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With COVID-19 vaccination rates reaching the double dose rate for the states and territories to open up, Australia is poised to begin living with COVID-19.

While the vast majority of Australians welcome reduced restrictions, the physical and psychological implications for people with compromised immune systems may, understandably, lead to increased anxiety.

We, therefore, welcome the announcement by the Australian Technical Advisory Group (ATAGI) recommending booster shots of the COVID-19 vaccine for people who are severely immunocompromised and might not be fully protected by the regular two doses of a vaccine.

Recommendations specific to the 3rd dose:

  • An mRNA vaccine (Pfizer or Moderna) is preferred to Vaxzevria (AstraZeneca) for this 3rd dose.
  • AstraZeneca can be used for the 3rd dose for individuals who have received AstraZeneca for their first 2 doses if there are no contraindications or precautions for use, or if a significant adverse reaction has occurred after a previous mRNA vaccine dose which contraindicates further doses of mRNA vaccine (e.g., anaphylaxis, myocarditis).
  • The recommended interval for the 3rd dose is 2 to 6 months after the 2nd dose of vaccine. A minimum interval of 4 weeks may be considered in exceptional circumstances (e.g., anticipated intensification of immunosuppression, outbreaks). People who have had a second dose more than 6 months ago should receive a 3rd dose whenever feasible.

Among the eligible groups, ATAGI has identified people with active haematological malignancies, people with cancer on current active treatment including chemotherapy, radiotherapy, and/or hormonal therapy, but excluding immunotherapy with immune checkpoint inhibitors, and some immunosuppressive therapies for chronic conditions.

More information on the ATAGI recommendation can be found below.

ATAGI statement on the use of a 3rd primary dose of COVID-19 vaccine in individuals who are severely immunocompromised | Australian Government Department of Health