Covid-19 vaccine booster shots: What Australians can expect as the world starts giving third jab
As Australia’s vaccination rollout continues, the world is already giving booster jabs. Experts reveal what we can expect and how it will affect you.
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As Australia edges closer to the magic vaccination rates that hold the promise of freedom from Covid lockdowns, restrictions and oppressive public health orders, talk is already turning to the question of what happens next.
Will there be annual rollouts of booster shots similar to the annual flu shot? And without them will we not inevitably find ourselves right back where we are now, as new and more virulent strains of Covid emerge in the months and years ahead?
Some scientists argue that it’s far too early to form a clear view, and that attention should be focused on hitting those vaccination targets of 70 and 80 per cent, while others are already talking about squireling excess vaccine stock away for booster use.
The reality is that we still have a fair way to go before we declare most Australians are fully vaccinated. Data from the Australian Government’s Operation COVID Shield showed that as of September 6, 63.8 per cent of people over the age of 16 had received one dose of Covid vaccine, and 39 per cent had been fully vaccinated.
Other countries have already started announcing — and even rolling out — booster programs. Not all countries will be offering the shots to the general population, rather focusing on the immunosuppressed, vulnerable and elderly. Countries include Israel, Austria, Hungary, Belgium, Germany, parts of the US, Ireland, Lithuania, Sweden, the UK, and Serbia.
Their decisions are based on a theory that the Delta variant will drive up infections, and that protection from some vaccines may wane over time. There has been some early research undertaken in this area, and while some has shown a booster reduces the odds of testing positive to Covid, researchers agree that further studies are needed over time to determine the level and duration of protection offered by a third dose of the vaccine.
A spokesperson for Federal Health Minister Greg Hunt said the Australian government’s Australian Technical Advisory Group on Immunisation (ATAGI) was ready to address any longer term immunity or emerging variants of the virus through additional doses if it is needed.
“ATAGI is closely monitoring local and international data about the frequency and severity of Covid-19 infection in fully vaccinated individuals to inform future booster strategies,” she said.
“ATAGI is also reviewing the international data on the efficacy, effectiveness and safety of additional doses for high-risk patient populations and the population more generally.”
Based on current evidence, ATAGI recommends using the same Covid-19 vaccine for the two doses of the primary course. The group has also provided clinical advice for the circumstances under which a mixed schedule can be used.
“These circumstances include a serious adverse event following the first dose of a COVID-19 vaccines, people with specific precautionary conditions and people who may have received an incomplete course of a Covid-19 vaccine brand not available in Australia,” the spokesman said.
Epidemiologist Professor Tony Blakely from Melbourne University last week said the extra doses of Pfizer coming into Australia this month would make a big difference.
“This is good news because it means we can vaccinate more people quicker with Pfizer and Pfizer reduces transmission more than AstraZeneca,” he said.
“The good news is we’ll have a lot of mRNA vaccines in a few months and we’ll be able use them as booster for people who have had AZ and for kids. We’re now pretty confident the vaccines work well in combination.”
But Canberra-based infectious diseases expert Professor Peter Collignon said he didn’t think the issue of booster shots should be on the table for discussion in Australia yet, especially given the fact that national targets for full vaccination are still a way off.
He said Australians should not lose focus on achieving full vaccination as a priority, adding that it offered the best protection against the virulent Delta strain of Covid.
“The people who are getting sick and hospitalised are primarily the unvaccinated,” he said.
“The vaccine was designed to stop you dying or getting seriously ill and the data is showing that the Pfizer and AstraZeneca are still very good at doing this.”
He said there was not solid data yet to suggest vaccine efficacy was waning.
“At the moment out problem is not boosters, it’s getting everyone vaccinated,” he said.
Professor Collignon also believes that mixing and matching vaccines, such as having Pfizer for a first dose and AstraZeneca for the second, was likely to become accepted practice in the months to come.
“If anything you might get a better immune response, although the down side is the side effects like low-grade fever may be more severe,” he said. “The reality is we are going to end up mixing and matching. There is no data to suggest it is a problem.”
Professor Collignon said there were also ethical issues associated with offering booster Covid vaccines when so much of the world remained unvaccinated and pointed out that some of the poorest countries where there was low vaccination presented risks of new variants developing that could affect the rest of the world.
Virologist and physician, Professor Kanta Subbarao, director of the WHO (World Health Organisation) Centre for Reference and Research on Influenza at the Doherty Institute agrees.
In a podcast released by the Institute, she said Australia was on par with other high income countries when it came to vaccination rates, but in low income countries only 2.14 per cent of people had received a first dose of vaccine.
The WHO has publicly appealed to countries to hold off on boosters until at least the end of September, by which time it hopes at least 10 per cent of every country’s population will be vaccinated.
Professor Subbarao said neighbouring countries like PNG and Fiji were seeing far greater outbreaks of Covid than seen in Australia.
“Rather than talking about booster doses, third doses, I think we should be taking a very good look at providing vaccines to our neighbouring countries,” she said.
“I think that we cannot begin to talk about opening up our borders if we aren’t doing more to help countries around us, countries from which travellers will come, that will introduce the virus onto Australia when the borders open.”
Professor Subbarao said there was no evidence to support routine booster shots – except perhaps in immunosuppressed people – had any benefit.
“We have shifted our expectations to actually wanting the vaccine to reduce transmission,” she said.
“These vaccines were not designed to reduce transmission. If they reduced transmission that was an extra, but now that is something we want to see happen because we want this pandemic to be brought under control.”
The principal behind administering an additional dose would be to shore up those levels of antibodies that were waning in the hope they would provide better protection against the Delta variant, and may in fact prevent and reduce transmission.
“We have no evidence, no data to say that would happen, but there’s a real tension because the policy makers and politicians are responsible for protecting their own citizens and that is what they want to do and if the scientific evidence says that there might be a benefit to a third dose and they can afford to buy that third dose they want to do that,” Professor Subbarao said.
“On the other hand, the tension is the fact that if we recognise that this pandemic is continuing as it is because people are unvaccinated – 98 per cent of the world’s population is unvaccinated – so what is the end game?
“How do we get out of this if we just keep vaccinating people in middle and high income countries over and over and over again, while new variants emerge because there’s uncontrolled replication of the virus in other countries around us?
“It’s not feasible to maintain this strategy of vaccinating people that are already vaccinated and not vaccinating people that aren’t because it’s the new variants that emerge that are really causing the issue of whether to revaccinate.”
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