3rd Sep 2021
1. The Expert Committee on COVID-19 Vaccination (EC19V) has been closely reviewing the data regarding the need for additional vaccine doses and recommends the following:
a. Persons with moderate to severe immunocompromise should receive a third dose of the same Pandemic Special Access Route (PSAR) mRNA vaccine two months after their second dose as part of their primary course of vaccination, and,
b. Persons aged 60 years and above, as well as residents of aged care facilities should receive a booster dose of a PSAR mRNA vaccine six to nine months after the completion of vaccination with two doses
Persons with moderate to severe immunocompromise
2. Immunocompromised persons are at risk of severe COVID-19, and a protective immune response from vaccination will be important to reduce this.
3. There is evidence that persons with moderate to severe immunocompromise have a blunted immune response to the two-dose COVID-19 vaccination. Studies have shown that a third dose increases the likelihood that immunocompromised persons develop a robust protective immune response.
4. As such, EC19V recommends that persons who are significantly immunocompromised receive a third dose of the same PSAR mRNA vaccine they had received for the first two doses, two months after their second dose. This will include persons with the following conditions:
a. Transplant patients on medications that suppress the immune system, including solid organ and allogenic stem cell transplants
b. Cancer patients on active treatment with chemotherapy or on other therapies that suppress the immune system
c. Haematological cancers
d. Treatments for non-cancer conditions that suppress the immune system
e. End-stage kidney disease on dialysis
f. Advanced or untreated HIV
5. Persons who are significantly immunocompromised should be referred to receive the third dose by their doctors, who would have the best understanding of their medical condition.
Persons aged 60 years and above, as well as residents of aged care facilities
6. Seniors are also at risk of more severe disease with COVID-19 infection, and ensuring a continued high level of immunity is therefore important. Seniors may develop a lower immune response to the initial two doses of vaccines, and immunity has also been observed to decline over time. While COVID-19 vaccination continues to provide a high level of protection against severe disease from infection, there is data that protection against asymptomatic and symptomatic infection can wane over time from the initial vaccination. The current strong protection against severe disease could decrease in the months ahead particularly for those who are at higher risk. A booster dose will increase the level of immunity and ensure that a high level of protection from severe disease is maintained across a longer period.
7. As such, EC19V recommends that persons aged 60 years and above, as well as residents of aged care facilities should receive a booster dose of a PSAR mRNA vaccine six to nine months after having completed a vaccination with two doses.
8. EC19V encourages immunocompromised persons to receive three doses as part of their primary series vaccination, and for seniors to receive a booster dose six to nine months after their second dose. This will help ensure high levels of protection against COVID-19 infection and severe disease. All other medically eligible persons should complete two doses of PSAR mRNA vaccines if they have not already done so.
EXPERT COMMITTEE ON COVID-19 VACCINATION
3 SEPTEMBER 2021