A government pandemic adviser on Saturday defended a vaccine policy shift in Hong Kong requiring residents to pay for an additional Covid-19 booster shot from April 20, as he argued public resources should be prioritised for vulnerable groups. Ivan Hung Fan-ngai, a member of the administration’s Covid advisory panel, also warned of a possible rebound in cases in June or July, but said the public should not worry as the city had already built strong immunity against the coronavirus. On Friday, the government announced that groups deemed at high risk of developing severe Covid symptoms would be entitled to a free booster shot this year from April 20, at least six months after their previous dose or infection. However, other residents would have to pay for their fourth or fifth Covid shot from the private sector from the same date. Health secretary Lo Chung-mau on Saturday said it would be up to private clinics to decide on the charge. Hung, chief of the University of Hong Kong’s infectious diseases division, told a radio show on Saturday that the government had adopted a “correct and reasonable” approach to focus on care for the high-risk population. The new arrangement would not affect Hongkongers’ motivation to get inoculated, Hung argued. “I believe that residents who need to travel, and are cautious of their higher infection risks, will be willing to pay for the booster out of their own pockets,” he said. But Hung and officials were split on whether the booster charge should be standardised on the private market. While the medical expert said he expected the government to make recommendations on a flat rate soon, minister Lo revealed separately at a health event on Saturday that the charge would be determined by private institutions, in line with the current practice for flu jabs. Dr Samuel Kwok Po-yin, president of the Association of Private Medical Specialists of Hong Kong that represents clinics providing free and paid vaccinations, said it was fair for the market to determine the price of the booster shot given it was not part of any government-sponsored programme. Kwok said he expected the price to be around HK$1,000 (US$128), similar to what non-locals paid at private clinics, and predicted the fee would not be “too unreasonable” due to the keen competition in the market. Hong Kong clinic injects 21 people with expired BioNTech Covid-19 vaccines According to the authorities, high-risk groups comprise people aged 50 or older, including care home residents, adults from 18 to 49 with underlying conditions, those aged at least six months with immunocompromised conditions, pregnant women and healthcare workers. Hung explained that children aged six months to seven years old would not be categorised as high risk, as two doses would be sufficient to protect them from severe Covid symptoms. “We’ve also observed that the proportion of severe cases among children who have been infected after two doses was low, with many not displaying any symptoms at all,” the infectious diseases specialist said. For children who have never been infected, Hung said parents could take them for their first booster, but there would not be a need for this demographic to get a fourth jab. Under the measure announced on Friday, children aged at least six months who are not immunocompromised can still receive the first three vaccine doses for free if they have not been infected before. Residents who have booked Covid-19 shots before April 20 will not be affected by the new policy. High-risk group should still get additional Covid jabs, Hong Kong experts say Hung meanwhile appealed for calm over a possible rebound in Covid cases in June and July. “This estimation is based on our previous peak at the end of last year. For the elderly, their antibody levels would have dropped after six months, resulting in lowered immunity and leading to a small rebound,” he noted. He also warned of a heightened risk of other upper respiratory infections, such as the flu and the respiratory syncytial virus, or RSV. Meanwhile, the government announced on Saturday that the indemnity fund covering adverse events following Covid-19 inoculation had recently granted its second compensation related to a death case occurring after vaccination. The amount was HK$2 million (US$254,780) The case involved a man who died on the same day he received his first jab in November 2021. He did not show discomfort or severe allergic reaction, while the autopsy found the cause of death appeared to be anaphylaxis and ischaemic heart disease. The expert committee that assessed the case earlier said the causal relationship between death and vaccination was indeterminate. Additional reporting by Edith Lin