Adults aged 65–74 years with a medical risk condition (including severe immunocompromise) are recommended to receive COVID-19 vaccine every year and can consider a second annual dose

Adults aged 65–74 years with a medical risk condition (including severe immunocompromise) are recommended to receive an annual dose of COVID-19 vaccine and can consider a 2nd annual dose, given approximately 6 months apart, based on a risk-benefit assessment. A dose every 6 months is most likely to benefit people with certain medical risk conditions and/or those living in residential care facilities.^36,37 

An annual COVID-19 vaccine dose is funded through the NIP for all adults aged 65–74 years. 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.
• Presence of medical risk conditions that increase the individual’s risk of severe disease: Some medical conditions independently increase the risk of severe COVID-19 but to a lesser extent than age.¹³ Populations with medical risk conditions are heterogeneous due to highly variable risk estimates across the literature. People with certain underlying conditions associated with the highest risk may benefit from COVID-19 vaccination such as those with immunocompromising conditions, cystic fibrosis, chromosomal abnormality and chronic neurological conditions.^13-15  
• Potential risks associated with COVID-19 vaccination: Most adverse events following COVID-19 vaccination are mild and self-limited. 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. Example conditions associated with increased risk of severe outcomes from COVID-19.

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.