Immunisation weekly update – 14 July 2021

14 July 2021

Recommended interval between AstraZeneca vaccine doses in outbreak situations

On 13 July, ATAGI released a statement which recommends that in outbreak situations, a shorter interval of 4 to 8 weeks is preferred between the first and second doses of COVID-19 Vaccine AstraZeneca. Shortening the gap between first and second doses will bring forward short term protection, which is expected to be beneficial in outbreak situations.

In non-outbreak settings, the preferred interval between doses of COVID-19 Vaccine AstraZeneca remains at 12 weeks.

Who is eligible to receive the Pfizer COVID-19 vaccine?

The following people are currently eligible for the Pfizer vaccine:

• All people aged 40 to 59 years
• All residential aged care workers aged 16 years or older 
• Certain eligible people aged 16 to 39 years – check eligibility criteria  
• People aged 60 years and over with a contraindication to the AstraZeneca vaccine or with a history of the following:
• Cerebral venous sinus thrombosis, Heparin-induced thrombocytopenia, Idiopathic splanchnic (mesenteric, portal, splenic) vein thrombosis, Antiphospholipid syndrome with thrombosis 

Identifying, diagnosing and treating TTS

This new clinical guideline for health professions outlines the primary care approach to identifying, diagnosing and treating thrombosis with thrombocytopenia syndrome (TTS) after COVID-19 AstraZeneca vaccine.

Key messages

• Primary health care providers should consider the potential for a patient having TTS if they present with possible thrombosis or thrombocytopenia 4-42 days after they have received a dose of the AstraZeneca vaccine.
• Suspected cases should be immediately referred to an emergency department if they are acutely unwell (for example, they have a neurological deficit).

More information on TTS: Patient information sheet and Information for Providers.

Prioritisation of aged care workers

Prioritisation of residential aged care workers is particularly important given it will be mandatory for all aged care workers to have received a minimum first dose COVID-19 vaccine by 17 September as a condition of employment.

Vaccination sites are requested to facilitate access to a vaccine booking (with AstraZeneca or Pfizer if available) withintwo weeks upon receiving a request from an aged care worker where possible. All aged care workers, regardless of age, can access the Pfizer vaccine. 

For more information click here.

Home visits for patients who cannot attend a clinic

Both the Pfizer and AstraZeneca COVID-19 vaccines are in multi-dose vials. This may make it challenging to administer vaccines off-site such as for home visits, or at residential aged care or disability accommodation facilities. The following advicehas been provided for vaccine providers for administering COVID-19 vaccines off-site:

• transport the vial and draw up the dose at the site of administration. For the Pfizer vaccine, you can either dilute the vaccine in your practice or at the site of administration
• transport pre-drawn doses if you can appropriately store the vaccine and deliver it promptly. This means protecting the vaccine from light and maintaining appropriate cold chain. This also means delivering the vaccine within one hour if kept at room temperature, or six hours if stored at 2-8°C. If you cannot ensure these conditions, you should transport the vial and draw up the dose on site.

You must ensure that each vial or dose is stored at the recommended temperature and does not exceed the total maximum storage period specified in the Product Information. See AstraZeneca product information and Pfizer product information. ATAGI recommends that, when possible, pre-drawn doses kept at room temperature be used within an hour to minimise any remote potential risk of infection. See Transporting, storing and handling vaccines p20

MBS item numbers that can be claimed for COVID-19 vaccination home visits: 

• 90005 Flag fall service Fee: $67.35 Benefit: 85% = $57.25
• 10660 In-Depth Patient Assessment Fee: $45.95 Benefit: 85% = $39.10
• 93624 Suitability assessment (first dose) Fee: $36.50 Benefit: 85% = $31.05
• 93644 Suitability assessment (second dose) Fee: $28.75 Benefit: 85% = $24.45

Two zoster vaccines now available for use

The ATAGI clinical statement provides recommendations for the two zoster vaccines now available for use, Zostavax and Shingrix.

• Shingrix is preferred over Zostavax from age 50 years and above for prevention of herpes zoster and its complications, due to its higher efficacy. However, availability is expected to be limited, and it needs to be privately prescribed.
• Zostavax remains a readily available and effective alternative vaccine for immunocompetent adults aged ≥50 years who wish to reduce their risk of herpes zoster. It is recommended and funded under the National Immunisation Program (NIP) for immunocompetent people aged 70 years of age (with catch-up for those aged 71-79 years until October 2021).

Where to report a cold chain breach

Cold chain breach of all COVID-19 vaccines should be reported to the Vaccine Operations Centre (VOC) on 1800 318 208. VOC hours of operation are from 7am to 10pm AEST, or email COVID19VaccineOperationsCentre@Health.gov.au. 

Cold chain breach of National Immunisation Program (NIP) vaccines should be reported to the Public Health Unit (PHU). Fill out the Cold chain breach and vaccine wastage reporting form and submit to PHU along with data logger report and temperature chart. 

• Sydney PHU: SLHD-Immunisation@health.nsw.gov.au
• South Eastern Sydney PHU: SESLHD-PublicHealthUnit-IMMTeam@health.nsw.gov.au

For privately purchased vaccines, contact the vaccine manufacturer for further advice following a cold chain breach.

Mandatory reporting of all nip vaccines

From 1 July 2021, vaccination providers are required to report all National Immunisation Program (NIP) vaccines administered to the Australian Immunisation Register (AIR) within 24 hours, and no more than 10 working days after the vaccination. 

Health professionals should use the latest version of their clinical software to make sure they meet reporting requirements.

For more information click here.

Covid-19 live stream update for GPs

Join the latest COVID-19 vaccine live stream update for GPs.

The panel will provide latest key updates and answer participants’ questions live about the COVID-19 vaccine rollout.   

Details:  Thursday,  15 July 11:30am (AEDT) | Click link to join 

Get involved by submitting questions and comments!

Catch up on previous webinars 

New resources 

• COVID-19 vaccination – Primary care approach to thrombosis with thrombocytopenia syndrome after COVID-19 AstraZeneca vaccine 
• COVID-19 vaccination – Aged care vaccination rollout – Update for residents and families
• COVID-19 Vaccination- Guidance for residential aged care providers on reporting of COVID-19 vaccination for workforce
• COVID-19 vaccination- Guidance for in -home and community aged care providers on reporting of COVID-19 vaccinations of the workforce
• COVID-19 vaccination- why is my in-home and community aged care employer asking me if I have received a COVID-19 vaccination?
• COVID- 19 Vaccination – Why is my residential aged care employer asking me if I have received a COVID-19 Vaccination?