Waiting game on booster shots advice

Health Minister announces booster shots for the immunocompromised and signals incoming advice on third doses for the wider population, as Guild awaits detail on pharmacy’s role

From this week, Australians who are severely immunocompromised will be offered the option to receive a third COVID-19 vaccine dose to boost their protection to the highest level, said Health Minister Greg Hunt on Friday.

The move follows advice from the Australian Technical Advisory Group on Immunisation (ATAGI) and other leading vaccination and health experts, backed by latest research.

“Australians who are severely immunocompromised may have a decreased immune response to a COVID-19 vaccination and be more at risk from severe COVID-19. An additional booster dose for this specific cohort will ensure they continue to be protected,” Minister Hunt said.

“If you or someone in your family are severely immunocompromised, we encourage you to reach out to your GP or specialist to discuss whether an additional dose is required.”

The recommended interval for the third dose is two to six months after their second dose of vaccine. ATAGI’s advice is that an mRNA vaccine (Pfizer or Moderna) is the preferred option for a third dose.

Australians who are mildly to moderately immunocompromised are not currently recommended by ATAGI to have a third dose at this stage.

The Pharmacy Guild of Australia told AJP that it is “awaiting further detail” on whether pharmacy would play a role in delivering booster shots.

The Government said it expects to receive advice from the TGA and ATAGI within the coming weeks about the administration of booster doses for the general population, the Guild pointed out.

“We’re planning on booster shots being available for everybody,” said Minister Hunt on Monday.

“There are probably three parts to the equation. One is the supply. We have over 150 million doses available for the next year and beyond.

“Two is the logistics, we have a system which is doing that. Three is the medical science,” he said, as the Government awaits expert advice.

Minister Hunt confirmed: “ATAGI or the Technical Advisory Group will provide advice by the end of October on the national program.

“We have over 150 million vaccines that are secured for the future, and so we’re able to implement that on the timeframe and with the urgency and immediacy that is suggested by ATAGI, if and when they provide that, but we’re expecting that before the end of October.”

Booster doses are can optimise protection due to waning of immunity over time. This could help reduce the amount of breakthrough infections and deaths among the vaccinated.

A large recent analysis has found that in England between 2 January and 2 July 2021, there were 256 deaths from breakthrough infections among the 51,281 who died with COVID-19.

This means just 0.5% of all deaths from COVID-19 during that time period were breakthrough deaths in the fully vaccinated. By comparison, unvaccinated individuals made up 76% of COVID-19 deaths.

The remaining deaths were in people who had only received one dose of vaccine, or who had received two but been infected prior to vaccination or 14 days elapsing post-second dose. The median age of breakthrough deaths was 84.

However the characteristics of breakthrough deaths can reflect the characteristics of the population that is more likely to be double vaccinated as well as having an increased risk of a breakthrough death, and numbers are relatively low and should therefore be interpreted with caution, the researchers said.

The Office for National Statistics found 13.1% of breakthrough deaths occurred in people who were identified as likely to be immunocompromised.

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