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Australians with weak immune systems to get Covid-19 vaccine booster shots

Australians WILL get booster doses of the Covid vaccine as Greg Hunt sets out new timeline – here’s what you need to know

  • Severely immunocompromised Australians will get third dose of Covid-19 jab 
  • They will be given a third Pfizer shot between two and six months after second
  • There has been no recommendation on booster shots for the general population

Australia’s vaccine scientists have recommended booster shots for severely immunocompromised Australians over 12.

They will be given a third Pfizer shot between two and six months after their second dose, even if they had AstraZeneca before.  

A decision on booster shots for the general population is expected by the end of October, Health Minister Greg Hunt said on Friday.

Australia’s vaccine scientists have recommended booster shots for severely immunocompromised Australians over 12. Pictured: A Sydney CBD vaccination hub

Mr Hunt said the booster shots will roll out from Monday.

‘I’m pleased to be able to announce the first stage of the booster programme today,’ he said. 

Immunocompromised people include those who have had an organ transplant and some cancer patients.

Chief Medical Officer Paul Kelly said boosters for the general population could be rolled out between three and eight months after the second dose. 

The Australian Technical Advisory Group on Immunisation said in a statement on Friday: ‘ATAGI recommends a third dose of Covid-19 vaccine as part of the primary course in individuals who are severely immunocompromised.

‘This is to address the risk of suboptimal or non-response to the standard two dose schedule.

‘The third dose is intended to maximise the level of immune response to as close as possible to the general population.’

ATAGI said it does not recommend subsequent doses beyond the third dose at this time.

‘A third dose is likely to be last dose that you have to do [in your life],’ Professor Kelly said. 

Pictured: Dr. Jamal Rifi administers the Pfizer vaccine at the Belmore Sports Ground vaccination hub in western Sydney

Pictured: Dr. Jamal Rifi administers the Pfizer vaccine at the Belmore Sports Ground vaccination hub in western Sydney

‘Many patients who fail to respond to third doses may not respond to further doses,’ it said. 

The group said a gap of two to six months after the second dose was preferable but this could be reduced to four weeks in exceptional circumstances such as anticipated intensification of immunosuppression and Covid-19 outbreaks. 

‘People who have had a second dose more than six months ago should receive a third dose whenever feasible,’ it said.

‘An mRNA vaccine (Pfizer or Moderna) is preferred to Vaxzevria (AstraZeneca) for this third dose.’ 

Israel was the first country to start rolling out booster shots on July 30. The US, UK and EU countries have followed.  

Who will be given a third dose? 

People with the following immunocompromising conditions and therapies:

  • Active haematological malignancy
  • Non-haematological malignancy with current active treatment including chemotherapy, radiotherapy, and/or hormonal therapy, but excluding immunotherapy with immune checkpoint inhibitors
  • Solid organ transplant with immunosuppressive therapy
  • Haematopoietic stem cell transplant (HSCT) recipients or chimeric antigen receptor T-cell (CAR-T) therapy within 2 years of transplantation.
  • These patients require revaccination with 3 additional doses of COVID-19 vaccine, irrespective of doses given prior to transplantation, commencing generally ≥3-6 months after their transplant after discussion with their treating specialist.
  • Those beyond 2 years from transplant should discuss with their treating specialist about the need for a 3rd dose.
  • Immunosuppressive therapies including:
  • High dose corticosteroid treatment equivalent to >20mg/day of prednisone for ≥14 days in a month, or pulse corticosteroid therapy.
  • Multiple immunosuppressants where the cumulative effect is considered to be severely immunosuppressive.
  • Selected conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDS):
  • including mycophenolate, methotrexate (>0.4 mg/kg/week), leflunomide, azathioprine (>3mg/kg/day), 6-mercaptopurine (>1.5 mg/kg/day), alkylating agents (e.g. cyclophosphamide, chlorambucil), and systemic calcineurin inhibitors (e.g. cyclosporin, tacrolimus)
  • excluding hydroxychloroquine or sulfasalazine when used as monotherapy
  • Biologic and targeted therapies anticipated to reduce the immune response to COVID-19 vaccine:
  • including B cell depleting agents (e.g. anti-CD20 monoclonal antibodies, BTK inhibitors, fingolimod), anti-CD52 monoclonal antibodies (alemtuzumab), anti-complement antibodies (e.g. eculizumab), anti-thymocyte globulin (ATG) and abatacept
  • excluding agents with likely minimal effect on vaccine response such as immune checkpoint inhibitors, anti-integrins, anti-TNF-α, anti-IL1, anti-IL6, anti-IL17, anti-IL4 and anti-IL23 antibodies
  • Primary immunodeficiency including combined immunodeficiency and syndromes, major antibody deficiency (e.g., common variable immune deficiency (CVID) or agammaglobulinemia), defects of innate immunity (including phagocytic cells), defects of immune regulation, complement deficiencies and phenocopies of primary immunodeficiencies.
  • Advanced or untreated HIV with CD4 counts <250/μL or those with a higher CD4 count unable to be established on effective antiretroviral therapy
  • a 3rd primary dose is not required for people living with HIV, receiving ART with CD4 counts ≥250/μL
  • Long term haemodialysis or peritoneal dialysis 

Source: ATAGI