Should I be updating my COVID vaccination now?
Over the last year, COVID vaccination recommendations have been updated regularly. So it can be difficult to keep track of how many vaccine doses you and your family members need.
This may seem confusing, but it is actually a good approach to take when navigating a pandemic, especially when the virus keeps changing. Let鈥檚 look at the current Australian recommendations and why vaccine advice needs to evolve over time.
Why do recommendations need updating?
The nature of the COVID pandemic has changed over the past two years and will likely continue to change. The virus of today is聽听补苍诲听聽than the virus of 2020.
The collective immunity of the Australian population has improved, thanks to聽聽(95% of Austalians aged over 16 have had two doses) and a聽聽of infections at the start of this year.
础听聽and rising immunity levels in the population mean the benefits and risks of vaccination聽.
The goal is to make sure we use the current vaccines in a way that offers the most benefit and least harm.
Recently ATAGI聽聽the interval between primary doses (that is the first two doses) should be eight weeks and people should wait until three months after they have had natural infection before they get the next vaccine they are due. The advisory group said the extended dose interval had been shown to improve immune response to vaccination and may reduce the risk of myocarditis and pericarditis.
Preventing serious illness
ATAGI鈥檚 COVID vaccination聽聽are designed to minimise the risk of serious illness in the individual being vaccinated.
Preventing the spread of virus was of prime importance last year. We鈥檝e since learnt serious illness is less common with the Omicron variant and the vaccines鈥� ability to prevent its spread is聽.
ATAGI has now identified the prevention of serious illness and death as the principal role for vaccines聽.
Nonetheless, a substantial number of people still become seriously unwell from Omicron and require聽. Fortunately, booster doses of the COVID vaccines聽聽at preventing severe infections.
Who needs a winter shot?
There are several groups of people for whom a 鈥渨inter鈥� booster dose is recommended 鈥� to be given from four months after the booster or third dose (whatever the season).
A person鈥檚 age is the single biggest risk factor for severe COVID disease. The presence of immunosuppression or some other chronic health conditions is聽, but age plays the most substantial role.
Risk of death and admissions to intensive care units are聽聽among those aged 65 and older. So the benefits of preventing serious illness with a winter dose are most clear in this age group. A study from Israel showed聽聽COVID hospitalisations and deaths after a second booster (a fourth dose) in Israeli adults aged 60 years and over.
This case is strengthened because the very rare, yet serious, side effects of vaccination 鈥� like聽聽after mRNA vaccines 鈥� are uncommon in this age group. If you are over 65, you should plan for a winter dose from four months after your booster. Accordingly, residents of aged care facilities are聽聽a winter dose, as are those in disability residential care.
First Nations people aged 50 years and older and anyone aged 16 years and older who have severe immune-suppression are also recommended for a winter shot.
What about others aged 16 to 64?
For most Australians aged 16 to 64, it is not clear a fourth 鈥渨inter booster鈥� vaccination is needed.
鲍碍听聽shows the primary course and booster or third dose of COVID vaccination have been effective at preventing serious disease from Omicron, however indicate that immunity from the booster dose is also likely to wane.
Are kids aged 5鈥�15 due another shot? What about under 5s?
COVID vaccination has not been recommended for babies and children under 5 years.
When it comes to children and young teenagers (who are not severely immunocompromised) we don鈥檛 have enough evidence of the extra benefit of a booster (third) dose.
What we do know is that serious illness in this age group, including those with severe immunocompromise and other medical conditions, is rare.聽聽in the US, South Africa and the UK have suggested that although there may be a higher hospitalisation rate with Omicron compared to Delta infection they were聽聽(less likely to need ICU, ventilation or lead to death).
We also know the risk of vaccination, principally聽, is rare in children under 11 years old (but under active surveillance) and side effects are proportionally larger in聽.
At present, the benefits of vaccination are smaller than for adults and the majority of already-vaccinated young teenagers are not experiencing severe disease.
The most up-to-date advice from ATAGI is聽聽and shown below. But as the benefit versus risk equation continues to change, expect these recommendations to change too. Remember the aim remains the same: to prevent serious illness for you and in our community.
This article was first publiched on聽聽and written by聽Associate Professor Nicholas Wood聽from the Faculty of Medicine and Health at the University of Sydney.