PBAC recommends new NIP adult vaccine listings

New Pharmaceutical Benefits Advisory Committee (PBAC) recommendations could significantly change who can access funded COVID-19 and RSV vaccines.

At its December 2025 meeting, PBAC considered applications for funding COVID-19 vaccines and RSV vaccines on the National Immunisation Program (NIP). While both recommendations were positive, how would they apply in practice?

Smaller cohort recommended for COVID-19 vaccine eligibility

PBAC recommended significantly tighter eligibility criteria for COVID-19 vaccines going forward.

The National COVID-19 Vaccination Program – including the community pharmacy program is scheduled to end on 30 June 2026. While no announcements have yet been made, the PBAC outcomes signal COVID-19 vaccination will be incorporated into the NIP. PBAC recommendation is an important step to enable this NIP listing.

PBAC considered a proposal to fund Pfizer’s Comirnaty COVID-19 vaccines in a smaller population cohort. The proposal has been supported by PBAC, recommending NIP funding for four cohorts of adults as requested by Pfizer, the product sponsor.

Who would be eligible for funded COVID-19 vaccination?

For current and future Comirnaty COVID-19 vaccines, PBAC’s recommendation supports NIP funding in specific age and risk groups only.

Under this framework, NIP-funded doses would only be available for patients who are:

• 75 years and over (two doses per year)
• 65–74 years (one dose per year)
• 18–64 years with severe immunocompromise (one dose per year)
• Aboriginal and Torres Strait Islander peoples aged 50–74 years (one dose per year).

Patients outside these groups would not be eligible for NIP-funded COVID-19 vaccination, including healthy adults aged 18–64 years, children, and Aboriginal and Torres Strait Islander peoples under 50 who do not meet the high-risk criteria.

The proposed dosing schedule reflects an endemic management approach, with annual vaccination for most eligible groups.

‘PBAC noted the requested populations and doses were based on updated advice from the Australian Technical Advisory Group on Immunisation (ATAGI),’ the committee said. ‘This is a smaller group than current arrangements under the National COVID-19 Vaccination Program (NCVP).’

What did PBAC recommend for RSV vaccination on the NIP?

PBAC considered a submission from GSK to fund their RSV vaccine Arexvy on the NIP for prevention of RSV-related lower respiratory tract disease in at-risk adults susceptible to severe complications.

The recommendation supports funded access for the Arexvy RSV vaccine for:

• adults aged 75 years and over
• Aboriginal and Torres Strait Islander peoples aged 60–74 years.

If adopted, this would see two additional population cohorts currently recommended for RSV vaccination by the Australian Immunisation Handbook able to access the vaccine free-of-charge on the NIP. However, the recommendation does not extend to all people currently recommended for RSV vaccination – such as adults aged 60–74 years who have medical conditions which increase their risk of severe RSV disease.

PBAC also confirmed that one dose of Arexvy is considered equivalent to one dose of Pfizer’s Abrysvo vaccine under the proposed NIP listing.

The proposed NIP listing would still involve a substantial cost to government, even after revised assumptions and a price reduction. However, the committee considered the sponsor’s updated cost inputs acceptable and concluded the vaccine was cost-effective in the proposed populations.

PBAC also noted that no new clinical evidence had been submitted, but that revised pricing and cost data supported its previous conclusions on clinical benefit and value for money.

‘Consistent with previous advice, PBAC considered there is a high clinical need for vaccines, such as Arexvy, to reduce the risk of RSV in adults,’ the committee said.

When would these changes take effect?

There’s no clear timeframe. PBAC recommendations for vaccines require price negotiation, government approval, procurement and regulatory listing to become funded on the NIP.

Given the expiry of COVID-19 immunisation program funding, 1 July 2026 could be a potential implementation date for the COVID-19 NIP funding. Current COVID-19 vaccine program eligibility is based on ATAGI advice, so changes could happen at any time ATAGI chooses to provide updated advice.

And as for patients asking when the RSV vaccine may be funded on the NIP? They probably could be encouraged to keep their eye on the TV news for any future announcements!

Upskill in vaccination administration and legislation by visiting the PSA Vaccination (immunisation) Education Hub.