Paddington Family Practice is delivering 1st, 2nd and booster doses of Pfizer vaccination.
All people aged 12 years of age or older are now eligible for the primary 2 dose schedule of Pfizer vaccination 3 weeks apart.
From Monday 11th October patients who are severely immunocompromised are recommended to have a primary 3 dose schedule to boost their level of protection. This means that a third dose of Pfizer vaccination is recommended 2 months after their second covid19 vaccination. (see below for list of conditions for which 3rd doses are recommended as part of the primary schedule)
From 28th October all people aged 18 years or older are eligible for Pfizer booster 6 months after their second dose of covid vaccination, regardless of whether this vaccine was Pfizer, AstraZeneca or Moderna.
Pfizer 3 Dose Primary Schedule Information
Recommendations on the use of a 3rd primary dose of COVID-19 vaccine in individuals who are severely immunocompromised
• ATAGI recommends a 3rd primary dose of COVID-19 vaccine in severely immunocompromised populations to address the risk of suboptimal or non-response to the standard 2 dose schedule. The 3rd dose is intended to maximise the level of immune response to as close as possible to the general population.
• ATAGI recommends that all individuals aged ≥12 years with certain conditions or on therapies leading to severe immunocompromise, as defined in Box 1, receive a 3rd primary dose of a COVID-19 vaccine.
• An mRNA vaccine (Pfizer or Moderna) is preferred to Vaxzevria (AstraZeneca) for this 3rd dose. AstraZeneca can be used for the 3rd dose for individuals who have received AstraZeneca for their first 2 doses if there are no contraindications or precautions for use, or if a significant adverse reaction has occurred after a previous mRNA vaccine dose which contraindicates further doses of mRNA vaccine (e.g., anaphylaxis, myocarditis).
• The recommended interval for the 3rd dose is 2 to 6 months after the 2nd dose of vaccine. A minimum interval of 4 weeks may be considered in exceptional circumstances (e.g., anticipated intensification of immunosuppression; outbreaks). People who have received a 2nd dose more than 6 months ago should receive a 3rd dose as soon as feasible.
• An individual with an unlisted condition should only be considered for a 3rd dose where the treating physician has assessed the patient as having a similar level of severe immunocompromise to the listed conditions in Box 1, and where the benefits of a 3rd dose of COVID-19 vaccine outweigh the risks.
• Individuals who currently are not severely immunocompromised but who will commence significant immunosuppressive therapy ≥ 2 weeks after their 2nd dose do not require a 3rd dose, as it can be expected that an adequate response to 2 primary doses will be achieved.
• Antibody testing is not recommended to assess for immunity to SARS-CoV-2 following COVID19 vaccination, including in immunocompromised individuals after a 2nd or 3rd dose. There are no serological assays that provide a definitive correlate of immunity to SARS-CoV-2. ATAGI also does not recommend subsequent doses beyond the 3rd dose at this time. Many patients who fail to respond to 3rd doses may not respond to further doses.
• Protection from 3 primary doses in severely immunocompromised individuals may still be lower than the general population. Risk mitigation strategies such as mask wearing and social distancing should continue to be used even after receipt of a 3rd dose.
• ATAGI will continue to monitor the evidence around duration of protection and advise on the need for subsequent (booster) doses in immunocompromised populations to address waning of protection or risk from variants of concern.
• ATAGI will provide further advice on booster doses for healthcare workers, older adults and the general population separately.