ATAGI update on boosters following COVID-19 meeting on 11 November 2022

ATAGI has reviewed its booster dose advice (November 2022) for COVID-19 vaccines in the context of increasing case numbers in Australia and the emergence of the XBB and BQ.1 Omicron subvariants.

ATAGI wishes to provide the following updates:

• ATAGI has made no new recommendations at this time, including no changes to the number of COVID-19 vaccine booster doses recommended.
• ATAGI emphasises the importance of remaining up to date with recommended doses of COVID- 19 vaccines, especially for people aged 65 years and older and those at higher risk of severe COVID-19:
  • As of 9 November 2022, 5.5 million eligible people living in Australia (27.8% of the eligible population) had not received a first booster dose, and 3.2 million people aged 50 years and older (42.7%) had not received a second booster dose.¹
  • Adults aged 30 to 49 years can consider a second booster dose, and 4.4 million people aged 30-49 years (84%) have not yet received one.¹
  • Under-vaccinated people are at an increased risk of severe illness and death. Staying up to date with vaccine recommendations is an important way a person can protect themselves in the current context of increased COVID-19 cases.
  • ATAGI continues to recommend that all people defer COVID-19 vaccination for 3 months after a confirmed SARS-CoV-2 infection. The next scheduled dose should then be given as soon as possible.
  • Eligible individuals can receive either a bivalent or original COVID-19 vaccine, whichever is available to them. Both bivalent and original vaccines result in an improvement in the immune response against Omicron subvariants.
• The increase in COVID-19 cases in Australia commenced a few weeks ago. It is unclear when the wave will peak or end. Any reduction in community transmission in Australia from an additional booster dose in people who are already up to date is likely to be minimal.
• A recent wave of the XBB subvariant in Singapore was of short duration and of small size. Severe disease and death were rare in people who had received at least two doses of a COVID-19 vaccine.²
• ATAGI notes the following measures recommended by health officials during the current increase in COVID-19 cases:
  • people are advised to use masks in indoor public places and crowded settings ³
  • people who test positive for COVID-19 or feel unwell should stay at home until symptoms resolve ³
  • People eligible for oral COVID-19 treatments, should speak with their doctor before they get sick to see if COVID-19 antivirals are right for them.⁴
• ATAGI continues to actively review the role of booster doses in the COVID-19 vaccination program. New booster dose recommendations are anticipated in early 2023 in preparation for winter. Future recommendations will aim to provide ongoing clear guidance across all groups including time since last dose and definitions of eligibility.

References

1. Department of Health and Aged Care, Australian government. COVID-19 vaccine roll-out, 10 November 2022. Available from: COVID-19 vaccine rollout – 10 November 2022 (Accessed 13 November 2022)
2. Ministry of Health, Singapore. Update on COVID-19 situation and measures to protect healthcare capacity. 2022. Available from: Update On Covid-19 Situation and Measures to Protect Healthcare Capacity (Accessed 13 November 2022)
3. Department of Health and Aged Care, Australian government. New COVID-19 variant leads to increase in cases. 2022. Available from: New COVID-19 variant leads to increase in cases (Accessed 13 November 2022)
4. Department of Health and Aged Care, Australian government. Oral treatments for COVID-19. 2022. Available from: Oral treatments for COVID-19 (Accessed 13 November 2022)