many people, but a lot of people still don’t even know that it is readily available. So again, some of the practical elements of what vaccines are available and what people should get also need to be really well communicated so that it’s not too hard for people.’

There are currently four million Omicron-specific booster doses available in Australia, with the Government expecting another 10 million to arrive later this month – the largest supply of COVID vaccines to arrive on Australia’s shores since late 2021. 

With the emphasis on protecting those most vulnerable, Minister Butler has said there will be a push for aged care residents to receive a booster, with providers encouraged to bring both local GPs and pharmacists into their facilities to facilitate the program. 

The Health Minister also noted that there will be a new incentive payment for general practices to visit both aged care and disability facilities to provide the latest phase of the vaccine program. He is referring to the flagfall MBS item number 90005, which was recently increased from $58.15 to $118.15.

‘This new incentive payment will be much simpler,’ Minister Butler emphasised during a press conference.

Since a spike in the seven-day rolling average of more than 16,000 cases in mid-December, the number of reported infections in Australia has continued to decline, down to 2656 at the end of January. 

Though Associate Professor Griffin believes that the data indicates Australia is past its most recent wave, he is cautious, saying the public has been ‘overly reassured’ at the conclusion of every wave.

‘Everyone thinks that means that’s the end of it – but it doesn’t mean COVID is over,’ he said. 

‘Transmission continues, there are still patients in hospital, there are unfortunately still patients not surviving this infection – and there will be subsequent waves. 

‘That sort of information needs to be reinforced with the additional booster recommendation, so people understand that there is still a risk and it’s worth protecting yourself from that.’

Last year was the deadliest of the pandemic on record in Australia, with the nearly 15,000 confirmed deaths seven times high than 2020–21 combined. More than 1500 COVID deaths have also been recorded in 2023 already, while the Australian Bureau of Statistics estimated in November that 80% of coronavirus-related fatalities had occurred during the Omicron wave.

Associate Professor Griffin says GPs have an important role to play in educating patients regarding the risks and benefits of vaccination, and would like to see them receive more support in this space.

‘I appreciate the workload of GPs at the moment, how hard it is to be on top of everything, how hard it is to find time to educate patients, but that’s what GPs do fantastically well,’ he said. 

‘So they’re going to be really key to this rollout, particularly because we’re going to focus on those that are vulnerable. So probably those that are seeing their GP regularly because of a number of medical problems – it would be an opportunity even to start having those conversations now. 

‘That’s where I think making sure the GPs have the tools and the resources to do that readily will be really important.’

ATAGI’s advice is based on Australia’s current context, with the advisory group continuing its surveillance of COVID-19 infection rates, new variants, and vaccine effectiveness to determine any future recommendations. 

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