The Australian Technical Advisory Group on Immunisation (ATAGI) have updated their recommendations on the use of booster doses of COVID-19 vaccine in 2023.

ATAGI recommends a 2023 COVID-19 vaccine booster dose for adults in the following groups, if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received:

• All adults aged 65 years and over; and

• Adults aged 18-64 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.

ATAGI advises the following groups should consider a 2023 booster dose if their last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or longer, and regardless of the number of prior doses received, based on an individual risk benefit assessment with their immunisation provider.

• All adults aged 18-64 years without risk factors for severe COVID-19; and

• Children and adolescents aged 5-17 years who have medical comorbidities that increase their risk of severe COVID-19, or disability with significant or complex health needs.

ATAGI advises that a booster dose is not recommended at this time for children and adolescents aged under the age of 18 who do not have any risk factors for severe COVID-19

All currently available COVID-19 vaccines are anticipated to provide benefit as a booster dose, however bivalent mRNA booster vaccines are preferred over other vaccines. For ages in which a bivalent vaccine is not approved, use a vaccine approved for that age group.

Administration of a 2023 COVID-19 booster dose should aim to occur prior to June 2023 and at a time of 6 months or greater following the most recent COVID-19 vaccine dose or confirmed infection.

The Australian Government has accepted this advice and will include the 2023 booster dose for recommended people in the COVID-19 Vaccination Program from 20 February 2023.

In 2023, COVID-19 vaccines will continue to be principally administered by primary care providers such as general practitioners and pharmacists. All primary care vaccination sites may commence administering the 2023 booster doses to the eligible patients if they have available stock and appointments. To support the roll-out of the 2023 booster dose, all primary care sites have had their Pfizer bivalent (grey) allocations increased from 240 to 600 doses per fortnight. Please continue to consider your demand when placing orders. You can order less than your maximum allocation.

Streamlined payment arrangements for primary care came into effect from 1 February 2023. Payments for the 2023 booster dose will remain the same as for the administration of other doses.

COVID-19 Pfizer Bivalent BA.4-5 vaccine

Following the Therapeutic Goods Administration (TGA) granting provisional registration for the Pfizer (Comirnaty) Bivalent Original/Omicron BA.4-5 COVID-19 vaccine (Pfizer bivalent BA.4-5) vaccine for use as a booster dose in people aged 12 years and older, the ATAGI has provided the following recommendations:

• the Pfizer bivalent BA.4-5vaccine can be used as an alternative vaccine for booster doses in people aged 12 years or older, according to the current ATAGI 2023 Booster Advice.

• The Pfizer bivalent BA.4-5 vaccine is not currently registered for use in children aged younger than 12 years or as a primary course vaccination

• An approved alternative COVID-19 vaccine such as. Pfizer 5-11 years vaccine, should be used in children aged 5-11 years who require a booster dose.

The Australian Government will include the Pfizer bivalent BA.4-5 in the COVID-19 Vaccination Program for boosters in people aged 12 years or older from 6 March 2023. The Government intends to make the Pfizer Bivalent BA.4-5 vaccine available in all primary care sites participating in the vaccine roll-out who wish to administer the vaccine.

Primary Care has played a pivotal role in the success of the COVID-19 Vaccine Roll-out Program. Your continuing participation in the Program is vital to the success of keeping everyone in Australia safe during the pandemic and we look forward to continuing this working relationship in 2023.