Latest news (17 June): The Australian Technical Advisory Group on Immunisation (ATAGI) recommends the COVID-19 Pfizer vaccine (Comirnaty) as the preferred vaccine for those aged 16 to under 60 years. You can read more about this update on the Commonwealth Government Department of Health website.
Latest news (9 June): The Australian Technical Advisory Group on Immunisation (ATAGI) has updated its advice about the interval between COVID-19 vaccines and most other vaccines (including the flu vaccine). The preferred minimum interval between a dose of influenza vaccine and a dose of either Pfizer/BioNTech (Comirnaty) vaccine or Oxford/AstraZeneca vaccine is now 7 days (previously 14 days). You can read more about this change on the Commonwealth Government Department of Health website.
A summary of COVID-19 vaccine clinical resources is available on the Australian Government website.
For public health alerts and advisories relating to COVID-19 and other threats to the health and wellbeing of Canberrans, see the ACT Chief Health Officer alerts.
What are the current ATAGI recommendations on use of COVID-19 vaccines?
ATAGI statement on revised recommendations on the use of the AstraZeneca COVID-19 vaccine
On 17 June 2021, ATAGI issued a statement on its revised recommendations regarding the use of the AstraZeneca COVID-19 vaccine.
The statement, which includes the current recommendations, can be found of the Australian Government Department of Health website.
ATAGI statement on the use of COVID-19 vaccines in an outbreak setting
On 13 July 2021, ATAGI issued a statement on use of vaccines in an outbreak setting addressing the specific application of these recommendations in the setting of a significant COVID-19 outbreak involving the Delta variant. This includes:
- the re-assessment of benefits versus risks on the AstraZeneca COVID-19 vaccine for adults under 60 years old
- updated advice about the optimal interval between the two doses of the AstraZeneca COVID-19 vaccine in an outbreak setting.
In non-outbreak settings, the preferred interval between doses of AstraZeneca COVID-19 vaccine remains at 12 weeks.
The statement can be found on the Australian Government Department of Health website.
Who is currently eligible for vaccination?
The ACT is vaccinating people in 1a, 1b, people aged 30 years and over, Aboriginal and Torres Strait Islander people aged 16 years and over and pregnant people aged 16 years and over.
ATAGI recommends the COVID-19 Comirnaty (Pfizer) vaccine as the preferred vaccine for those aged 16 to 59 years, but the AstraZeneca vaccine can be provided to people aged 18 to 59 years of age. Adults aged under 60 can choose to receive the AstraZeneca vaccine if they speak to their GP and give informed consent.
- quarantine and border workers
- health care workers working in high-risk exposure and transmission areas, like COVID-19 testing clinics, respiratory clinics and some emergency department staff
- residents and staff of aged care and disability residential care facilities
- people aged 70 years and over
- other health care workers, including aged and disability care
- Aboriginal and Torres Strait Islander people aged 50 years and older
- people aged 16 and over with an underlying medical condition*
- people aged 16 and over with disability
- critical and high-risk workers
- household contacts of quarantine and border workers
- other eligible individuals like:
- carers of people in 1a and 1b
- carers of children with underlying medical conditions
- disability and aged care support volunteers
*The medical conditions and categories listed on the Commonwealth Government’s website are a guide to those that might be considered an underlying medical condition for Phase 1b. This is not an exhaustive list. Clinicians are encouraged to use their own expert judgment to determine whether an individual should receive a priority vaccination under Phase 1b. Please consider the overarching principle that those at higher risk of severe disease should be prioritised for vaccination.
- People aged 30 years and over, Aboriginal and Torres Strait Islander people aged 16 years and over and pregnant people aged 16 years and over, can now get vaccinated.
How do my eligible patients under 60 years of age book their vaccination appointment?
People aged 30-59 years of age, and people eligible in Phase 1a and 1b can book an appointment at the Garran COVID-19 mass vaccination clinic:
- online directly via MyDHR or via the Vaccine Eligibility Checker, or
- by phone on 02 5124 7700 (8am to 5pm, Monday to Friday).
Second dose appointments will be made during the first visit at the clinic.
Further information on priority groups for vaccination is available on the Australian Government website.
Pregnant people getting the COVID-19 vaccine
All pregnant people in the ACT are now eligible for a Pfizer COVID-19 vaccine.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and Australian Technical Advisory Group on Immunisation (ATAGI) released a joint statement recommending that pregnant people are routinely offered Pfizer mRNA vaccine (Comirnaty) at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant people and their unborn baby.
Read the latest Joint statement between RANZCOG and ATAGI about COVID-19 vaccination for pregnant people and the COVID-19 vaccination – Shared decision making guide for people who are pregnant, breastfeeding or planning pregnancy.
Can I refer patients aged 60 and over for Comirnaty (Pfizer) vaccine?
At this stage, individuals aged 60 years or over are not able to choose which vaccine they receive unless there is a history of one of the precautionary conditions listed below.
National Cabinet has agreed that, in line with the advice of ATAGI, the Comirnaty (Pfizer) vaccine will be prioritised for people aged 16 to 59 years. The COVID-19 AstraZeneca vaccine will be prioritised for people aged 60 years and over. This will apply across all phases.
The Comirnaty (Pfizer) vaccine is limited to:
- people with a history of certain medical conditions and certain reactions to the first dose of the AstraZeneca vaccines — see below
- residential aged-care facility residents, through the completion of the Commonwealth’s existing in-reach program
- disability-care residents with complex needs who need in-reach vaccination services
- people in remote and very remote communities, where it makes sense to use a single vaccine for all or most of the community
- in very limited circumstances, quarantine, border and frontline healthcare workers who are 60 years and older and not already vaccinated, if the relevant state or territory determines the worker should be fully vaccinated as soon as possible
- residential aged-care workers, who can choose to have the Pfizer vaccine, regardless of their age, if they wish.
Comirnaty (Pfizer) vaccine is also recommended for people 16 years and above with:
- a past history of cerebral venous sinus thrombosis (CVST)
- a past history of heparin-induced thrombocytopenia (HIT)
- a past history of idiopathic splanchnic (mesenteric, portal and splenic) venous thrombosis
- anti-phospholipid syndrome with thrombosis
- a history of certain reactions to the first dose of the AstraZeneca vaccine, for example:
- anaphylaxis to a previous dose of AstraZeneca vaccine, or to an ingredient of the vaccine
- thrombosis with thrombocytopenia occurring after the first dose of AstraZeneca vaccine
- other serious adverse events attributed to the first dose of the AstraZeneca vaccine
Please refer to the vaccine booking process for patients with a history of these medical conditions.
COVID-19 vaccine ingredients are listed in the TGA consumer medicines information (CMI) and product information (PI) for:
Further information can be found at Australian Government website and the National Centre for Immunisation Research and Surveillance (NCIRS).
How do I facilitate an appointment for patients with one of the precautionary conditions recommended to receive Comirnaty (Pfizer) vaccine?
If you have a patient who is aged 60 years or over and has any of these conditions, you may be able to recommend the Pfizer vaccine:
- a past history of cerebral venous sinus thrombosis (CVST)
- a past history of heparin-induced thrombocytopenia (HIT)
- a past history of idiopathic splanchnic — mesenteric, portal and splenic — venous thrombosis
- anti-phospholipid syndrome with thrombosis
The clinician template to recommend Pfizer vaccine (form) can also be used (optional) to facilitate vaccination for patients.
Clinicians can also email email@example.com with the following information. If the patient has one of the precautionary conditions, a member of the booking team will contact the patient directly on the phone number provided to make a vaccine appointment:
- patient name
- date of birth
- contact phone number
- Medicare number (if applicable)
- medical condition (eligibility)
Not all contraindications to the AstraZeneca COVID-19 vaccine are captured in this booking process. For patients with:
- anaphylaxis to a previous dose of the AstraZeneca COVID-19 vaccine, or to an ingredient of the vaccine see What if my patient has anaphylaxis or specific allergies related to the COVID-19 vaccine?
- thrombosis with thrombocytopenia occurring after the first dose of the AstraZeneca COVID-19 vaccine an alternate second dose will be arranged as part of their follow up. See What is Thrombosis with thrombocytopaenia (TTS), and what are the pathways for advice and investigation in the ACT?
- other serious adverse events attributed to the first dose of the AstraZeneca COVID-19 vaccine see How do I report an adverse event following immunisation?
What if my patient has anaphylaxis or specific allergies related to the COVID-19 vaccine?
A dedicated COVID-19 vaccine allergy clinic at the Canberra Hospital will run monthly from July 2021 to assess suitability of COVID-19 vaccinations.
The COVID-19 vaccine allergy clinic will assess any patient who has had:
- an anaphylactic reaction to a COVID-19 vaccination
- immediate (within 4 hours) and generalised symptoms of a possible allergic reaction to a previous dose of a COVID-19 vaccination
- generalised allergic reactions to polyethylene glycol (PEG) or polysorbate 80 in the past, including medications used for bowel preparation, steroid joint injections
- a prior history of anaphylaxis to vaccines or multiple drugs where polysorbate 80 or PEG may have been the cause.
- for allergic and anaphylactic reactions to COVID-19 vaccines
- vaccine type
- date of reaction
- copy of adverse event following immunisation (AEFI) notification, if available
- treatment required
- copy of any discharge letter from treating hospital
- vital signs taken at the time of reaction
- a copy of any blood tests, in particular tryptase levels for suspected anaphylaxis
- for previous allergic reactions to vaccine components PEG or polysorbate 80
- a list of implicated medications
- copy of any letters from previous specialist review
- list of vaccinations given without incident
People with a history of severe allergy to foods, venom or medications, including latex, that don’t contain the listed excipients should be able to be vaccinated in the community.
However, if there is concern, these people can be considered for vaccination in the specialist COVID-19 vaccination service at the Garran COVID-19 mass vaccination clinic.
At this stage, referrals for either the COVID-19 vaccine allergy clinic or the specialist COVID-19 vaccination service at the Garran COVID-19 mass vaccination clinic should be referred to the Department of Immunology at the Canberra Hospital.
Following the review of the referral, advice about COVID-19 vaccination will be provided.
If indicated, a COVID-19 vaccine appointment will be made for the client by the COVID-19 vaccine allergy clinic at the specialist COVID-19 vaccination service within the Garran COVID-19 mass vaccination clinic.
What evidence is required to confirm eligibility for vaccination?
Information regarding eligibility documentation for people with underlying medical conditions is also highlighted below.
Adults (people aged 16 and over) with an underlying medical condition
People with an underlying medical condition, including disability, need to demonstrate their eligibility for vaccination under phase 1b.
People with an underlying medical condition need to show one of these forms of evidence:
- clinical records for those attending their usual GP
- a MyHealth Record
- a referral from a GP or treating specialist
- alternative medical records, including:
- a printout of medical history as recorded in clinical records
- a printout of chronic-disease care plan
- a valid script or medication prescribed to treat one or more of the relevant medical conditions.
Where none of these are available, an eligibility self-declaration form is acceptable.
How do I report an adverse event following immunisation (AEFI)?
An adverse event following immunisation (AEFI) is any untoward medical event that occurs after a vaccination has been given which may be related to the vaccine itself or to its handling or administration. A conclusion regarding a causal relationship with the vaccine is not necessary to suspect or report an AEFI. An AEFI is a notifiable condition under the ACT Public Health Act (1997).
All uncommon, unexpected or serious AEFI, or any event considered to be significant following immunisation, must be notified by medical practitioners or other health professionals to the ACT Health Immunisation Unit on (02) 5124 9800 (Monday-Friday, 8.30am-4.30pm) or by email to firstname.lastname@example.org using the COVID-19 vaccine AEFI reporting form.
Routine notifications can be made during business hours. For urgent advice after hours, contact the Immunisation Unit on (02) 5124 9800 and follow the prompts. All notifications of AEFI received by ACT Health will be reported on to the Therapeutic Goods Administration.
Who should be referred to the Access and Sensory Clinic?
To better support individual needs, designated appointment times are now available at the Access and Sensory clinic, within the Garran COVID-19 mass vaccination clinic.
The clinic is available for people with disability and their support staff, volunteer or carer attending the appointment with them.
What is Thrombosis with thrombocytopaenia (TTS), and what are the pathways for advice and investigation in the ACT?
Thrombosis with thrombocytopenia syndrome (TTS) is a newly described serious condition, with unusual blood clots in the brain (cerebral venous sinus thrombosis) or in other parts of the body, associated with low platelet levels after vaccination with COVID-19 vaccine AstraZeneca. This condition is also being referred to as ‘vaccine induced immune thrombotic thrombocytopenia’ (VITT) or ‘vaccine induced prothrombotic immune thrombocytopaenia’ (VIPIT).
Clinicians should be alert to any new, severe, persistent headache or other significant symptoms, such as severe abdominal pain with an onset between 4 to 42 days after vaccination with COVID-19 Vaccine AstraZeneca.
For cerebral venous sinus thrombosis ‘red flag’ features include new onset of severe persistent headache that is not settling with analgesia.
Patients may also present with features of raised intracranial pressure (acute severe headache, vomiting, confusion), focal neurological deficits and/or seizures.
In the ACT, discuss urgently with haematology at The Canberra Hospital any patient presenting within 42 days of vaccination with features suggestive of thrombosis in any body system and assess urgently for thrombocytopaenia and elevated D-dimers.
The Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ) have an advisory statement, including investigation algorithms, for clinicians that is being updated regularly. Please refer to the latest version available here.
Further information for health professionals outlining a primary care approach for identifying, diagnosing and treating TTS after the COVID-19 AstraZeneca vaccine is available on the Australian Government Department of Health website.
ACT Office of the Senior Practitioner – restrictive practices
In the ACT, restrictive practices cannot be used to administer any voluntary medical procedures, including COVID-19 vaccines.