Covid booster now required to be ‘up to date’

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Communicable Disease COVID-19 Live blog

By

Bianca Nogrady

And the WHO has recorded the biggest one-week drop in new covid infections globally.

Welcome to The Medical Republic’s Covid Catch-Up.

It’s the latest covid-19 news in one convenient post. Email bianca@biancanogrady.com with tips, comments or suggestions.

10 February

A booster dose is now required to meet the definition of fully vaccinated against covid – or ‘up to date”, ATAGI says.
The vaccine expert advisory group updated its advice late yesterday, and now anyone aged 16 or over must have a booster vaccine dose to be considered up to date with their covid vaccination.
The booster dose can be given within three months of their final dose of primary vaccination, and while AstraZeneca’s covid vaccine has just been approved as a booster, the Pfizer and Moderna vaccines are the preferred booster vaccine.
Children and adolescents aged up to 15 years are up to date after completing their primary course of vaccination. Individuals who are severely immunocompromised, and who are advised to get three primary doses and a booster, do not require the fourth dose to meet the criteria for up to date, as the Australian Immunisation Register does not record information on medical status.
Those who have experienced prior covid infection also must have a booster but can delay it until four months after their infection.

AstraZeneca’s covid vaccine has been provisionally approved for use as a booster, although the Pfizer and Moderna vaccines are still the preferred option, the Therapeutic Goods Administration says.
In a brief announcement, the TGA says the viral vector vaccine must only be given as a booster in consultation with a healthcare professional, and at this stage is only approved for over-18s.

Global new covid infections have had the biggest ever weekly decline, suggesting the tide has finally gone out for the Omicron outbreak.
New infections dropped by 17% over the past week compared to the previous week, although the number of deaths has increased by 7%, according to the latest figures from the World Health Organisation.
Cases are still rising dramatically in Germany, which reported a 22% increase over the past week, but the United States has seen a 50% decrease and India a 41% decrease in new cases.

Get your influenza vaccinations, especially children, say experts who are concerned that this winter will see a return of the virus after nearly two years’ respite.
Speaking to the ABC, University of Sydney infectious disease expert Robert Booy says Australia will likely have at least a modest influenza season this year, and warns that “flu in young children is worse than covid is in young children” .
Already the European Centre for Disease Control and Prevention has warned that influenza A is now circulating in Europe.
Public health interventions to prevent covid spread have similarly prevented influenza spread, but the lifting of those measures and return to school is likely to see influenza spread. There are also concerns that the lifting of restrictions on international visitors will increase the risk of influenza spreading in Australia, the ABC reported.

Covid vaccines should be prioritised for vulnerable groups and those who are yet to complete their primary course, before giving boosters to adolescents, the European Centre for Disease Prevention and Control has advised.
Primary vaccination against covid provides high levels of protection for adolescents against severe disease and hospitalisation – at least with the Delta variant. But given the low risk of severe disease in this age group, the lack of data about the safety and effectiveness of boosters in adolescents, and the agency’s own modelling suggesting boosters were “unlikely to have a considerable effect on the population-level transmission of SARS-CoV-2”, they advised that priority should be given to ensuring more of the population has received their primary course of vaccines and vulnerable populations their boosters.

Covid vaccination during pregnancy is associated with significantly higher antibody levels than infection-acquired immunity in mothers, and greater persistence of antibodies in their offspring.
A study published in JAMA looked at SARS-CoV-2 spike protein antibody levels in 77 infection-naïve women vaccinated against covid during pregnancy and 12 unvaccinated women who were infected with covid during pregnancy.
At the time of delivery, vaccinated mothers had significantly higher antibody titres than those who had been infected. At six months after delivery, 57% of the infants born to vaccinated mothers still had detectable SARS-CoV-2 antibodies compared to 8% of those infants born to mothers infected with covid during pregnancy.

Nearly one in three people aged over 65 with covid go on to develop a new and persistent condition in the post-acute phase, including hypertension, fatigue, kidney injury or mental illness, research suggests.
A study published in the BMJ looked at outcomes in four groups of people: a random group of around 130,000 propensity-matched individuals from 2019, a group of around 130,000 diagnosed with covid around the same period in 2020 and the same number of people from 2020 not diagnosed with covid, and a historical cohort of around 113,000 people with viral lower respiratory tract illness.
Overall, 32% of the covid group had at least one new-onset or persistent diagnosis in the post-acute phase of covid, although this was actually lower than the number seen in those with a viral lower respiratory tract illness.
When the analysis was limited to individuals admitted to hospital with covid, the proportion of those who with new-onset or persistent condition was nearly 9% higher than that seen in the viral respiratory illness group.
Compared to the non-covid group of 2020, those with covid had a 7.5-fold greater odds for respiratory failure, five-fold greater odds of fatigue and 2.2-times greater odds of myalgias.
Amongst those aged 75 years and older, there was an even larger increase in the risk of neurological problems including dementia, encephalopathy and amnesia.

The scientific verdict is in: the federal government’s COVIDSafe app sucked.
According to a paper published in The Lancet, which evaluated the app’s usefulness in tracing more than 25,300 close contacts of 619 confirmed COVID-19 cases in NSW between May and November 2020, the app picked up just 17 (<0·1%) additional close contacts who weren’t identified by conventional contact-tracing.
The prospective study, which was funded by NSW Health and the NHMRC, involved anyone who tested positive and who had the app running on their phone during at least part of their infectious period. An app-linked contract trace was defined as a close contact suggested by the app. Researchers also conducted interviews with public health staff in NSW to get their perspectives on how useful the app was for contact tracing.
Firstly, only 22% of the positive cases had the app running for any part of their period of infectiousness. Then only 79 of the estimated 25,000 close contacts were app-suggested contacts who actually met the definition for “close contact”, and of these 62 were also identified by conventional contact tracing, and none went on to test positive for covid.
Of the remaining 17 who the app identified as close contacts of four cases, “all completed their quarantine period without testing positive for SARS-CoV-2, hence no public exposure event was prevented by the app during the study period”.
The public health personnel who had to use it found it added to their workload, was not user-friendly and in some cases even slowed down the process of contact tracing.
Well, that was at least $9 million well spent.

Meanwhile, 63 Australians died of covid yesterday, bringing the total for the past seven days to 462 deaths.

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