ATAGI approves fourth shots for over-30s

The immunisation expert panel has also cut the recommended interval between a first and second booster.

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From Monday 11 July, a second booster dose of covid vaccine will be available to all adults aged 30 and over and is recommended for those aged 50 and over, ATAGI announced at lunchtime today. 

The expert group has also cut the recommended interval between a recent covid infection or first booster and a second dose from four months to three.  

People who are already eligible for a second or “winter” booster remain at higher risk of serious disease and should have their second jab as soon as possible. 

The updated recommendations are designed to help reduce severe disease driven by a surge in the Omicron BA.4 and BA.5 subvariants, and to reduce the burden on the healthcare system in coming months. 

“ATAGI recognises that some people aged 30 to 49 years would also like to reduce their risk of infection from covid-19 and therefore may consider a winter booster dose,” the agency said.  

“While rates of hospitalisation, severe disease, and death from covid-19 are low in this age group, other factors such as time off work and the risk of long covid may influence an individual’s personal decision to have a winter booster dose. 

“The impact of vaccination on transmission and maintenance of healthcare capacity in this age group is uncertain but likely to be limited.” 

ATAGI said it did not currently support making the second booster dose available to healthy adults under 30 since it was unclear whether the benefits outweighed the risks in this population. 

In announcing the new recommendations, Health Minister Mark Butler said they would come into effect on Monday to give the primary care sector time to start making bookings. 

He added that the primary care vaccination system had “lots of capacity”. 

“They’re running at a much lower level of activity than they were at the peak of vaccinations last year – about 80% lower – and there is lots of vaccine in their system,” he said. 

Mr Butler added that ATAGI had not made a formal recommendation that healthy adults aged 30-49 should have a second booster dose, so it remained a personal decision of the patient.   

“If you’re in the healthcare industry, or if you are worried about the impact that having to isolate if you get covid will have on your life, you should feel free to go out and get that second booster,” he said. 

RACGP vice president Dr Bruce Willett welcomed ATAGI’s announcement, but also warned that GPs need greater support. 

“GPs and general practice teams on the frontline fighting this virus urgently need a helping hand,” he said. 

“The pandemic is not over, and we are battle weary. As the backbone of the covid-19 vaccine rollout we will play a prominent role delivering these second boosters, but we are under enormous pressure and need all the help we can get from government.” 

Today’s announcement comes in the wake of calls from NSW Health Minister Brad Hazzard for expanded eligibility and Victorian Premier Dan Andrews, who wants a fourth dose for health workers. Prime Minister Anthony Albanese has also backed a fourth dose, saying earlier this week that Australia “will inevitably follow what has occurred in other parts of the world and roll out a further booster shot”. 

The medical community has not always spoken with one voice, with some experts arguing Australia should wait for a vaccine that more effectively targets the newer Omicron variants rather than broadening eligibility for a fourth dose. 

However, as more Australians’ immunity wanes, the proportion of infections due to the BA.4 and BA.5 sub-variants increases, and some states face an Omicron third wave, the prospect of waiting for a more targeted vaccine has become less attractive. 

“Personally, I think we won’t have those in time to help us with this current wave, which is looking very significant,” Dr Paul Griffin, an infectious diseases expert at Mater Health Services, told 3AW yesterday. “We’re seeing really sharp increases in case numbers across the country, and I think it might just be a little bit far away to wait for those variant-specific boosters.”  

“We’re talking to Moderna and Pfizer [about their bivalent vaccines] and I met with them last week,” Mr Butler told 6PR, also yesterday. “The Health Department’s having formal negotiations with them to make sure we get priority access to this next generation of variant vaccines, but they’re not on the market just yet.” 

Despite pressure on the health system and the likelihood of an Omicron third wave driven by the BA-4 and BA.5 subvariant, Mr Butler told 3AW there was “more than enough vaccine in the warehouses and more than enough capacity in our pharmacies, in our GP surgeries” to deliver the boosters.

“The real challenge is to get people lining up to get it,” he said.

While welcoming the availability of a fourth dose, Mr Butler said he was also concerned that five million Australians had not yet received a booster dose, despite having gone at least six months since their second jab. Meanwhile, 40% of over-65s – who have been eligible for a fourth dose for more than three months – have still not had one. 

Mr Butler also cautioned that while the TGA was well advanced in its review of Moderna’s covid vaccine for under-5s, it was also crucial that children in this age group get vaccinated against influenza.