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the COVID-19 Pfizer vaccine be preferred over AstraZeneca for adults aged under 50 years. This is because there is a potentially higher risk of thrombosis with thrombocytopenia in people aged under 50, who receive the AstraZeneca vaccine
the AstraZeneca vaccine be used in adults aged under 50, if the benefits outweigh the risks for that person – and they have made an informed decision based on the risks and benefits
people who have had the first dose of AstraZeneca without any serious adverse effects, can be given the second dose. This includes people aged under 50.
The AZ vaccine can be stored in cold chain conditions of 2°C to 8°C for a maximum of 6 months as per expiry date printed on the vial. DO NOT FREEZE
The vials should be stored in their original outer packaging (carton) to protect them from light.
Opened – in vial
After first opening(needle first penetrate the bung), the multidose vial must be used within:
6 hours when stored at room temperature (up to 30°C), or
2 days (48 hours) when stored in a refrigerator (2°C to 8°C)
The vial can be re-refrigerated, but after first opening the cumulative storage time at room temperature must not exceed 6 hours, and the total cumulative storage time must not exceed 48 hours. After this time, the vial must be discarded.
Opened – drawn up in syringe
The stability of the vaccine after drawing it up into a syringe has not been studies and it therefore should be administered immediately after being drawn up.
Each dose should be used as soon as practical once withdrawn from the vial into a syringe.
You may pre-draw multiple doses from one vial into syringes and:
Use syringe within one hour if stored at room temperature, or
Use syringe within six hours if stored at 2°C to 8°C
ATAGI recommends thatpre-drawn doses be used within an hourin order to minimise any remote potential risk of infection.
Checks before vaccine administration
Check vial expirydate
Check time since opening (needle first penetrate the bung)
If the vial has been opened/penetrated and there is no clear indication of the date & time of opening, the vial must be disposed of and VOC notified via the stock management reporting.
Needles and syringes
Drawing Up
Needle: a sterile 19 or 21 gaugeNON- coring bevelled drawing up needle is recommend for drawing up
Syringe: a 2ml or 3ml syringe is recommended for doses of 0.5ml or greater
Administration
A new syringe and needle must be used for administration to each individual
A sterile 22 to 25 gauge 25mm length needle is recommended for IM administration
For individuals with obesity a 38mm length needle is recommendedfor IM administration
AstraZeneca – Managing excess doses
Excess doses are vials of COVID-19 vaccine which will expire before the next scheduled patientbooked for COVID-19 vaccine.
Batching bookings within a vaccination session to match the number of doses in a vial. (e.g. book 10 appointments for 10 dose vial)
Plan for cancelled appointments or no-showsin order to minimise vaccine wastage.
Use identified excess doses for other patients or staff who fit the eligibility criteria and who are present in the practice.
Where these options are not available, practices should use identified excess doses for other patients or staff who fit the 2A or 2B eligibility criteria.
Maintain a reserve list of eligible patients who could come in at short notice
If a vial is opened but refrigerated, then the vaccine can still be administered up to 48 hours post opening.
COVID-19 Symptom Checker – encourage patients to get tested, particularly as the weather starts to cool down and people display more flu or cold symptoms.
“Make Up” Pfizer doses for RACF residents who missed a second dose
Primary Health Networks (PHNs) are working to implement local solutions to ensure access to people who missed out on their second Pfizer dose at a residential aged care facility.
If your facility is aware of people who have missed a second Pfizer dose, please forward these details to your local PHN, if you haven’t already. Email j.cardoso@cesphn.com.au
The Department of Health has updated its COVID-19 vaccine doses policy. The updated policy specifies that people should only be vaccinated if they expect to be at the facility to receive both doses. The policy also provides that first doses should not be administered at a second dose clinic.
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