NIAC Recommendations for additional COVID-19 Booster Vaccination

All those who are unvaccinated or incompletely vaccinated are strongly recommended to complete a primary COVID-19 vaccination course and booster vaccination as outlined in Table 2. Access for hard to reach populations and new arrivals should be facilitated.

2. All those aged 65 years and older and those with immunocompromise at the time of their primary or first booster vaccination and who have not yet availed of the recommended second booster vaccine are strongly recommended to do so.

3. A first mRNA COVID-19 booster vaccine is now recommended for those aged 5 – 11 years with immunocompromise associated with a sub optimal response to vaccines at the time of their primary or additional vaccination

4. A second mRNA COVID-19 booster vaccine is now recommended for

• those aged 50-64 years

• those aged 12–49 years who o have underlying medical conditions associated with a higher risk of severe COVID-19 o are residents of long term care facilities

5. A second mRNA COVID-19 booster vaccine is recommended for • healthcare workers, and when practicable, should be given at the same time as seasonal influenza vaccine.

6. A third mRNA COVID-19 booster vaccine is recommended for

• those aged 65 years and older

• those aged 12 – 64 years with immunocompromise associated with a sub optimal response to vaccines at the time of their primary or booster vaccination When practicable, it should be given at the same time as seasonal influenza vaccine.

7. To enhance maternal protection and provide optimal benefit to the infant, an additional mRNA COVID-19 booster vaccine is recommended in pregnancy at 16 weeks gestation or later for those who have not received a booster vaccine in the current pregnancy.

8. mRNA booster vaccines should be given as follows:

• aged 30 years and older: Comirnaty (0.3ml/30 mcg) or Spikevax (0.25ml/50 mcg)

• aged 12-29 years: Comirnaty (0.3ml/30 mcg)

• aged 5-11 years: Comirnaty (0.2ml/10mcg)

9. Following the primary vaccine series or confirmed SARS-CoV-2 infection, a four month interval is recommended for any subsequent COVID-19 vaccine doses. A minimum interval of three months may be exceptionally used.

10. COVID-19 vaccines may be given at the same time or at any interval before or after any vaccine. This includes seasonal influenza and pertussis vaccines.

11. If an mRNA booster vaccine is contraindicated or declined, a non-mRNA vaccine may be given.

These recommendations reflect a dynamic vaccination programme. Scientific evidence is emerging and being refined. Recommendations may be updated when more information becomes available.