ATAGI recommends third booster shot for immunocompromised individuals

Australia’s advisory group on immunisations has today recommended individuals who are “severely immunocompromised” receive a third booster shot of a COVID-19 vaccine two to six months after receiving the second.

The updated advice from the Australian Technical Advisory Group on Immunisation (ATAGI) was provided to address the risk of suboptimal or non-response to the standard two-dose schedule, and is intended to maximise the level of immune response to as close as possible to the general population.

As for which vaccine immunocompromised people should receive, ATAGI recommends an mRNA vaccine (Pfizer or Moderna) over AstraZeneca for the third dose.

However, ATAGI says “AstraZeneca can be used for the third dose for individuals who have received AstraZeneca for their first two doses if there are no contraindications or precautions for use, or if a significant adverse reaction has occurred after a previous mRNA vaccine dose which contraindicates further doses of mRNA vaccine”.

“The recommended interval for the third dose is two to six months after the second dose of vaccine,” says ATAGI.

“A minimum interval of four weeks may be considered in exceptional circumstances (e.g., anticipated intensification of immunosuppression, outbreaks). People who have had a second dose more than 6 months ago should receive a third dose whenever feasible.”

The vaccine advisory group does not recommend subsequent doses beyond the third at this point in time, but notes protection from three doses in severely immunocompromised individuals may still be lower than the general population.

As such, ATAGI recommends people continue risk mitigation strategies such as mask wearing and social distancing even after receipt of a third jab.

“ATAGI will continue to monitor the evidence around duration of protection and advise on the need for subsequent (booster) doses in immunocompromised populations to address waning of protection or risk from variants of concern,” says ATAGI.

“ATAGI will provide further advice on booster doses (including for healthcare workers, older adults and the general population) separately.”

Updated at 2.14pm AEST on 8 October 2021.

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