Adults aged 18–64 years with severe immunocompromise are recommended to receive COVID-19 vaccine every year and can consider a second annual dose

Adults aged 18–64 years with severe immunocompromise are recommended to receive COVID-19 vaccine every year and can consider a 2nd annual dose, approximately 6 months apart, based on a risk-benefit assessment.

An annual COVID-19 vaccine dose is funded through the National Immunisation Program for adults aged 18–64 years with severe immunocompromise. For details see the National Immunisation Program schedule.

People who have had haematopoietic stem cell transplant or CAR-T cell (chimeric antigen receptor T-cell) therapy may have reduced immune response to vaccination and require 2 priming doses, given 8 weeks apart, when revaccinated for the first time.

Risk-benefit considerations for a 2nd annual dose may include:

• Age-related risk of COVID-19 and its complications: COVID-19 can occur at any age, but the risk of severe disease in adults increases with age.
• Potential risks associated with COVID-19 vaccination: Most adverse events following COVID-19 vaccination are mild to moderate and self-limited. Very rare but serious adverse events such as myocarditis and pericarditis have been reported with the highest incidence amongst adolescent and young adult males after a 2nd mRNA vaccine dose.^6-8
• Individual’s personal preferences: Personal attitudes towards preventing severe COVID-19 and related complications may influence decisions about vaccination

See Table. Types of medical conditions and immunosuppressive therapy and associated levels of immunocompromise.

NCIRS (National Centre for Immunisation Research and Surveillance) publishes GRADE evidence assessments that support COVID-19 vaccination recommendations in Australia. View the COVID-19 vaccine GRADE assessments on the NCIRS website.