THE Sentinel-Times joined the rising crescendo of calls for an immediate rollout of booster shots, especially in aged care where residents were vaccinated in February and March this year, and for whom the protection of their COVID-19 vaccination is waning.

And on Wednesday, October 20, the Australian Health Minister, Greg Hunt came to the party.

During a press conference in Canberra, with Professor Paul Kelly, the Chief Medical Officer of Australia, he said it was his intention to rollout the booster shots in Aged Care in the second week of November.

But, just as importantly, he said there wouldn’t be a need to prioritise groups to receive the booster shots next because Australia had more than sufficient supplies to meet all demand.

In his opening remarks, Mr Hunt paid tribute to the people of Australia for coming out in such numbers to get vaccinated.

“So, to Australians, I want to say thank you and congratulations, but keep going. There are many people still to come forward for first doses and there are many people still to come back for their second doses, and that second dose program is providing real and significant protection.

“Just to put this in context, I think it’s important to acknowledge what’s happened here in the ACT. The ACT is at 98.1 per cent first vaccinations – it is one of the most highly vaccinated societies in the world.

“Victoria is close to the 90 per cent mark, it’s at 89.2 per cent first doses. In terms of second doses, South Australia has hit a key milestone, South Australia is at 60 percent. And Tasmania and Victoria are expected to pass the 70 per cent mark within the coming 24 to 48 hours.”

Mr Hunt also provided an update on the booster program.

“But the consideration through the TGA, which has to receive an application from the respective vaccine manufacturers, is in advanced consideration and we’ll have a critical meeting next Monday with regards to the Pfizer vaccine. Moderna and AstraZeneca, at this stage, are still to submit their booster vaccine application,” Mr Hunt said.

“It’s different from the third dose for immunocompromised, which was considered part to the primary treatment program, and that’s why that decision was able to be made.

“But we are expecting that there will be two parts to any advice in relation to the TGA and ATAGI, and that would be aged care – we want to commence that in the second week of November subject to advice that we have and subject to confirmation both from ATAGI and the TGA and the general population; and Paul will run through those.

“But we’re ready. We’re in a position to commence and, and to make sure that that additional protection is provided.”

Professor Paul Kelly said Australia’s booster program was under active consideration.

“On the booster program, that is currently actively being looked at with ATAGI, I had several meetings with the ATAGI group, the Australian Technical Advisory Group on Immunisation, who reports directly to the Minister for Health, yesterday about boosters, and to hear the latest information we have from around the world.

“There are several countries now that have started on booster programs in different, different ways, but particularly in Israel, where they’ve gone very rapidly with a, with a booster program for the whole population, and we were able to look at the data that had come out from Israel yesterday.

“And it very much confirms that this is a safe, that it is effective in all age group for both decreasing infection as well as severe disease, and then for the older age groups, death – preventing- prevention of death.

“That is absolutely proven now from the Israeli data. That is the way that they have done it, and, and that’s before ATAGI now to be looked at.

“And the Minister has also mentioned the TGA has their processes as well, working with Pfizer in the first instance because that company has provided all of the information about booster programs, dose, and how, how long after the second dose that might be given. And we fully expect other, other companies, particularly Moderna, to come through with that information in coming months.

JOURNALIST: “Can I just clarify on the booster program? So, you mentioned starting with aged care and then moving to the general population. Will you roll through priority groups like with the initial rollout or will it be aged care first and then everyone else?”

GREG HUNT: “I’ll let Paul add to it. But there’s unlikely to be the need to prioritise because we have sufficient vaccine and so Paul will update in particular on the ATAGI deliberations.

“But the simple thing is time. And because we have sufficient vaccine, we have a system capable of delivering, my understanding is, every state and territory has spare capacity at this point in time.

“So, we want to keep the machine running to keep the program rolling and that would mean we would be one of the first countries after Israel and I know consideration is on elsewhere if we were to move to a whole of population program.

“But that’s the ATAGI advice, it’s clear direction there likely to go towards aged care, it’s likely that we’ll have general population but we also have to actually have the ATAGI- the TGA approval. Now, that’s in the late stages. Key meeting next week. Then they would work with Pfizer.

“And then once that’s approved, we’re looking to commence the aged care program in the second week but there wouldn’t be any barrier once there was product approval for any aged care facility of they wish to or state to commence before that time.”

PAUL KELLY: “So, couple of things I’d quickly say there. Just firstly, doubly vaxxed, first course of the vaccine means you’re fully vaccinated.

“So, for anything that’s coming through on phase B, phase C, phase D of the national plan, fully vaccinated means you’ve completed your first and second dose.

“The booster gives you a boost in your protection. And certainly, as the Minister has said, ATAGI is going through that advisory advice to Government about how that should be best done, and we will have that very soon.”

GREG HUNT: “We have the supply, we have the mechanism, the last part is the medical advice and the medical approval.”

JOURNALIST: “Just to follow that question, is it likely that the whole general population will need a booster shot or is it more likely to be people in the healthcare sector and are dealing with a lot of COVID patients? Can you give us some more detail on that? And just maybe to the Minister as well, you said that, moving into 70 per cent double vaccinated through phase B, can you give us more idea on what should be happening now that we’re in phase B?”

PAUL KELLY: “So, I’m not going to pre-empt the ATAGI advice. But just going back to the Israeli data again, they found this was effective in all age groups. And so- and as the Minister has said, we have the supply, enough supply to give to all age groups but we’ll wait for the ATAGI advice on that.

I think the other thing that’s- that has generally being done, in fact, all of the booster programs around the world have done this. They’ve picked a time after the second dose of the vaccine, that’s varied in some countries, so we’ll see what ATAGI’s advice is on that.

“When you think back to how we started the program earlier this year, there was a priority of older people, aged care, those 1A and 1B priority. So, they will be the first in line because they are now six or more months after the- after that second dose.

“So, it’s likely that they will be doing the first ones to get it, but let’s see what ATAGI comes up with.”

JOURNALIST: “Minister, how prominent do you think that the booster campaign will be? Will it be like first and second shots that politicians are speaking about the necessity of getting a booster every day, encouraging the public to show up? Or is it going to be perhaps more like other immunisations that we have in the course of our general life? And is it possible to get an update on any progress on under 12 vaccinations?”

GREG HUNT: “Sure. So, in terms of boosters, yes, we will be supporting it with an advertising campaign, we will be encouraging people. But as Paul said, it’s a booster, you’re fully vaccinated at two doses.

JOURNALIST: “Under 12s?”

PAUL KELLY: “So, for the under 12s, the way that this works of course is we rely on the company, the pharmaceutical company to come to the TGA at the first instance and then there will be advice from ATAGI just as we’re doing with the booster program.

“At the stage, we don’t have any advice from the company although we do understand that they have provided information to the FDA which is the US equivalent of the TGA. And we expect some decision from them later this month or earlier next month.”

GREG HUNT: “So, we have the supply, we have the distribution mechanism, we’re ready to do it. And I think the 12 to 15 campaign is the best example. Advice was provided, we opened up two weeks later and then, 12 to 15 -year-olds have done a fantastic job along with their parents.

“Although, in my case, in my family, I had to get out of the way of my 12-year-old. You know, he said he was off to the pharmacy and so, that’s just one example.”

US booster study

On October 16, 2021, the world’s leading medical journal, The Lancet, published a comprehensive study on the waning effect of the Pfizer vaccine. UK studies have found similar results with AstraZeneca and other vaccines, that their effectiveness wanes over time.

In the USA study, between December 14, 2020, and August 8, 2021 some 4,920,549 double vaccinated individuals were assessed to evaluate overall and variant-specific effectiveness of BNT162b2 (Pfizer–BioNTech) against SARS-CoV-2 infections and COVID-19-related hospital admissions by time since vaccination among members of a large US health-care system.

In summary, the study found:

“For fully vaccinated individuals, effectiveness against SARS-CoV-2 infections was 73% (95% CI 72–74) and against COVID-19-related hospital admissions was 90% (89–92). Effectiveness against infections declined from 88% (95% CI 86–89) during the first month after full vaccination to 47% (43–51) after 5 months. Among sequenced infections, vaccine effectiveness against infections of the delta variant was high during the first month after full vaccination (93% [95% CI 85–97]) but declined to 53% [39–65] after 4 months. Effectiveness against other (non-delta) variants the first month after full vaccination was also high at 97% (95% CI 95–99), but waned to 67% (45–80) at 4–5 months. Vaccine effectiveness against hospital admissions for infections with the delta variant for all ages was high overall (93% [95% CI 84–96]) up to 6 months.”