Booster doses of Covid-19 vaccine can be given to over-60s from five months after they received their last dose, according to official recommendations.
Where a person has had a confirmed Covid-19 infection after they were vaccinated, administration of the booster dose should be delayed for at least six months after the infection was diagnosed, according to the National Immunisation Advisory Committee.
Government ministers announced earlier this week that Niac had approved booster shots for those aged between 60 and 79 years, but said it could only be administered six months after a person got their regular second dose in the initial vaccine rollout.
However, in its formal recommendation published on Wednesday, Niac says a booster dose of Pfizer vaccine should be given "after an interval of six months (or at least five months)"? following the last dose of vaccine.
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Many 60 to 69-year-olds only received their second doses of AstraZeneca vaccine in the summer, and so will not be eligible for a booster until December or even later.
In its recommendation, Niac says booster doses can be given at the same time or at any interval before or after the seasonal flu vaccine.
“Booster doses will not contribute immediately to outbreak management or take the place of public health and social measures,” it warns.
The World Health Organisation has urged rich countries to ensure available vaccine supplies are used to immunise populations in poorer countries with poor access to supplies, rather than on third shots for already vaccinated people.
Niac acknowledges that vaccines are a scarce resource and recommendations for boosters “must be based on need and evidence-driven”.
“Niac fully supports the Government’s commitment to global vaccine equity and took into account vaccine supply and the potential for donation to low and middle income countries in these recommendations.
“Access to and completion of a primary vaccine series by countries is an essential prerequisite to controlling the SARS-CoV-2 pandemic on a global basis. Until global control is achieved, all countries remain at risk.”
Niac says the most effective way to prevent people being hospitalised and dying from Covid-19 is to ensure all eligible people are vaccinated. In the US, it points out, unvaccinated people are 10 times more likely to require hospitalisation than those who are fully vaccinated. In Ireland, unvaccinated people accounted for 70 per cent of ICU admissions since April.
It says high levels of vaccine effectiveness against hospitalisation, severe disease and death have been sustained this year “for at least five to six months”.
“There is attenuation of protection against infection over time since primary vaccination with some increase in hospitalisation and severe illness, although overall good protection against severe disease is sustained.”
Despite over 97 per cent of over-60s being fully vaccinated, the incidence of breakthrough infections requiring hospitalisation has increased in this population, Niac says.
“Vaccinated older people are much less likely to require hospitalisation but if they do, they carry the same risk of severe disease and death as the unvaccinated.”
It says Covid-19 boosters “show similar safety” as primary vaccine courses and “have not shown unexpected patterns with regard to short-term safety”? when administered at least five months after the first course.
In Israel, booster doses along with public health and social measures "have been shown to extend protective benefits, reversing Covid-19 disease incidence trends and reducing rates of hospitalisation."
The European Medicines Agency has not yet fully approved the Pfizer vaccine, which has a conditional marketing authorisation. Earlier this month, the EMA said booster doses "may be considered" in adults.
