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Wednesday, December 8, 2021

Experts agree on importance of third vax dose, particularly for vulnerable in aged care

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Numerous Australian medical experts have backed calls for a third COVID-19 vaccine dose this week, to ensure the ongoing protection of elders.

Leading the charge was doctor and journalist Dr Norman Swan, who told the ABC that the discourse should shift from talk of ‘boosters’ to a formal acceptance of COVID-19 vaccination as a three-step programme.

“These are three-dose vaccines… like Hepatitis B, like the human papilloma virus was initially…” he said.

The Federal Government has indicated in its National Plan that a booster campaign will commence once 70 per cent of the Australian population has been double vaccinated, a milestone met this week.  

But although the Australian Technical Advisory Group on Immunisation (ATAGI) has formally recommended a third dose for immunocompromised individuals, no advice has been released for the general, 60+ cohort.

“We need to have a campaign, one would have thought, starting now… to protect our most vulnerable,” Swan said.

“You’re already seeing outbreaks in residential aged care in New South Wales, elderly people are dying vaccinated,” Swan said.

Dr Karen Price, president of the Royal Australian College of General Practitioners (RACGP), told Aged Care News that formal advice regarding third-dose vaccinations should be received by next month.

“GPs will stand by for that advice,” she said.

“Our priority right now is giving people their first two jabs and providing a third primary dose to severely immunocompromised people.”

“There are reports this week that Pfizer is expected to suggest to the Therapeutic Goods Administration an eight-month gap between second and third doses.

“Given that many older people were early in the queue to receive their first and second doses, they will be amongst the first to receive their third vaccine if approved.”

Professor Nigel Mcmillan, program-director of infectious diseases and immunology at Griffith University, told Aged Care News that a third-dose schedule would follow international precedent.

“Other countries have taken this approach and targeted over 65s (UK) as well and I believe they will eventually recommend this [in Australia]. 

“Others have a blanket third dose for all (the US).”

It is unclear as to the consistency of vaccine supply, and in the event of a shortage, there is a clear policy dilemma: should we push for more of the general population to be double-dosed, or move to prioritise third doses for the older, more vulnerable cohort?

“Ideally we would want both,” McMillan said.

“Obviously as we get high community rates [of vaccination] the virus finds it harder to circulate and at 90 per cent we would be well covered.

“[But] as the majority of deaths are in over 60s it makes sense to boost.

“Version 2 vaccines will be better at herd immunity than current ones and they are slated to come in Q1 2022.”

Whatever the outcome for dosing regimens, MacMillan advises that hygiene measures established during the pandemic must continue to be adhered to as we embark on the road to COVID-normal.

“Because as we age things wear out, including our immune systems, even with a third booster some will not make a strong immune response, so it’s important to continue the other measures of protection, like vaccinated-staff, masks and hand washing.”

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