The Conversation: Let’s hold off vaccinating children and teens against COVID-19. Prioritising adults is our best shot for now
Some countries who have successfully vaccinated a high proportion of their adult population are now shifting the focus of their COVID-19 vaccine rollout towards children and adolescents.
The following article reviews various international vaccine strategies for the younger population, and explores COVID-19 vaccine safety, including expected vaccine side effects and reports of myocarditis and pericarditis in adolescents. It looks at the potential impact that vaccination of children could have on transmission, herd immunity and keeping schools open.
The World Health Organization (WHO) recognises that globally the vaccine rollout has been slow and inequitable. Low income countries have insufficient vaccine supplies to protect high-priority groups.
In Australia where rates of COVID-19 community transmission is low, it is important that efforts remain on maximising vaccine coverage for adults and those who are at highest risk of severe COVID-19 disease.
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Australia's COVID-19 vaccine coverage update- July 5 2021
The Australian Government Department of Health continue to publish information relating to the COVID-19 vaccine rollout; including data on population coverage.
Latest figures show that 71.64% of Victorians aged 70 years and over have received their first dose of COVID-19 vaccine, with 16% having completed both recommended doses.
To view these statistics and read other information relating to vaccine distribution and uptake, please refer to:
Australian Government Department of Health: Australia's COVID-19 vaccine rollout
New immunisation reference page: Myocarditis and pericarditis following mRNA COVID-19 vaccines
Myocarditis is an inflammatory disease of the heart muscle, whilst pericarditis is an inflammatory disease of the lining of the heart muscle. They are rare conditions, most commonly associated with viral infections (including SARS-CoV-2) but can also be triggered by other factors such as medications and autoimmune conditions. Globally, an increased number of cases above an expected population rate of myocarditis and pericarditis have been reported in individuals who have received mRNA COVID-19 vaccines (eg. Comirnaty™ and Moderna).
Our new reference page discusses the temporal association of myocarditis and pericarditis with mRNA COVID-19 vaccination, symptoms, investigations, as well as the implications on future COVID-19 vaccination.
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MVEC: Myocarditis and pericarditis following mRNA COVID-19 vaccines
New immunisation reference page: Moderna COVID-19 vaccine
Following the announcement by the Australian Government that 25 million doses (as well as additional variant specific versions) of Moderna's COVID-19 vaccine, Elasomeran, had been secured for the Australian population, this vaccine was last week granted provisional determination by the TGA.
Our new reference page explores the various clinical trials involving Elasomeran, as well as details the immunogenicity, efficacy and safety data available for this vaccine.
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MVEC: Moderna COVID-19 vaccine
TGA grants provisional determination for the Moderna COVID-19 vaccine, Elasomeran
The Therapeutic Goods Administration (TGA) has granted provisional determination to Moderna Australia Pty Ltd for their COVID-19 vaccine candidate, Elasomeran. It is being considered for use in those aged 12 years or older for active immunisation to prevent COVID-19 disease. It is an mRNA vaccine requiring two doses, given 28 days apart.
Granting provisional determination means that Moderna Australia Pty Ltd is now eligible to apply for provisional registration. Following the provisional pathway provides a formal and transparent mechanism for speeding up the registration of promising new medicines with preliminary clinical data.
Provisional determination is only granted once the TGA has considered all eligibility criteria, including evidence of a plan to submit comprehensive clinical data.
You can read the press release from the TGA below:
TGA grants provisional determination for the Moderna COVID-19 vaccine, Elasomeran
For more information on the process of COVID-19 vaccine provisional approval please refer to our reference page:
MVEC: Provisional registration of COVID-19 vaccine(s) in Australia
ATAGI 关于使用 COVID-19 疫苗阿斯利康的修订建议声明，2021 年 6 月 17 日
ATAGI has revised the recommendations for COVID-19 vaccination within Australia.
Due to a higher risk and severity of thrombosis with thrombycytopenia syndrome (TTS) related to the use of COVID-19 AstraZeneca, Comirnaty™ is now the preferred COVID-19 vaccine for individuals aged 16-59 years. Due to the risk of severe outcomes related to COVID-19 disease for individuals aged 60 years and over, the benefits of vaccination in preventing disease outweighs the risk of developing TTS.
Individuals aged less than 60 years who have received their first dose of COVID-19 AstraZeneca without any serious adverse events (eg. anaphylaxis or TTS) should continue to receive their second dose.
For more information please refer to the link below:
ATAGI 关于使用 COVID-19 疫苗阿斯利康的修订建议声明，2021 年 6 月 17 日
New immunisation reference page: COVID-19 mixed vaccine schedules
With the emergence of variant COVID-19 strains, global vaccine supply issues, and the need to rapidly immunise the population, a number of clinical trials are investigating the option of “mixed schedules”. Mixed schedules have been used previously in other vaccination strategies and involve the administration of different vaccine brands to complete a vaccine course.
Our new reference page explores the clinical trials underway which aim to determine the safety of mixed scheduling, the immunogenicity, as well as the recommendations for intervals between doses.
Due to a lack of available data, mixed vaccine schedules are not currently approved in Australia however are in use in Canada and across Europe.
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MVEC: COVID-19 mixed vaccine schedules
流感疫苗和 COVID-19 疫苗接种 - 对住宅老年护理和残疾人护理机构的居民和工作人员的建议发生变化
由于当前维多利亚州爆发了 COVID-19 疫情，澳大利亚首席卫生官 Paul Kelly 已建议更改针对某些群体的流感和 COVID-19 疫苗接种时间的建议。
为了确保住院老年护理机构和残疾人护理机构的所有居民和工作人员尽快接种疫苗，之前流感疫苗和 COVID-19 疫苗之间 14 天的最短间隔不再适用于该群体。
缩短这一时间不会对任何一种疫苗的有效性产生任何影响，并将为最弱势群体提供快速保护。流感疫苗和 COVID-19 疫苗不应在同一天接种。
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首席医疗官保罗·凯利教授和埃里克·杨准将于 2021 年 5 月 27 日举行的新闻发布会
Nature：混合搭配新冠疫苗可引发有效的免疫反应
一项涉及 663 名参与者的试验的初步结果已经发布，该试验接受了混合时间表的 COVID-19 疫苗品牌。接受第一剂阿斯利康 (AstraZeneca) 疫苗的参与者在至少 8 周后接受辉瑞 (Pfizer) 疫苗的第二剂疫苗。
第 2 剂接种后产生的抗体水平高于第 1 剂接种后产生的抗体水平。与阿斯利康 COVID-19 疫苗的标准 2 剂疗程相比，产生的免疫反应也更强。混合方案所报告的副作用与接受相同品牌方案的患者所经历的副作用相似。这与英国的一项类似研究形成鲜明对比，该研究显示混合接种 COVID-19 疫苗后常见副作用的报告较多。
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WHO: COVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) reviews cases of mild myocarditis reported with COVID-19 mRNA vaccines
The WHO Global Advisory Committee on Vaccine Safety (GACVS) COVID-19 subcommittee has released a statement following the review of a small number of cases of myocarditis reported in individuals who have received COVID-19 mRNA vaccines.
Cases have predominantly been reported in adolescents and young adults, with a typical symptom onset occurring within 4 days of vaccination. Reports were more common following receipt of a second dose of the vaccine. GACVS notes that most cases of myocarditis appear to be mild.
The COVID-19 subcommittee reiterates that the benefit of vaccination in reducing deaths and hospitalisations due to COVID-19 disease outweighs potential risk of vaccine side effects.
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