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COVID-19 Vaccine


ATAGI – Clinical guidance on COVID-19 vaccine in Australia in 2021


Latest COVID-19 resources

Defrost Calc
COVID-19 vaccine Defrost Expiry Calculator
1. LATEST UPDATES – SEPTEMBER 2022

Moderna Bivalent vaccine (Original/Omicron)

When will Moderna bivalent vaccine rollout commence?

  • From 10 October 2022
  • Moderna Bivalent will be included in the COVID-19 Vaccination Program for boosters in people aged 18 years, as per ATAGI advice.

Is there an EOI process for Moderna bivalent vaccine?

  • All COVID-19 Vaccine sites will be automatically onboarded for Moderna bivalent in tranches – no EOI process
  • Your PHN will advise you which tranche you will be onboarded in.
  • Sites will need to complete the Moderna Site Readiness Declaration
  • If sites do not complete the site declaration and place an order within 8 weeks, they will be deactivated for Moderna Bivalent in CVAS.

How can sites order Moderna bivalent vaccine?

  • Select Moderna “bivalent 18+ blue/green” from CVAS
  • All primary care sites will receive an ongoing allocation of 100 doses

Who can receive Moderna bivalent vaccine?

  • Moderna bivalent vaccine can be used as any booster dose but is NOT recommended for primary course of vaccination
  • Moderna bivalent vaccine should NOT be used in anyone under 18 years as it is not registered for this age group.
COVID-19 vaccines in at-risk children aged 6 months to <5 years

Atrisk Kids

On 3 August 2022, ATAGI released recommendations on COVID-19 vaccine use in children aged 6 months to <5 years.

 

Recommended for at-risk children: 

ATAGI recommends COVID-19 vaccination for children aged 6 months to <5 years with severe immunocompromise, disability, and those who have complex and/or multiple health conditions which increase the risk of severe COVID-19. This includes conditions listed in the ATAGI recommendations and similar conditions.

Not recommended for all children: 

ATAGI does not currently recommend vaccination for children aged 6 months to <5 years who are not in the risk categories for severe COVID-19.

Dosing and schedule:

Paediatric formulation (25mcg) Moderna COVID-19 vaccine, 2 primary doses 8 weeks apart. Children with severe immunocompromise should receive a 3rd primary dose, 8 weeks after the 2nd dose.

General Practice EOI Paediatric Moderna (6 months to 4 years) for at-risk children (Stage 1)
  1. EOI general practice invitation: 26 July 2022
  2. EOI submission deadline: 29 July 2022
  3. Approval for Paed Moderna: pending COVID taskforce 

Which patients will be eligible for Paediatric Moderna in Stage 1 of the rollout?

  • only at-risk children aged 6 months to 4 years
  • at-risk includes: children with immunocompromise, comorbidities and/or disability, see list of conditions

When will vaccination of at-risk children commence?

  • The Australian Government will include the Moderna vaccine for children aged 6 months to under 5 years in the COVID-19 Vaccination Program from 5 September 2022.

How many practices will be approved to administer Paediatric Modernain in Stage 1 of the rollout?

  • the at-risk cohort is expected to be relatively small
  • only a small number of vaccination sites is expected to be included in Stage 1 

Contact coronavirus@cesphn.com.au for further information.

TGA provisionally approves Novavax for use in 12-17 year olds  

On 25 July 2022, the TGA provisionally approved the Novavax COVID-19 vaccine for use in individuals aged 12-17 years. The potential use of this vaccine in the national COVID-19 vaccination program in this age group will be considered by ATAGI who will provide advice to the Government in the coming weeks.

Previously, Novavax was provisionally approved for the use as a primary course and as a booster dose in adults aged 18 years and over.

TGA provisionally approves Paediatric Moderna vaccine

On 19 July 2022 the TGA provisionally approved a paediatric dose of the Moderna COVID-19 vaccine for use in individuals aged 6 months to less than 6 years. The paediatric Moderna vaccine is made in the same way as the Moderna vaccines for older individuals, however it contains a lower concentration of the active ingredient 25 micrograms per 0.25ml (compared to 50 micrograms per 0.25ml).

Immunisation providers should NOT use Moderna in children aged 6 months to less than 6 years until ATAGI provides advice to the Government on these matters in the coming weeks. ATAGI is reviewing data on the impact of SARS-CoV-2 infection on children aged 6 months to <5 years and will provide advice on the use of COVID-19 vaccines in this age group to the Government in the coming weeks.

Reinfection period – now 28 days

28d

The COVID-19 reinfection period has been reduced from 12 weeks to 28 days. People who’ve had COVID-19 more than 28 days ago and have new symptoms should stay home, test and isolate if positive.

Winter booster – 30+ years now eligible

7 July 2022: ATAGI has updated its recommendations for a winter dose of COVID-19 vaccine to help reduce severe disease from the emerging surge of Omicron BA.4 and BA.5 subvariant infections, and to reduce the burden on Australian hospitals and the healthcare system in coming months. The updated recommendations are:

  • Adults aged 50 to 64 years are now recommended to receive a winter booster dose of a COVID-19 vaccine.
  • Adults aged 30 to 49 years can receive a winter booster dose of a COVID-19 vaccine, however the benefit for people in this age group is less certain.
  • The interval recommended between a recent SARS-CoV-2 infection or the first booster dose and a winter booster dose is now 3 months.

25 May 2022: Expanded ATAGI recommendations on winter COVID-19 booster doses for people at increased risk of severe COVID-19

Booster dose 

ATAGI recommendations on the use of a booster dose of COVID-19 vaccine

COVID-19 vaccine FAQ
Overseas vaccines

ATAGI advice People who have received either a first dose or a full course of a COVID-19 vaccine that is not TGA-approved or TGA-recognised should be offered two doses of an alternative TGA-approved vaccine brand available in Australia to be considered fully vaccinated. People should begin their full course of a TGA-approved or recognised COVID-19 vaccination at an interval of 4 to 12 weeks after their most recent COVID-19 vaccine dose.

2. COVID-19 VACCINES

COVID-19 vaccines for Children

All immunisation providers must complete the additional age specific COVID-19 vaccine for children training modules.

Resources 

Patients resources

Vaccine Champion Certificate (1)

Community resources

Provider resources

Paediatric Pfizer – 5 to 11 years  

Provider training

Provider information

Patient information

Moderna – 6 to 11 years

Provider training

Novavax

Provider information

Patient information

Pfizer 12+ (adult)

Patient information

Pericarditis and Myocarditis

Moderna

Provider information (adult)

 

Provider resources (children)

Patient information (children)

Patient information (adult)

AstraZeneca 

Patient information

Thrombosis with thrombocytopenia syndrome (TTS)

3. Provider Information

Websites: Clinical considerations and Advice for vaccine providers

Resource Collection: Advice for COVID-19 vaccine providers and Provider resources

COVID-19 vaccine administration errors

ATAGI guidelines on the management of a range of possible vaccine administration errors, including when a replacement (repeat) dose is recommended.

Winter Booster doses
  • ATAGI Advice on recommendations for key population groups for an additional COVID-19 vaccine winter dose from April 2022 – table
  • ATAGI recommended doses and vaccines – flowchart
Booster dose 

ATAGI recommendations on the use of a booster dose of COVID-19 vaccine

Sedation for vaccination

This provides an overview of the use of sedation as one of a range of measures to assist in the safe administration of COVID-19 vaccines, in patients with anxiety disorders or needle-phobia.

AIR042 report – COVID-19 Vaccination Status 

The AIR042 report identifies patients:

  • aged over 5 years who have not yet received a COVID-19 vaccination, and
  • people aged 16 and over due for a booster dose.
  • See guidelines on how to download AIR042 report.

Air042a A

Appointment Translation

The NSW Multicultural Health Communication Service’s online Appointment Reminder Translation Tool allows you to translate appointment details into your client’s language.

Practice Incentives Program COVID-19 in-reach vaccination

The Practice Incentives Program (PIP) COVID-19 in-reach vaccination payment is a time-limited payment to support general practices that undertake in-reach COVID-19 vaccination services for residential aged care and disability support workers in their workplace.

This payment is only available for Medicare Benefits Schedule (MBS) COVID-19 vaccine suitability assessment services (for primary vaccine course and subsequent booster vaccine doses) that are administered via an in-reach COVID-19 vaccination clinic between 29 April 2021 to 30 June 2022. See payment guidelines.

COVID-19 care in the community

Please refer to HealthPathways for the current definitions of low, medium and high risk. These definitions will be frequently updated and will differ between the two LHDs

Fit testing
  • We are pleased to confirm that CESPHN will be offering free fit testing for all GPs and practice nurses in our region.

ATAGI advice on the definition of fully vaccinated

Vaccines that are not TGA approved or recognised

ATAGI advice People who have received either a first dose or a full course of a COVID-19 vaccine that is not TGA-approved or TGA-recognised should be offered two doses of an alternative TGA-approved vaccine brand available in Australia to be considered fully vaccinated. People should begin their full course of a TGA-approved or recognised COVID-19 vaccination at an interval of 4 to 12 weeks after their most recent COVID-19 vaccine dose.

Transfer of vaccines
  • Too much COVID-19 vaccine stock? Can’t use up vaccines before defrost expiry? Call CESPHN on 1300 986 991 option 7 for COVID-19 or email coronavirus@cesphn.com.au to notify us of excess vaccines available for redistribution.
  • Need more COVID-19 vaccine stock? Delivery delays? Not enough supply?Call CESPHN on 1300 986 991 option 7 for COVID-19 or email coronavirus@cesphn.com.au for assistance with accessing emergency vaccine supplies.
COVID-19 booster vaccines

Resources

MBS Booster Incentive

Booster dose number

  • When entering directly onto the AIR site, there is no requirement for entering a dose number for adults.  AIR record all adult doses as V (valid). The immunisation history statement does not list doses for adults.
  • If you are required to enter a dose number, it can be entered as ‘3’ but AIR will count them according to date given so it does not need to be changed if it automatically defaults to ‘1’ in practice software.

Further information:

Disposal of COVID-19 vaccines

Pfizer 12+ shelf-life extension – some batches of Pfizer with manufacturer expiry 28 Feb 2022 have had their shelf life extended. Check information sheet before discarding vials.

What is vaccine wastage?

Vaccine wastage refers to the loss of vaccine doses due to cold chain breaches, expired vials or other damage.

How do you dispose of COVID-19 vaccines?

The COVID-19 Vaccination Training gives details on how to dispose of vaccines:

  • Prior to disposal, the outer packaging (carton) should be defaced by striking through at least one panel of the carton with a sharpie or similar marker.
  • Any unused vaccine or waste material should be disposed of in accordance with local requirements in a clinical waste bin – vials must be disposed of in the provided sharps container to ensure they cannot be accessed.

Reporting requirements for vaccine wastage:

Remember to notify wastage to the Vaccine Operations Centre (VOC) through the COVID-19 Vaccine Administrative System (CVAS):

  • wastage less than 5 vials should be reported in your “Vaccine Stock Management Report
  • wastage of 5 vias and over should also be reported within the “Wastage Report”
  • wastage “incidents” (e.g. damaged vials or breach of cold chain requirements), of 5 vials and over must be reported immediately (within 2 hours of the incident occurring) by calling the VOC on 1800 318 208
COVID-19 exposure

NSW Health is currently responding to a number of COVID-19 outbreaks all across NSW. Healthcare workers are at high risk of exposure to COVID-19.

  • Cleaning post COVID-19 positive case: Guidelines
COVID-19 Safety Plan

The following guides should be adapted to suit your practices procedures and workflows:

Medical exemptions for COVID-19 vaccines
Overseas COVID-19 vaccines

Reporting overseas vaccines in AIR

COVID-19 vaccines given overseas that have been recognised by the Therapeutic Goods Administration (TGA) can now be recorded on the Australian Immunisation Register (AIR).

  • Covishield (AstraZeneca)
  • Coronavac (Sinovac)
  • Covaxin (Bharat Biotech)
  • BBIBP-CorV (Sinopharm)
  • Sputnik V (Gamaleya Research Institute)

It is important that country of immunisation and batch number are recorded. A list of all vaccines currently able to be reported to AIR is available on the AIR vaccine code page which is updated regularly.

 

COVID-19 vaccine brand that is not available in Australia

ATAGI advice People who have received either a first dose or a full course of a COVID-19 vaccine that is not TGA-approved or TGA-recognised should be offered two doses of an alternative TGA-approved vaccine brand available in Australia to be considered fully vaccinated. People should begin their full course of a TGA-approved or recognised COVID-19 vaccination at an interval of 4 to 12 weeks after their most recent COVID-19 vaccine dose.

 

Clinical support COVID-19 vaccines
ATAGI
Product Information
Mixed (heterologous) schedules
  • ATAGI recommends completing the vaccination course with the same vaccine. Mixed schedules using 2 different vaccines to complete the primary vaccination course are only recommended in special circumstances See page 17 – ATAGI Clinical Guidance
Consent
PPE
MBS items
  • 93624: Dose 1
  • 93644: Dose 2
  • 93644: Dose 3 (immunocompromised)
  • 93644: Booster
  • 90005: Flag fall (co-claim with 93624 or 93644)
  • 10660: In-depth assessment: GP attend to patient >10 mins (co-claim with 93624 or 93644)
  • 93666: Booster incentive (co-claim with 93644 – booster only)
  • 93715: Providing treatment to COVID-19 positive patients
4. PATIENT INFORMATION
COVID-19: Identifying the symptoms

Sympt

Needle Phobia 

Information for adults with a needle phobia – 14 Feb 2022

 

COVID-19 vaccine exemptions

 

This fact sheet outlines when a vaccine may not be recommended, or when you should postpone your vaccination.

 

Concessional Access RAT

Rapid antigen testing – concessional access program

The Australian government is introducing a temporary Rapid Antigen Test Concessional Access program. This program starts on 24 January 2022 and ends on 30 April 2022.

If you have a valid, eligible Commonwealth concession card, you can access up to 10 rapid antigen tests through participating community pharmacies, at no cost to you. You can access a maximum of 10 rapid antigen tests over the three-month period, but no more than 5 tests in any month.

De-Isolation protocols
Register positive RAT result

Register positive COVID test results with Service NSW

COVID-19 Vaccine Claims Scheme

See policy on the new COVID-19 Vaccine Claims Scheme which sets out the rules that govern the scheme.

COVID-19 Vaccine Claims Scheme – Policy

COVID-19 Vaccine Claims Scheme – Guidance for conditions

COVID-19 Vaccine Claims Scheme – Guidance for injuries caused by vaccine administration

Proof of COVID-19 vaccination and exemption

See accepted proof of vaccination

Exemption

See accepted proof of medical exemption

Valid immunisation medical exemptions must be recorded on the AIR by a medical practitioner, and will appear on a patient’s AIR Immunisation History Statement. 

The Department is working with Services Australia on enhancements to the AIR that will allow individuals with a valid medical contraindication to COVID-19 vaccines to generate a COVID-19 Digital Certificate.

Missing COVID-19 vaccination records

If your COVID-19 vaccinations aren’t showing after 10 days, or can’t be updated by the provider, call the Australian Immunisation Register.

Roadmap to freedom

Roadmap for the fully vaccinated – NSW Health

Find a clinic an book
COVID-19 vaccine information

TTS information

TTS information sheet and Risk/Benefit informaiton sheet

Information for teens/kids
Preparing for COVID-19 vaccine
Translated resources 
Websites 
Posters
5. Safety Information
Anaphylaxis
Reporting Adverse Events

NSW Health: What is a serious adverse event?

Health professionals are required to report suspected reactions, known as adverse events following immunisation (AEFI) particularly if they are unexpected or significant.

If a patient has an immediate serious reaction or is unwell in the days after a vaccination, you must report to:

and

See also:

TGA safety reports

COVID-19 vaccine weekly safety report

COVID-19 vaccine safety surveillance

 

COVID-19 vaccine administration errors

ATAGI guidelines on the management of a range of possible vaccine administration errors, including when a replacement (repeat) dose is recommended.

 

Advice on Vaccine Errors

Don’t forget to check – Poster

  1. Advice retlating to patient:
    • Open disclosure of the incident to the patient/parents of the patient.
    • Inform patient of any expected side effects and possible remedies to help with side effects.
    • Arrange follow up appointment for patient with GP – mainly as a health check, but also to maintaining the GP/patient relationship.
    • Give the Patient/Parents HCCC contact details in case they want to report a complaint:
  2. Advice relating to practice:
      • Usual incident reporting process within the practice
      • Inform the practice Insurer
      • Review practice policies/process to avoid error in future
  3. Clinical advice:
    • Send patient to ED if patient clinical unwell
    • Call NSWISS (Specialist Immunisation Clinic) if clinical advice re patient symptoms is required
    • Report AEFI if patients has symptoms – download the AEFI TGA Reporting Form
    • For accidental overdose see below.
  4. For COVID-19 vaccinations, send an error report to Vaccine Operations Centre (VOC):
Accidental overdose
  1. If an accidental overdose occurs, it is recommended to observe vital signs and, if symptomatic, to treat the symptoms. There are no specific overdose symptoms to be aware of.
  2. Follow the above Advice on Vaccine Errors – This error must be recorded through your normal jurisdictional medication error reporting systems.
  3. For more information, the Poisons Information Centre may be contacted on 131 126.
Revaccination following vaccine error

If an error has occurred during vaccine preparation or vaccine administration, resulting in an inadequate two-dose primary course, another dose may be recommended. The aim of replacement doses is to attain a level of immune response that is comparable to that expected following completion of a two-dose primary course of a COVID-19 vaccine according to the recommended dosage and schedule (ATAGI, 2021u).

Vaccine Administration Error ATAGI Recommendation

Less than half of the vaccine dose volume (estimated) was administered

Give a replacement dose a minimum of 1 week after the invalid dose, and a subsequent dose as indicated

Incorrect diluent (such as sterile water for injection) used to dilute Pfizer (COMIRNATY) (For Age 5 to <12 Years) vaccine dose

Give a replacement dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) a minimum of 1 week after the invalid dose, and a subsequent dose as indicated

Only the diluent of Pfizer (COMIRNATY) (For Age 5 to <12 Years) was administered (i.e. no Pfizer (COMIRNATY) vaccine ingredient)

Give a replacement dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) as soon as feasible, and a subsequent dose if indicated

If the 2nd dose of Pfizer (COMIRNATY) (Age 5 to <12 Years) is administered less than 14 days after the first dose, it is considered an invalid dose.

An additional dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) should be administered as a replacement dose. The interval between the invalid 2nd dose and the replacement dose is flexible, recommended at 4 to 12 weeks after the invalid 2nd dose (ATAGI, 2021u).

6. COVID-19 Vaccination Training
Mandatory COVID-19 training  

In order to administer vaccines, each health professional involved in the administration of COVID-19 vaccines is required to complete the training.

COMPLETE NOW: COVID-19 Vaccination Training Program

All vaccine administrators must complete the training before the roll-out at their site, and each site is required to maintain a record of completion for all practitioners at their site.

Non-Clinical COVID-19 training modules

Non-clinical modules are also available and provide training on:

  • vaccine handling
  • vaccine storage
  • communication support

These modules were designed to support practice staff including:

  • reception staff
  • administration staff
  • practice manager
Other immunisation education

For COVID-19 vaccinerelated education modules, see Immunisation Education webpage

7. Digital Tools
Australian Immunisation Register

It is mandatory under the Australian Immunisation Register Act 2015 to report all COVID-vaccine encounters to the Australian Immunisation Register (AIR). See Australian Immunisation Register fact sheet – 14 May 2021.

Mandatory reporting & penalties:

COVID-19 vaccine encounters should be uploaded into AIR at the time of administration, or within 24 hours, to ensure consumer immunisation information is up to date.

How to report a vaccination to the AIR:

  • Clinical software integrated with AIR (eg: Best Practice, Medical Director)
  • Onlne AIR site accessed via PRODA/HPOS
My Health Record
Data Extration Tools
8. Communication Materials
Addressing vaccine hesitancy

Tool to address vaccine concerns: CoRiCal

Covid Risk Calculator (CoRiCal)

 

  • What is my chance of getting COVID-19?
  • If I get COVID-19, what are my chances of dying?
  • What is my chance of getting myocarditis?
  • What is my chance of dying from myocarditis?

Understanding and addressing vaccine hesitancy

Resources to address vaccine hesitancy 

Communication tools to address vaccine hesitancy

Hesitancy

Multicultural communication materials

Translated resources 

Supporting communication for the COVID-19 vaccination program – This glossary was developed to help community organisations, translators and interpreters, bilingual workers, and community leaders to better understand and communicate about vaccine development and implementation.

COVID-19 communication materials

Information for teens/kids

Guidance to help people make informed decisions

Information for Aboriginal and Torres Strait Islander peoples

9. Clinic locations & home vaccine services

COVID-19 vaccine clinics

Find a GP or Pharmacy vaccine clinic – Vaccine Clinic Finder.

NSW Health Vaccination Centre – Book appointment

See list of GP Respiratory Clinics in CESPHN

Vaccine Clinic Finder

VCF Connect

Vaccine Clinic Finder Connect (VCF Connect) is designed  for clinics to self-manage COVID-19 vaccine clinic details on the COVID-19 Vaccine Clinic Finder. See RACGP training on VCF Connect. Quick Reference Guide – Vaccine Clinic Finder (VCF) Connect

VCF Connect – Power Point

Contact CV19.Products@Health.gov.au

 

CESPHN Vax at Home program 

The CESPHN Vax at Home Service is ONLY for those people who are housebound and not able to leave their house to receive a COVID-19 vaccination or booster (their carers will also be able to be vaccinated).  

Patient self-referrals will NOT be accepted. Patients should speak with their GP for referral to this program if appropriate. Referrals will be accepted from general practitioners and from Local Health Districts. More information.

 

The Vax at Home Service will accept referrals for people 16 years and over. For children 12-16 years with special circumstances and may require further support, referrals will be reviewed on a case by case basis.

 

Referrals MUST be sent through this Vax at Home Service Online Form – for people who are housebound and reside in the Sydney Local Health District or South Eastern Sydney Local Health District regions.

For further information (no referrals) on the program, please email vaxathomeservice@cesphn.com.au

10. Aged Care | Indigenous | Disability

RACF

See CESPHN Immunisation – RACF webpage

Aboriginal and Torres Strait Islander

See CESPHN Immunisation – Indigenous webpage

Disability 

Submitting an Expression of Interest for Commonwealth in-reach (VAPP)

Disability service providers may submit an expression of interest to the Department of Health for Commonwealth in-reach support, where this is still the most appropriate vaccination service. Disability Service Providers should submit the form; or, for individuals in need of in-home support, the PHN can submit the form on their behalf.

Once received, a VAPP provider will be allocated to support the disability service provider or individual with their vaccination needs. Where to go for more information More information on the Winter dose, vaccination options, and the in-reach program for people with disability are available on the Department of Health’s website. Enquiries can also be sent to DisabilityCovidVaccineDelivery@health.gov.au

Provider resources

Access to COVID-19 vaccines

In-home and community aged care recipients and workers

COVID-19 vaccination – COVID-19 vaccine information for in-home and community aged care recipients and workers

Aged 60 years and over

  • GP clinic
  • Commonwealth Vaccination Clinic (GP respiratory clinic)
  • Aboriginal and Torres Strait Islander Community Controlled Health Service
  • State or territory AstraZeneca vaccination clinic

Aged under 60 years

  • State or territory Pfizer vaccination clinic

Visit website to find out how to book your vaccination appointment.

11. Pharmacy
  • Find a COVID-19 vaccine pharmacy
  • Spikevax (Moderna) information
  • Vaxzevria (AstraZeneca) information
13. Support

Support Contacts 

Need support? See COVID-19 Q&A April 2020

NSWISS clinical Support: NSW Immunisation Specialist Service

VOC: Vaccine Operations Centre

VCF connect

CVAS: COVID-19 Vaccine Ordering System

Department of Health COVID-19 support: 

Translating service

  • For translating and interpreting services, call 131 450.
State vaccine centres 
  • NSW Health COVID-19 Vaccination Program hotline 1800 571 155
  • Sydney Local Health District COVID-19 Vaccination Program hotline on 1800 955 566

GPRC support

  • GPRC Hotline: 02 6289 8822

CESPHN COVID-19 support:

Subscribe to Sydney Health Weekly to receive immunisation updates

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