ATAGI Advice on winter dose of COVID-19 vaccine

The Australian Technical Advisory Group on Immunisation (ATAGI) recommends an additional dose of COVID-19 vaccine for winter for selected population groups who are at greatest risk of severe illness from COVID-19 and who have received their primary vaccination and first booster dose. These groups include:

• Adults aged 65 years and older
• Residents of aged care or disability care facilities
• People aged 16 years and older with severe immunocompromise (as defined in the 11th February 2022 ATAGI statement on the use of a third primary dose of COVID-19 vaccine in individuals who are severely immunocompromised)
• Aboriginal and Torres Strait Islander people aged 50 years and older.

ATAGI recommends the rollout of the winter dose for the above groups commence from April 2022 and coinciding with the rollout of the 2022 influenza vaccination program. The Australian Government has accepted this advice and will include the winter dose for recommended people in the COVID-19 Vaccination Program from 4 April 2022.

The additional winter COVID-19 vaccine dose can be:

• given from 4 months or longer after receipt of a previous booster dose of a COVID-19 vaccine OR
• given from 4 months after a confirmed SARS-CoV-2 infection if this has occurred since the previous booster

• co-administered with influenza vaccine.

In special circumstances, individuals may be able to receive their winter dose at a shorter interval. For example, in vaccination in-reach programs to aged care, disability care or remote communities, where some flexibility of the minimum interval may help vaccinate a larger proportion of individuals. However, it is important not to delay the influenza vaccine if an individual is not yet eligible for a second booster COVID-19 vaccine dose.

Comirnaty (Pfizer) or Spikevax (Moderna) are the preferred vaccines for this winter dose. Vaxzevria (AstraZeneca) can be used when an mRNA vaccine is contraindicated or a patient declines vaccination with an mRNA vaccine. Nuvaxovid (Novavax) can be used as a booster if no other COVID-19 vaccine is considered suitable for that individual.

Payments for the winter dose will remain the same as for the administration of other booster doses.

ATAGI Booster Advice

ATAGI continues to recommend:

• All individuals aged 16 and older to receive a booster dose of COVID-19 vaccine, 3 months following completion of their primary course. For most individuals this will be a third dose. This booster dose is important for protecting them against COVID-19.
• For any person aged 16 and older who has not received their first booster yet, ATAGI recommends they receive it as soon as possible, 3 months following completion of their primary course.

Protection against infection wanes after the first booster dose. However, protection against severe disease (rather than all infection) is relatively well maintained, especially in young healthy populations.