ATAGI notes that testing rates have decreased and there are likely to have been many people with undetected SARS-CoV-2 infection within recent months.
It is recommended to defer vaccination for 6 months following a confirmed SARS-CoV-2 infection, as this, together with prior vaccine doses received, will boost protection against COVID-19. This will provide an increase in protection against severe illness and protect the healthcare system during a time of high demand. Anticipated benefits of a 2023 COVID-19 vaccine booster doseĪn additional COVID-19 booster dose is anticipated to address waning of protection against severe COVID-19 prior to winter. Of note, early evidence suggests that the newer Omicron subvariants do not cause more severe disease compared with the original Omicron subvariant (BA.1) 5. COVID-19 vaccines may have a reduced and/or shorter duration of protection against infection from these subvariants compared with older variants, however vaccines (together with hybrid immunity from natural infection) continue to provide strong protection against severe COVID-19. Numerous immunological studies report reduced neutralisation of new Omicron subvariants by both vaccine-induced and naturally derived antibodies 3,4. These have co-circulated without any specific subvariant establishing clear dominance. Multiple new Omicron subvariants have emerged since the BA.4/5 wave in Australia during July and August 2022, displaying increased immune-escape properties (e.g. Rationale Epidemiology of SARS-CoV-2 as of February 2023 **Includes those with a medical condition that increases the risk of severe COVID-19 illness (refer to ATAGI clinical guidance) or those with disability with significant or complex health needs or multiple comorbidities which increase the risk of poor outcomes from COVID-19.A 2023 booster dose should be given 6 months after a person’s last dose or confirmed infection. *mRNA bivalent booster preferred for ages in which a bivalent vaccine is not approved, use a vaccine approved for that age group.Ongoing surveillance of COVID-19 infection rates and clinical outcomes, new variants, and vaccine effectiveness will inform future recommendations for additional booster doses.Administration of a 2023 COVID-19 booster dose should aim to occur prior to June 2023 and at a time of 6 months or greater following the most recent COVID-19 vaccine dose or confirmed infection.COVID-19 vaccine can be co-administered with influenza and other vaccines.Moderna Original/Omicron BA.4/5 is currently under evaluation by the Therapeutic Goods Administration. These include: Pfizer Original/Omicron BA.4/5, as well as Pfizer Original/Omicron BA.1 or Moderna Original/Omicron BA.1. Regarding vaccine choice, all currently available COVID-19 vaccines are anticipated to provide benefit as a booster dose, however bivalent mRNA booster vaccines are preferred over other vaccines.ATAGI advises that a booster dose is not recommended at this time for children and adolescents aged under the age of 18 who do not have any risk factors for severe COVID-19.Children and adolescents aged 5-17 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.All Adults aged 18-64 years without risk factors for severe COVID-19.ATAGI advises the following groups should consider a 2023 booster dose if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received, based on an individual risk benefit assessment with their immunisation provider.Adults aged 18-64 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.ATAGI recommends a 2023 COVID-19 vaccine booster dose for adults in the following groups, if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received:.These recommendations replace previous ATAGI COVID-19 vaccine booster advice. ATAGI has evaluated this risk in the context of high population levels of hybrid immunity (i.e., combined immunity from past infection and past vaccination), the evidence regarding COVID-19 vaccine effectiveness, including for new bivalent vaccines, and the changing epidemiology of COVID-19 related to newly emerged subvariants of Omicron. The goal of the Australian COVID-19 vaccination program remains the prevention of severe illness from COVID-19.
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