Key Points
- Some Aussies upset they can't get new COVID vaccine.
- Omicron-specific vaccine is being rolled out this week.
- It's only been recommended for those who haven't had all their boosters or those who are severely immunocompromised.
The rollout of the first Omicron-specific bivalent COVID-19 vaccine has raised questions about whether Australians who have already had four doses should be able to get a fifth.
On Monday, the rollout began of , which targets the original 2020 COVID-19 variant as well as Omicron variant BA.1. The updated vaccine also appears to give some extra protection against subvariants BA.4 and BA.5, the main Omicron variants circulating in Australia.
The Australian Technical Advisory Group on Immunisation (ATAGI) has recommended the vaccine can be used for any booster dose (your third or fourth vaccine) in people aged 18 years or older.
But some Australians who have already had four doses of the vaccine when they were eligible some months ago, want to be able to get a fifth dose and question why the government hasn't put this forward as an option.
In response to this week, SBS News received several comments from people in Australia seeking information about how to get their fifth dose.
Melbourne man Jeff (not his real name) told SBS News he was upset at being unable to access the new vaccine, which is readily available in the United States and Singapore. He has already had a fourth vaccine dose and has never had COVID-19.
Jeff, who is aged in his 30s, said there were "equally smart" experts working in the US, Singapore and Australia yet "somehow Australia is much more restrictive than the other two".
"It's just so in your face that Americans have it and we don't, why not?"
"It's that sense of your brother or sister getting something, and you don't - it's that sense of unfairness."
Who can get a fifth dose in Australia?
The only group for which a fifth dose is currently recommended are severely immunocompromised people aged 16 years or older. They can get a fifth dose three months after their fourth dose.
This is in contrast to Singapore, where the Ministry of Health has recommended the bivalent as an additional fifth booster dose for everyone over the age of 18, because it broadens protection against variants and potential future ones. Americans have access to an even more advanced version of the vaccine, which targets the BA.4 and BA.5 variants.
University of Newcastle Associate Professor Nathan Bartlett, who is a viral immunologist, said there could be a number of reasons why Australia is not yet recommending the Moderna bivalent as an extra fifth dose.
He said COVID-19 cases were relatively low at the moment and were expected to stay fairly low as Australia headed into the warmer months. Average daily case numbers are down in every state except Western Australia and Victoria. In total Australia was recording around 5177 cases a day on 4 October, and there were 189 deaths in the week ending 7 October.
"I think it's a matter of focusing our attention on getting those who haven't had their full course of boosters, getting them boosted," he said.
"Perhaps talking about a third booster might just complicate that message a little bit ... so I think it's just keeping that messaging relatively straightforward."
The World Health Organisation's Strategic Advisory Group of Experts on Immunisation (SAGE) has said while the variant-containing vaccines had a "slightly superior neutralisation of the Omicron variant", it was a relatively modest effect that had only been seen in the laboratory. Effectiveness data is not yet available and so it is not yet recommending the bivalent vaccines be preferred over the original vaccines.
"These vaccines are absolutely fine, but what is much more important" for protection "is that you actually take the vaccine," SAGE executive secretary Joachim Hombach said on 11 October.
Around 72.2 per cent of Australians aged 16 years and over have had a third vaccine dose, but this drops to just 41.2 per cent of those aged 18 years and over for the fourth dose.
"These mRNA vaccines are incredibly safe," he said. "If there was concern that your protection was now waning, and you felt the need to get a third booster, then I wouldn't see any medical reason not to do that.
"Again it's more about supply, prioritising those who need either the first or second booster and getting them boosted as a priority."
When asked whether someone getting a fifth vaccine dose even if it was not recommended for them would still be eligible for the COVID-19 Vaccine Claims Scheme, which provides compensation for those suffering negative impacts from vaccination, a spokeswoman for the Department of Health and Aged Care said "the TGA approved vaccine must be used as recommended under the National COVID-19 Vaccine Program".
Should I wait for the vaccines targeting BA.4 and BA.5 instead?
The US has already approved bivalent vaccines targeting BA.4 and BA.5 from both Moderna and Pfizer, and has recommended people aged over 12 years old get boosted if it has been at least two months since their last dose.
Chief medical adviser to the US President, Dr Anthony Fauci (right) got a COVID-19 booster shot this month to protect him from BA.4 and BA.5 in the US while filming a segment for Stephen Colbert's (left) show. Credit: Raymond Hall/GC Images
"The FDA is seeing that as good enough evidence to fast track its approval and so now they can be rolled out as part of that in the USA," he said.
"Whether that level of evidence is sufficient for the TGA (Therapeutic Goods Administration) or ATAGI to similarly approve its use in this country, I don't know, we shall see."
Australia has not yet approved a specific vaccine to target BA.4 and BA.5. Source: AAP
But Professor Bartlett said it was unclear how long it could take for the vaccine to be made available in Australia. He warned it was also possible a new variant could emerge and the Omicron-targeting vaccines would then no longer be matched to the dominant strain.
"If you're needing your boost, either first or second boost, then you go and get boosted," he said.
"Really, whatever vaccine is available, the priority is to get boosted now, because we know that without one or two boosts, your immunity will be substantially lower and so you will be far more vulnerable.
"You're much better getting some better protection than none at all and waiting."
Infectious diseases specialist Associate Professor Sanjaya Senanayake of Australian National University said UK data showed the "old" mRNA vaccines (Pfizer and Moderna) still provided good protection against severe disease more than 15 weeks after being administered.
Professor Senanayake said mathematical modelling from Australia had shown that when around 50 per cent of the population is immune to COVID-19, which is similar to the situation in Australia, an Omicron-specific vaccine doesn't add too much of a benefit over the original mRNA vaccines.
"The take-home message would be that it is good to have the new BA.1 bivalent vaccine if you are eligible for a booster, as it is likely to give a slight benefit for severe disease over the current boosters in the current Australian COVID-19 climate," he said.
"But the current mRNA boosters still do a great job too."
The Moderna Spikevax bivalent vaccine is available at sites listed on the
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