HTAC Recommendation on AstraZeneca COVID-19 vaccine as Second Booster/ Fourth Dose for the prevention of COVID-19

Date of OIC-SOH Approval: 14 November 2022

This assessment followed the HTAC evaluation framework to evaluate COVID-19 vaccines using the following criteria: (1) responsiveness to magnitude and severity; (2) clinical efficacy and safety; (3) affordability, viability and feasibility; (4) household financial impact; (5) social impact; and (6) responsiveness to equity.

Evidence Summary: https://bit.ly/HTACRecomm_AstraZeneca2ndBoosteror4thDose

Policy Question

Should the DOH finance AstraZeneca as a second booster dose for HCWs, elderly aged 50 years and older, and 18 to 49 years old
with comorbidities as part of the 2022 COVID-19 vaccination strategies, to reduce COVID-19 cases, severe infection, and deaths?

Section 2. HTAC Recommendation (as of 11 November 2022)
Upon thorough deliberation, the HTAC sent a letter to the OIC- Secretary of Health on 11 November 2022, recommending COVID-19
Vaccine AstraZeneca as second booster to health care workers, elderly aged 50 years and older, and 18 to 49 years old with
comorbidities at least 4 months after the first booster dose. This is based on one real-world effectiveness study of AstraZeneca as
2nd booster (as of 03 November 2022) and the positive WHO recommendation for the use of any COVID-19 vaccines in the WHO
Emergency Use Listing (EUL) as second booster in these populations.
Meanwhile, the HTAC does not recommend the COVID-19 Vaccine AstraZeneca as second booster for healthy individuals ages 18 to
49 years for the following reasons:
          ● There is evidence on sustained protection of the first booster against severe COVID-19
          ● There is limited evidence on the protection of second booster among healthy populations ages 18 to 49 years
          ● Lack of WHO recommendation for 2nd booster for healthy population
          ● The use of existing COVID-19 vaccine supply shall be used to increase the vaccination coverage of the 1st booster dose