DOH approves guidelines for booster and additional COVID-19 vaccines, but no rollout yet

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Metro Manila (CNN Philippines, October 25) — Health Secretary Francisco Duque III has approved the recommendation of an independent panel to give COVID-19 booster shots and additional vaccine doses, but the program cannot be rolled out yet pending required documents and guidelines, the Department of Health (DOH) said Monday.

The recommendation of the Health Technology Assessment Council (HTAC) includes giving booster shots for healthcare workers and senior citizens six months after they complete the single- or two-dose COVID-19 vaccine, while immunocompromised patients are recommended to get additional shots at least 28 days after they complete their vaccination.

"The Secretary has approved the recommendations of HTAC at lahat po ng plano underway na [and all plans are underway]. We will have the third doses for the immunocompromised, senior citizens, and our booster for our healthcare workers," Health Undersecretary Maria Rosario Vergeire said in a media briefing.

DOH stressed that an amended emergency use authorization from the Food and Drug Administration is required before the rollout of the booster and additional shots. Vergeire said they have sent the application and initial documents to the drug regulatory agency, but DOH is finalizing the list of brands to apply for.

The official added they will wait for the final guidelines from the World Health Organization Strategic Advisory Group of Experts on Immunization (WHO SAGE), slated to be released in mid-November.

WHO has laid down the difference between booster and an additional shot.

Booster shots are given to those whose immunity is going down over time after completing their shots. An additional dose is for individuals who never reached the ideal immune response level and are usually those who are immunocompromised and the elderly.

Booster shots

The HTAC said booster shots can be given to other priority sectors from A3 (people with comorbidities), A4 (economic frontliners), and A5 (poor population) by 2022 if 50% of the sector have completed their shots and 70% of the total target population in hotspots such as Metro Manila, Cebu, Davao, Iloilo, Calabarzon, and Central Luzon have been vaccinated.

It said this will ensure maximum protection for the population because the "premature" rollout of booster shots would exacerbate the existing inequalities in vaccine supply.

Mixing-and-matching of vaccine brands is allowed for CoronaVac or commonly known as Sinovac and AstraZeneca, the HTAC said.

Those who completed their Sinovac shots should preferably be given Pfizer or AstraZeneca as their booster six months after completing their two doses.

For those who received Pfizer and single-dose Janssen vaccines, the HTAC said they can only receive the same brand or a similar vaccine type for their booster.

Those who completed their Moderna shots should ideally be given a Pfizer dose as booster, while a Pfizer booster should be administered to those who received two AstraZeneca shots. The HTAC said they can also get the same brand as their booster.

Additional COVID-19 shots

The HTAC recommended giving an additional shot of the same brand or a homologous or comparable type of dose at least 28 days after the completion of the initial COVID-19 vaccine series for immunocompromised individuals.

It also suggested that those immunocompromised who received Janssen and Sinovac should receive an additional dose of Pfizer vaccine.

Inter-Agency Task Force spokesperson Harry Roque said they will discuss HTAC's recommendation on Thursday. The decision of the IATF is forwarded to President Rodrigo Duterte, who will have the final say in the national vaccination policy.

Vaccine czar Carlito Galvez Jr earlier said the target for the rollout of boosters and additional shots is by early November.