All Australian adults are now eligible for a fifth COVID-19 vaccine, but data shows millions of people are yet to get their third and fourth doses, including those in high-risk groups.
Immunocompromised Australians with the highest risk of severe disease were already entitled to a fifth dose, and have been encouraged to get a sixth one when possible.
"The very strong recommendation from ATAGI is that it's now time for your next dose of COVID vaccine," Chief Medical Officer Paul Kelly said.
Millions of extra doses of vaccines targeting the Omicron variant are expected to land in Australia in coming weeks.
However, federal vaccination data shows most Australian adults are not yet up to date with the booster doses they are already entitled to.
Only 72.4 per cent of eligible Australians have had three vaccine doses and just 44.6 per cent have had four doses.
Even in higher-risk groups, booster dose uptake is lower than expected.
Almost one in four aged care residents — a group with one of the highest risks of severe illness or death with COVID-19 — have not yet received a fourth dose.
About 29 per cent of people aged 65 and over have not yet had a fourth dose.
Only 56.6 per cent of Aboriginal and Torres Strait Islander peoples have received three COVID-19 vaccine doses, and just 35.2 per cent have received a fourth dose.
About one in four National Disability Insurance Scheme participants have not had their third dose.
There are also big gaps in vaccine uptake between rich and poor parts of Australia, according to social scientist and vaccine advocate Julie Leask.
"There are regions in rural Queensland where booster rates for even a third dose are around 40 per cent, and you see them as high as over 90 per cent in parts of urban Perth — so we have disparities by postcode," Professor Leask said.
"Where you live should not dictate how well protected you are from COVID."
Concerns about aged care and over 65s
Aged care advocate Sarah Russell said booster dose rates in aged care facilities were "alarming".
"A fourth dose has been available to residents in aged care homes for quite some time now, yet nearly 25 per cent haven't had a fourth dose," she said.
"This is of great concern because residents in aged care homes … are a very vulnerable group at high risk of dying if they catch COVID.
"More than 3,800 have died [of COVID-19] in the last 12 months."
Dr Russell said the data raised questions about why so many aged care residents were not up to date with booster shots, and said it needed to be a high priority for the government.
"We need to make sure that residents and their families have information about the benefits of having a vaccine and hopefully we can get more residents vaccinated," she said.
"If it's not been made available to them, this is of great concern to me."
Even outside of aged care, it was important for people in older age groups to stay up-to-date with their booster shots, vaccine researcher and paediatrician Fiona Russell said.
"Protection has waned and the variants are more immune evasive, leading to an increase in severe outcomes since October 2022," Professor Russell said.
"The vast majority of people who end up in hospital or die from COVID are those that are over 65 years, are frail or have risk factors."
Time to 'think outside the box'
First Peoples Disability Network deputy chief executive June Riemer said there were many reasons why people had not taken up third and fourth booster doses.
"Most of our people living with disability live in poverty or live in disadvantage," she said.
"And when we talk about that, it's lack of access to services, lack of transport."
The Gumbaynggirr Dunghutti woman said many First Nations people in remote areas might not have good information available, making it hard to access booster shots, or they might even feel fear or shame about approaching medical institutions.
Concerns about cost was another issue, she said, adding many people might not know that getting a booster dose through a doctor or pharmacist should be free.
Ms Riemer said successful approaches used by First Nations communities early in the pandemic — like outreach officers going to events, designing culturally-appropriate information, and consulting directly with groups about what they needed — could still help.
"We need to think outside the box," she said.
Professor Leask said vaccine messaging needed to be clear and focus on the benefits of booster shots.
"We know that for those people who are six months from their last booster, having a booster will reduce your risk of hospitalisation by more than half — so there is that gain, but sometimes those messages get very lost in the technical details," she said.
She also said all Australians could do their bit to help, such as encouraging older family members to get a booster shot or talking to vulnerable friends.
"Those little campaigns make a difference in our everyday lives," she said.
