The National Immunisation Advisory Committee (NIAC) has issued updated recommendations to Roinn Sláinte on the medium term strategy for the COVID-19 vaccination programme including second booster doses. These recommendations are made recognising the uncertainties regarding the trajectory of SARS-CoV-2 infections, and on a precautionary basis to protect those most at risk of a severe outcome. They are based on current evidence and will be reviewed when more information becomes available.
1. Efforts to increase primary and first booster vaccination uptake should remain a public health priority. mRNA vaccines (Comirnaty and Spikevax) are the preferred vaccines for use in Ireland.
- Those aged 12 years and older, including those pregnant or breastfeeding, should complete a primary course and receive a booster vaccine (total of 3 doses)
- Those aged 5-11 years should complete a primary course (total of two doses)
- Those with immunocompromise associated with a sub optimal response to vaccines at the time of their primary or booster vaccination: a) aged 12 years and older should complete a primary course, an additional dose and a booster vaccine (total of four doses) b) aged 5-11 years should complete a primary course and an additional dose (total of three vaccine doses)
2. Those who have a contraindication to or who decline a primary course or booster dose of an mRNA vaccine should be offered a non-mRNA vaccine.
3. Those who have had previous SARS-CoV-2 infection should complete their primary and booster vaccination to optimise their protection.
Second Booster Vaccine
1. To maintain high levels of immunity in those most at risk of severe disease, a second booster dose of an mRNA vaccine is recommended for the following:
a) those aged 65 years and older
b) those aged 12 years and older with immunocompromise associated with a sub optimal response to vaccines
2. The second booster vaccine is recommended at least six months after the first booster. A minimum interval of four months may be used for operational reasons.
a) For those aged 12-29 years, Comirnaty (0.3ml/30 micrograms) should be given
b) For those aged 30 years and older, Comirnaty (0.3ml/30 micrograms) or Spikevax (0.25ml/50 micrograms) should be given
3. For those who have had a breakthrough infection following a first booster vaccine, it is recommended to defer the second booster vaccine for six months following infection onset. A minimum interval of four months may be used for operational reasons.
4. If an mRNA vaccine is contraindicated or declined, consideration may be given to using a non mRNA vaccine as the second booster vaccine, following an individual benefit-risk assessment