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COVID-19 booster shots (4th shot) available for patients 16+ years old with chronic conditions

The Australian Technical Advisory Group on Immunisation (ATAGI) has approved a fourth COVID-19 vaccine dose for people 16 years and over with chronic medical conditions such as diabetes. Previously the 4th shot was only authorised for those over 65 years of ago or those who are immunocompromised (have weakened immune systems). The latest information is available here.

Under the new guidance, people with a medical condition that increases the risk of severe illness (see list below) are now eligible, as are those with a disability who have significant or complex health needs, or multiple comorbidities that increase the risk of poor outcomes from COVID-19.

Fourth COVID-19 vaccine dose for chronic conditions

People within the new expanded group are those aged 16–64 with conditions including:

• Cancer, with examples as follows: Non-hematological cancer including those diagnosed within the past five years or on chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy (active treatment or recently completed) or with advanced disease regardless of treatment. Survivors of childhood cancer
• Chronic inflammatory conditions requiring medical treatment with disease modifying antirheumatic drugs (DMARDs) or immunesuppressive or immunomodulatory therapies with examples as follows: Systemic lupus erythematosus, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and similar who are being treated
• Chronic lung disease with examples as follows: Chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease and severe asthma (defined as requiring frequent hospital visits or the use of multiple medications).
• Chronic liver disease with examples as follows: Cirrhosis, autoimmune hepatitis, nonalcoholic fatty liver disease, alcoholic liver disease
• Severe chronic kidney disease (stage 4 or 5)
• Chronic neurological disease with examples as follows: Stroke, neurodegenerative disease (eg dementia, motor neurone disease, Parkinson’s disease), myasthenia gravis, multiple sclerosis, cerebral palsy, myopathies, paralytic syndromes, epilepsy
• Diabetes mellitus requiring medication
• Chronic cardiac disease with examples as follows: Ischaemic heart disease, valvular heart disease, congestive cardiac failure, cardiomyopathies, poorly controlled hypertension, pulmonary hypertension, complex congenital heart disease
• People with disability with significant or complex health needs or multiple comorbidities which increase the risk of poor outcome from COVID-19, particularly those with trisomy 21 (Down Syndrome) or complex multisystem disorders
• Severe obesity with BMI ≥ 40 kg/m2
• Severe underweight with BMI < 16.5 kg/m2

ATAGI said the list is not exhaustive, and that ‘providers may include individuals with conditions similar to those listed below, based on clinical judgment’.

No need for a 4th shot for the general population

The ATAGI said that for the general population, ‘There are no data to support the use of any additional primary doses of COVID-19 vaccine after a third primary dose’.  ‘Patients who do not respond to third doses may not respond to subsequent doses’.

The third dose is recommended between two and six months after the second dose. However, ATAGI said that a shorter interval of four weeks could be considered ‘in exceptional circumstances’, including ‘anticipated intensification of immunosuppression’, as well as outbreaks.

Other vaccine updates

ATAGI also reiterated that the additional winter doses should be delayed three months after a confirmed COVID-19 infection has cleared.

In March, ATAGI recommended a fourth dose for all over-65s, as well as all residents of aged and disability care facilities, regardless of age. Those aged 16 and above with severe immunocompromise and Aboriginal and Torres Strait Islander people aged 50 and older were also included in that recommendation.

Making a booster booking

Making a booking is simple and can be done online using the BOOK NOW button on top of this page or by calling 02 9817 2080. There is no waiting list.

As usual, vaccination will occur at our vaccination clinic on level 1 which is accessible by the internal lift or outdoor stairs. Please wear a mask and follow the signs.