Young Australians have been left doctor-shopping for health professionals willing to flout the rules and give them a fourth Covid vaccination.
As infections across the country continue to rise, health experts are now questioning if the second booster shot should be made available to people aged 16 to 29.
People in that age group are now not eligible to receive the fourth dose. The rules follow the advice of the Australian Technical Advisory Group on Immunisation (Atagi).
But Prof Robert Booy, an infectious diseases expert at University of Sydney, said he supported a review of the guidelines, arguing a fourth dose should be made available to the age group, but not mandated.
Booy said people who were highly social or in close contact with someone who has an underlying health condition should have the option, particularly as it would prevent the spread of the disease and reduce the risk of more long Covid cases.
Other experts disagreed the guidelines needed to be reviewed. Nicole Higgins, president of the Royal College for GPs, said she does not think the age group requires a fourth dose at this stage, adding “we need to see how Covid evolves over the next 3-6 months”.
Australia is experiencing a fourth Covid-19 wave, and some are choosing to seek out the extra vaccination.
When the bivalent vaccine – which provides protection against the original and an Omicron Covid strain – was made available in Australia, Greta, 26, decided to find a health professional who was willing to bend the rules.
The first pharmacy she approached refused, but the second pharmacy agreed to give her a fourth dose.
Greta, who preferred to remain anonymous, has not contracted Covid and lives with her parents, who are both immunocompromised. She said for her the benefits of getting the fourth dose outweighed the risks, and she found a health professional willing to do it.
“I had my third shot in January so I felt like I was vulnerable,” she said. “It felt like the only thing I could do at the moment because there aren’t many measures in place any more.”
Booy said he was aware of people in the 16-29 age group who have taken advantage of getting a fourth dose that would have otherwise expired.
Higgins said given supply was not a problem, she understood some health professionals may opt to use the shot rather than waste them. But she urged health professionals to follow the official guidelines.
Social scientist at the University of Sydney, Julia Leask, said she would not think less of a GP who made a clinical decision to administer the vaccine.
“I think clinical flexibility is reasonable,” said Leask, despite not supporting a review of the recommendations for the age group. “As long as the risks and limited benefits against infection itself has been clearly communicated and the patient understands them.”
Alex Faure, 29, said she was “itching” to get the vaccine because her partner was immunocompromised. She said she would like the opportunity for her GP to help her make the decision, based on her specific health needs.
“It’s a weird shift from being told the vaccine is the end of it all to now being told we can’t have it … and I think a lot of people don’t understand why we aren’t eligible,” she said. “I still want it even knowing the risks.”
One risk for the age group is developing myocarditis, an inflammation of the heart muscle. About one in 10,000 men and one in 30,000 women in the 16-29 age group who receive a Covid-19 dose are at risk, Booy said.
“It would need to be a conscious decision,” he said. “If you’re weighing up in a 22-year-old whether a one in 10,000 risk of myocarditis, which settles in one week, with getting Covid-19 which could lead to long Covid – that does need to be carefully thought through.”
A spokesperson for the federal health department, said Atagi met regularly and if new evidence became available it would consider and update the recommendations as required.