Fourth COVID-19 shot approved for over-30s

An additional 7.4 million Australians will be entitled to receive another COVID-19 booster from next week after the Federal Government accepted recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI) to expand the eligibility for a fourth shot to over 30s.

The updated guidance follows an increase in the number of people falling ill from respiratory virus infections, including COVID-19, over the past few months, placing an increased strain on the Australian healthcare system, particularly hospitals.

A contributing factor to the upsurge of COVID-19 cases comes from the SARS-CoV-2 Omicron BA.4 and BA.5 subvariants, which ATAGI says can partly escape the immune response generated by both prior vaccination and infection, with numbers expected to worsen over the coming months.

A first booster dose of the COVID-19 vaccine has been shown to increase the immune response to these new subvariants but wanes over several weeks; however, a winter dose (the second booster dose) is anticipated to boost this immune response.

“We are in the early stages of a third Omicron wave, and our Government is absolutely committed to making sure as many people as possible are protected with the vaccine,” the Minister for Health and Aged Care Mark Butler said.

“My message to everyone living in Australia aged 50 and over is to make sure you have the greatest protection against COVID-19 by having a fourth dose as soon as possible. If you are aged 30 to 49, and you want that extra protection, you can choose to get a fourth dose.

“The vaccine experts on the Australian Technical Advisory Group on immunisation have recommended it – and the Government has accepted this advice.”

ATAGI emphasised that people previously eligible for a winter booster dose remain at higher risk of severe disease and death from COVID-19 and should look to receive the booster dose as soon as possible; these include:

• all adults aged 65 years or older
• residents of aged care or disability care facilities
• Aboriginal and Torres Strait Islander people aged 50 years or older
• people who are severely immunocompromised (this will be their fifth dose)
• people aged 16 years or older with a medical condition that increases the risk of severe COVID-19 illness
• people aged 16 years or older with a disability, significant or complex health needs, or multiple comorbidities, which increase the risk of a poor outcome.

Adults aged between 50 to 64 years old are now recommended to receive a COVID-19 winter booster dose. Those aged between 30 to 49 are also now eligible, although the benefit for people in this group is less certain.

There was no support for making the fourth dose available to healthy adults under the age of 30 as it was not clear whether the benefits outweighed the risks in this population group.

ATAGI has also recommended that the interval between vaccine doses, or prior infection (whichever comes later), be reduced from four months to three months to provide earlier additional protection.

Individuals who have previously been infected with SARS-CoV-2, irrespective of which variant it may have been, should continue to receive recommended vaccine doses after three months, as prior infection alone will not provide sufficient protection against severe disease.

Vaccination, in addition to infection, as compared with prior infection alone, currently offers the best available protection against reinfection.

ATAGI acknowledges that increasing the uptake of fourth doses in the most at-risk population groups is anticipated to play a limited but important role in taking pressure off Australia’s health care system by reducing the risk of severe outcomes in individuals.

The group advises that other public health and social measures, in addition to vaccination, will have the most significant impact against the surge in Omicron BA.4 and BA.5 infections.  

This includes increased use of masks and expanding the use of antiviral treatment in people diagnosed with COVID-19, including those aged 50 years and above.

“My other message is that oral antiviral treatments can be life-saving for older people or people with chronic health conditions who are at higher risk of severe illness from COVID-19,” Butler added.

“It is vital a person starts the five-day oral treatment course as soon as possible after symptoms first appear.

“If you are at higher risk of severe illness, plan ahead. Speak to your doctor now about oral antiviral treatment for COVID-19.”

Almost 14 million people in Australia aged 16 and over have received three or more doses of the COVID-19 vaccine.

However, take-up of the vaccine's first and winter booster doses are considered suboptimal according to ATAGI, with only 70.6 per cent and 59.5 per cent of the respective eligible populations having completed initial doses.