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Information updates

ATAGI COVID-19 vaccine recommendations - December 2023

Monovalent COVID-19 Omicron XBB.1.5 vaccines are now available in Australia, following the Therapeutic Goods Administration of Australia (TGA) approval of the following XBB 1.5 vaccines for use as primary and additional doses:

  • Pfizer monovalent Omicron XBB.1.5 vaccine 5 - <12 years formulation (light blue cap)
  • Pfizer monovalent Omicron XBB.1.5 vaccine ≥12 years formulation (dark grey cap)
  • Moderna monovalent Omicron XBB.1.5 vaccine, registered for use in people aged 12 years and older.

The Australian Technical Advisory Group on Immunisation (ATAGI) advises the following:

  • All currently available COVID-19 vaccines are anticipated to provide benefit to eligible people, however the monovalent Omicron XBB.1.5 vaccines are preferred over other vaccines for use in children aged 5 years or older and adults who are currently recommended primary or additional doses of COVID-19 vaccine according to the Australian Immunisation Handbook
  • For those who have had the recommended 2023 dose/s of COVID-19 vaccine, ATAGI is not recommending further doses or re-vaccination with an XBB.1.5-containing vaccine at this time
  • ATAGI notes the recent increase in COVID-19 cases across Australia since November 2023. ATAGI encourages all people who have not yet had their recommended 2023 dose/s to receive them as soon as possible (see table below).

There are no monovalent XBB.1.5-containing vaccines registered for use in children aged 6 months to 4 years. Currently, Pfizer original (maroon cap) is the only formulation available for use in this age group. Providers can refer to the Australian Immunisation Handbook to check which vaccines are recommended by age group.

ATAGI updated the recommendations for doses of COVID-19 in February and September 2023. These recommendations have not changed at this time. As published in the September statement, the current recommendations for further doses are summarised below:

Table: Current recommendations for further COVID-19 vaccine doses (unchanged from September 2023)

 

first 2023 dose (February 2023 guidance)*

second 2023 dose (September 2023 guidance)*

 Age

At risk#

No risk factors

At risk#

No risk factors

<5 years

Not recommended

Not recommended

Not recommended

Not recommended

5-17 years

Consider

Not recommended

Not recommended

Not recommended

18-64 years

Recommended

Consider

Consider if severe immunocompromise^

Not recommended

65-74 years

Recommended

Recommended

Consider

Consider

≥ 75 years

Recommended

Recommended

Recommended

Recommended

  • *XBB.1.5-containing vaccine preferred for all doses. For eligible children aged 6 months to 4 years, use Pfizer Original 6 month - <5 year formulation (maroon cap) as the only available formulation for this age group. Timing: 2023 vaccine doses should be given from 6 months after a person’s last dose and can be given in early 2024, pending updated advice from ATAGI.
  • #Includes those with a medical condition that increases the risk of severe COVID-19 illness (refer to the Australian Immunisation Handbook) or those with disability with significant or complex health needs or multiple comorbidities which increase the risk of poor outcomes from COVID-19. 
  • ^ For details, refer to the ATAGI recommendations on the use of a third primary dose of COVID-19 vaccine in individuals who are severely immunocompromised.

Further information is available at https://www.health.gov.au/news/atagi-recommendations-on-use-of-the-moderna-and-pfizer-monovalent-omicron-xbb15-covid-19-vaccines

This news item was issued on 1 December 2023 by Jill Smith, CEO of ASCIA, the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.