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New ATAGI Recommendations for Omicron XBB.1.5 COVID-19 Vaccines

As our regions faces increasing numbers of COVID-19 cases, the Australian Technical Advisory Group on Immunisation (ATAGI) has issued updated advice regarding the use of Monovalent Omicron XBB.1.5 COVID-19 vaccines. Following the Therapeutic Goods Administration's approval, these vaccines are set to be included in the COVID-19 Vaccination Program from December 11, 2023 (1).

ATAGI advises that all currently available COVID-19 vaccines remain beneficial, but the monovalent Omicron XBB.1.5 vaccines are now preferred for specific groups. Notably, they are recommended for children aged 5 years and older, as well as adults eligible for primary or additional COVID-19 vaccine doses, according to the Australian Immunisation Handbook (2).

Currently a majority of Omicron subvariants circulating within Australia are a sub-lineage of XBB.1 (3). The World Health Organisation (WHO) is recommending COVID-19 vaccine formulations target the XBB.1 subvariant and move away from inclusion of the original strain (4). Human immunogenicity data demonstrated an 8.7 to 10.4 times increase in neutralising antibodies against the Omicron XBB.1.5 subvariant and other recently circulating subvariants at 29 days after receiving a dose of the Moderna monovalent XBB.1.5 vaccine (5).

For individuals who have received the recommended 2023 dose/s, ATAGI does not currently recommend further doses or re-vaccination with an XBB.1.5 vaccine. However, considering the recent increase in COVID-19 cases, ATAGI strongly encourages those who haven't yet received their 2023 doses to do so promptly (2).

Starting from December 11, 2023, Monovalent Omicron XBB.1.5 vaccines will be integrated into the existing COVID-19 Vaccination Program. All participating sites will be onboarded, receiving detailed information via email in the COVID-19 Vaccine Administration System (CVAS). An onboarding letter outlining ordering dates and other relevant details will be sent separately.

Approved Monovalent Omicron XBB.1.5 vaccines include:

  • b Pfizer (XBB.1.5) 5-11 years (Light Blue) vaccine is registered for use in people aged 5 years and older.
  • The Pfizer (XBB.1.5) 12 Years + (Grey) vaccine is registered for use in people aged 12 years and older.
  • The Moderna (XBB.1.5) 12 Years + (PFS) vaccine is currently registered for use in people aged 12 years and older.

There are no XBB.1.5-containing vaccines registered for children aged 6 months to 4 years, and providers are advised to consult the Australian Immunisation Handbook for recommendations for this age group.

While Novavax XBB.1.5 vaccine is not currently available, the original Novavax vaccine is suitable for individuals aged 12 years and older. However, ATAGI emphasizes a preference for an Omicron-based vaccine in this age group.

Recommendations for COVID-19 Doses

Source: Australian Government. Department of Health and Aged Care. ATAGI Update on the COVID-19 Vaccination Program (20/11/2023)

As the COVID-19 situation evolves, the Hunter New England and Central Coast Primary Health Network will monitor ATAGI updates and provide timely updates, with new anticipated advice expected in early 2024. Until then, the existing recommendations as per the Australian Immunisation Handbook remain in place.

Resources

  1. Australian Government. Department of Health and Aged Care. ATAGI Update on the COVID-19 Vaccination Program (20/11/2023)
  2. ATAGI recommendations on use of the Moderna and Pfizer monovalent Omicron XBB.1.5 COVID-19 vaccines | Australian Government Department of Health and Aged Care
  3. Government of New South Wales, Department of Health. NSW Respiratory Surveillance Report - fortnight ending 21 October 2023. Available at: https://www.health.nsw.gov.au/...
  4. World Health Organization. Statement on the antigen composition of COVID-19 vaccines. 18 May 2023. Available at: https://www.who.int/news/item/...
  5. Chalkias S, McGhee N, Whatley JL, et al. Safety and Immunogenicity of XBB.1.5-Containing mRNA Vaccines. medRxiv. Published online 2023:2023-09. Available from: https://www.medrxiv.org/conten...

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