More in line for a fourth Covid jab

Anthony Albanese says it is a question of ‘when, rather than whether’ more Australians will be allowed a fourth dose.

The Australian Technical Advisory Group on Immunisation is weighing up whether to recommend expanding Covid vaccine doses. Picture: Getty Images

Anthony Albanese says it is a question of “when, rather than whether” more Australians will be allowed a fourth dose of Covid-19 vaccine, as the Australian Technical Advisory Group on Immunisation weighs up whether to recommend expanding doses on Wednesday.

As Covid-19 hospitalisations grow and state health systems are battered by both the latest pandemic wave and a boom in flu cases, state health officials say an expansion in the number of Australians getting fourth doses must be considered.

Health Minister Mark Butler is also pushing medical authorities to give more Australians ­access to Covid-19 antiviral drugs, warning the current rules are too restrictive and nearly a million doses could go to waste.

The Prime Minister signalled on Tuesday night that expansion of the vaccine program was getting more likely. “I know that the authorities including ATAGI are looking at that. I think it’s a question of when rather than whether it will happen. We need to make sure that people continue to keep up their vaccinations,” he told Perth’s 6PR radio.

“I know a priority was making sure that people get their third shot, their booster shot, because the numbers weren’t as high as the health experts would have liked.”

The push to expand access to fourth vaccine doses comes as cases of the BA. 5 Omicron subvariant continue to increase and the new wave expands from the eastern states to the west.

There were 36,446 cases of Covid-19 recorded nationally on Tuesday and 46 deaths.

A total of 3511 people across Australia are in hospital with Covid-19 – with 118 patients requiring intensive care – according to the latest health department data.

Before Mr Albanese’s comments, Mr Butler on Tuesday said it was likely ATAGI would resist expanding fourth doses to all Australians, and may opt to add people aged between 50 and 60 to the current cohort. “Maybe ATAGI doesn’t make any change or maybe it simply reduces the age threshold down to something like 50 or 55 as we’ve seen in some other countries,” he told The Guardian.

The latest commonwealth data shows there have been 147,155 cases of flu so far this year, with the weekly case tally for June running well above the previous five-year average.

NSW Health Minister Brad Hazzard in Sydney said he had raised expanding fourth doses with other health counterparts in the past week. “I actually raised the issue at the health ministers’ meeting last Thursday and Friday … my view is we need to broaden it and we need to move quickly,” he said.“ Let’s get a fourth dose if we can do it.”

Australian Medical Association vice-president Chris Moy said younger people still had strong protection from severe disease if they had received one booster, and the increase in ­protection from infection that was conferred by a fourth vaccine waned quickly.

Dr Moy said the AMA was encouraging everyone over 65 to get a fourth shot, but were most concerned about those of all ages who had not had one booster.

“The studies from Israel where they’ve really been the first to give fourth shots have found that against Omicron, it basically only gives you short-term protection from prevention of infection, and the only major group that got the main benefit from reduction in severe disease and hospitalisation was those over 60,” he said.

“Whereas for people under 60, even if they only had the one booster, their protection against severe disease and hospitalisation was maintained.”

Dr Moy said that based on his discussions with ATAGI, there were several challenging aspects to deliberations on fourth shots. “They don’t want to get caught in a situation where they are accused of recommending a fourth shot too early with no evidence it is going to increase much of the benefit except for a slight transient reduction in infection rate but no increased benefit against severe disease,” he said.

But infectious disease and vaccine trial expert Paul Griffin said that even if immunity was boosted for only two to three months after a fourth shot, that could prove crucial in the midst of a winter BA. 5 wave. “As we do go through a very significant wave, even if we do see those sort of increased immunity levels for 10 to 12 weeks, that would obviously still be very helpful in among a big wave of transmission,” Professor Griffin said.

“I guess it’s the numbers ending up in hospital that’s a concern, and an additional dose would help to reduce that to a degree.”

University of Melbourne epidemiologist Tony Blakely said there were pros and cons in recommending fourth shots now.

“It will definitely help with reducing how much transmission there is,” Professor Blakely said. “For those people who are less than 65 and don’t have comorbidities having a booster now would give them a little bit more protection, so on all those aspects it makes good sense.

“On the other side we are getting to the point where we have to ask what is the cost-effectiveness of doing this, because the virus will still keep transmitting.”

State health chiefs, as well as the Australian Medical Association, say their main immediate concern is for those who have not yet received their initial booster.

Only 70 per cent of eligible Australians are vaccinated with a booster shot. Queensland’s booster rate is only 58.6 per cent.

In NSW, 64.6 per cent of people have had a booster, a low figure that state Health Minister Hazzard blamed on apathy.

“If you haven’t had your full three, to put it bluntly, you’re crazy,” he said.

The consideration of fourth doses came as Mr Butler met officials from the Pharmaceutical Benefits Advisory Committee on Tuesday. The Commonwealth has put in a formal submission to expand the current guidelines on antivirals, as state ministers call for change to combat growing Covid-19 hospital cases.