Aboriginal and Torres Strait Islander people aged 50–74 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

An annual COVID-19 vaccine dose is funded through the NIP for Aboriginal and Torres Strait Islander people aged 50–74 years. For details see the National Immunisation Program Schedule.

People who have had haematopoietic stem cell transplant or CAR-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 second 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 second mRNA vaccine dose.^6-8  
• Individual’s personal preferences: Personal attitudes towards preventing severe COVID-19 and related complications may influence decisions about vaccination. 

For additional information about conditions associated with increased risk of severe outcomes from COVID-19, see Table. Example conditions associated with increased risk of severe outcomes from COVID-19.