Briefing: ATAGI update on recommendations on a winter booster of COVID -19 Vaccine

The Australian Technical Advisory Group on Immunisation ATAGI updated and expanded their recommendations on a winter booster dose of COVID-19 vaccine for a number of at risk population groups.


The ATAGI recommends that the rollout of the additional booster dose for these groups starts from 25 May 2022.

Key points

An additional winter booster (4th dose for most people) is now also recommended for other people at increased risk, to be given four months after their first booster dose. This applies to people aged 16-64 who have:

  • A medical condition that increases the risk of severe COVID-19 illness including:
    • Non-haematological cancer within past five years
    • Active or recently completed cancer treatment
    • Advanced cancer regardless of treatment
    • Survivors of childhood cancer
    • Chronic inflammatory conditions requiring medical treatment with disease modifying antirheumatic drugs or immune-suppressive/immunomodulatory therapies
    • Chronic lung disease
    • Chronic liver disease
    • Stage 4 or 5 chronic kidney disease
    • Diabetes requiring medication
    • Chronic cardiac disease
  • People with disability with significant or complex health needs or multiple comorbidities which increase risk of poor outcome from COVID-19 (severe obesity, severe underweight).

Further information and specific details are available here.

As per previous advice, if an individual has had a recent confirmed SARS-CoV-2 infection, they should delay their winter booster dose until three months after their infection.

Groups recommended previously (advice from 25 March) ATAGI recommends that people in these groups who have not yet received their winter booster should get one as soon as possible, factoring in timing of first booster and infection (if applicable).

  • Adults aged 65 years and older.
  • Residents 16 years and older of aged care or disability care facilities.
  • People aged 16 years and older with severe immunocompromise as defined in the ATAGI statement on use of a 3rd primary dose of COVID-19 vaccine in individuals who are severely immunocompromised.
  • Aboriginal and Torres Strait Islander adults aged 50 years and older.

The following groups are currently not yet recommended to receive an additional winter booster dose:

  • Healthy people aged 16 to 64 years of age who do not have any risk factors for severe COVID-19.
  • Women who are pregnant without any other comorbidity that increases their risk of severe COVID-19.
  • People from occupational groups, such as healthcare workers, who do not have any other comorbidity that increases their risk of severe COVID-19.

For each of these groups it is recommended individuals complete the primary schedule of the COVID-19 vaccine. For those 16 and older (i.e. excl. 5–15yo’s) it is also recommended individuals receive a booster dose (3rd dose).

Other information

  • Choice of vaccine aligns with current recommendations for COVID-19 vaccine boosters.
  • Comirnaty (Pfizer) or Spikevax (Moderna) are the preferred vaccines for COVID-19 booster doses including the additional winter booster dose. Vaxzevria (AstraZeneca) can be used when an mRNA vaccine is contraindicated or a person declines vaccination with an mRNA vaccine. Nuvaxovid (Novavax) can be used if no other COVID-19 vaccine is considered suitable for that person.
  • The ATAGI will continue to review emerging evidence about booster vaccinations as it becomes available and will update recommendations and advice if needed.
  • Influenza vaccine can be co-administered with the additional booster dose of COVID-19 vaccine. However, if a person is not yet eligible for their additional booster dose, influenza vaccine could be given ahead of the additional booster dose.
  • As outlined in ATAGI’s previous statement on recommendations on a winter booster dose of COVID-19 vaccine, an additional booster is likely to provide only modest and transient protection against infection with the Omicron variant and onward transmission.

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