IMPORTANT NOTICE

This post is not the latest immunisation update and therefore may contain information or advice that is out of date. Please see our most recent update here.

Immunisation weekly update – 30 June 2021

30 June 2021

AstraZeneca vaccine – expanded access to people aged 18 to 39

It has just been announced that anyone 18 years and over is eligible for AstraZeneca vaccine.

This means people aged 18 to 39 – who are not otherwise eligible – can choose to receive the AstraZeneca vaccine after the appropriate individual risk-benefit analysis and consent process. Health providers should only vaccinate patients with AstraZeneca without a contraindication and if the person gives fully informed consent, noting they will be able to access Pfizer later in the year.

The medical advice on which vaccine to get – Pfizer or AstraZeneca – has not changed. The Pfizer vaccine remains the preferred vaccine for people under 60. However, under new arrangements, access to the AstraZeneca vaccine is being expanded to adults under 40 – provided they give informed consent. Making AstraZeneca available to a wider section of the population will give informed younger people the option to be vaccinated as Australia enters this next critical stage of the COVID-19 pandemic.

The eligibility checker will be updated to reflect these changes. Guidance on weighing up the potential benefits can be used to aid conversations with patients.

Resources

New indemnity provisions

The Prime Minister announced an indemnity scheme for practitioners who administer COVID-19 vaccines.

The scheme will cover all approved COVID-19 vaccines administered by all privately practicing health practitioners administering doses on behalf of the Commonwealth. This includes the expanded availability of AstraZeneca to people aged 18 to 39, if they so choose.

The scheme’s design includes a proposal to provide an administrative claims process which would avoid the need for patients to enter into litigation against a practitioner where there is clear evidence of a significant vaccine related injury.

The scheme will provide another layer of assurance to our vaccine administrators, and the Australian public, that the Government has full confidence in the rollout program and the vaccines being administered.

Roving vaccination clinics

On 24 June 2021, the Commonwealth announced they will be deploying roving clinics to 94 residential aged care facilities in the Local Government Areas (LGAs) of: City of Sydney, Bayside, Canada Bay, Inner West, Randwick, Waverley, Woollahra.

The roving clinics are offering a Pfizer COVID-19 vaccine to any residents and workers yet to receive a vaccine.

All 94 residential aged care facilities have received first and second dose clinics through the Commonwealth vaccine roll out in aged care.

Reminder to vaccinate

Noting the community transmission of COVID-19 in Sydney, it is important to continue to encourage your patients and people aged 60 and over to book for their AstraZeneca vaccine. This includes those who have not yet received their first dose, and a reminder to those due for their second dose. Please make sure you book patients in for their second dose at the same time as their first dose.

The recommended interval between two doses of COVID-19 Vaccine AstraZeneca is 12 weeks. Shortening the interval from 12 weeks to no less than 4 weeks between doses is acceptable and may be appropriate in certain circumstances, for example, imminent travel or anticipated risk of COVID-19 exposure.

It is important to remind patients about their upcoming second dose appointment. A second dose flyer for patients receiving their COVID-19 vaccine is available for distribution.

The ATAGI Clinical guidance on use of COVID-19 vaccine in Australia in 2021 (v5.1) states: “COVID-19 Vaccine AstraZeneca (AstraZeneca Pty Ltd) is provisionally registered in people aged ≥18 years and is given in a two-dose schedule. Efficacy against symptomatic COVID-19 ranges from about 62% to 73%, with the higher efficacy seen after a longer interval (12 weeks) between doses. Efficacy from day 22 after the first dose up until 12 weeks is about 73%.”

Expiring Doses of AstraZeneca Vaccine

Please check the batch expiry dates on your vaccines and rotate the stock appropriately to minimise the risk of expired vaccine doses.

There are three batches of AstraZeneca vaccine due to expire on 30 June 2021: PW40038 PV46672 PE40043

Ensure that all wastage of vaccine (including expiration) is reported in your stock management forms. Any wastage greater than 5 vials should be reported to the VOC, and a wastage report should be completed.

Waste needs to be disposed of in accordance with the mandatory training, and vials must be disposed of in the provided sharps containers to ensure they cannot be accessed.

Promotion of COVID-19 vaccinations

Recent TGA regulatory changes regarding the promotion of approved COVID-19 vaccines clarify the way healthcare professionals can communicate to the public about COVID-19 vaccines and gives greater flexibility to openly discuss vaccination.

The updated TGA regulations and guidance permits health practitioners, and others, to develop their own materials to communicate publicly about COVID-19 vaccines, within particular bounds. The TGA’s guidance states that the materials must not make statements that are misleading or deceptive, claim that vaccination is totally safe, or compare the different types of COVID-19 vaccines.

Practice Incentives Payments (PIP)

As patients start receiving second dosed of the AstraZeneca vaccine, eligible practices will start accruing COVID-19 Vaccine General Practice Incentive payments, set at $10 per patient who has received a Medicare Benefits Schedule COVID-19 vaccine suitability assessment service for both doses of the vaccine at the same practice.

COVID-19 Vaccine General Practice Incentive payments are based on the services provided from March 2021 and will be made with the PIP quarterly payment. Payments are expected to commence from the August 2021 payment quarter.

Planned and unplanned power outages

We are aware of many planned power outages coming up over the next couple of weeks. If your practice has been advised of a planned power outage, it is important you know what to do to maintain appropriate cold chain for your vaccines. It is not appropriate to take vaccines offsite, unless you are moving them to a purpose built vaccine specific refrigerator, which is data logged every 5 minutes, and twice daily temperature checks are monitored, in line with National vaccine storage guidelines – Strive for 5.

Uninterruptible power supply (UPS), also known as a battery backup, provides backup power when your regular power source fails, or voltage drops to an unacceptable level. During a power outage, internal batteries in the UPS keep loads running long enough for normal utility power to come back on or to properly shut down systems.

Benefits of UPS include:

Automated power supply coverage in power outages
Minimises human error and vaccine wastage
Does not take up much room
Keeps vaccines in refrigerator
Range of sizes

The size and design of a UPS determines how long it will supply power. Please see our information sheet “Alternative vaccine storage options in a power failure” for more information and where to purchase.

If the practice experiences an interruption to power supply (planned or unplanned) without back up power supply:

Consider covering the glass door with insulating material (cardboard, bubble wrap or a blanket) and place ice bricks in empty spaces, taking care not to place them alongside vaccines, and keep the door closed.
Ensure the fridge temperature is being monitored during this time.
If the power loss continues and the temperature of the vaccine fridge rises above 8°C, move vaccines to eskies, packed appropriately and monitor the temperature of the eskies using a min/max thermometer and the NSW Health temperature monitoring chart.
CESPHN have an information sheet on power failure action plan. Please print this off and keep a copy with your eskies, along with the National Vaccine Storage Guidelines ‘Strive for 5’, Appendix 9 – Checklist for Managing a Power Failure.
If power is off for extended periods of time, monitor your esky, and change over ice packs as required.

Other important points to consider:

Do not over order NIP vaccines. You can order twice a month, therefore only order what you need.
Ensure that responsible staff check and record the temperature readings (current, minimum and maximum) on the vaccine fridge twice daily (every day that the practice is open).
- Confirm all staff have completed HETI Vaccine Storage and Cold Chain Managementonline training module with certificates on file.
- Confirm all staff know how to record and reset readings.
- Confirm all staff know what to do if a breach is identified.
Check the data logger is set up correctly to record temperatures every five minutes.
- Confirm staff know how to download and review the data logger report.
If using a cooler as part of your back-up plan, make sure all staff know what to do in a power failure. Ensure you have adequate sized eskies to hold all vaccine stock, enough ice packs, bubble wrap and a portable digital thermometer per esky as a means of alternative vaccine storage if a fridge or power failure occurs.

Further support

CESPHN Immunisation: 1300 986 991, option 3 for immunisation

Public Health Unit: 1300 066 055

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 1 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 – ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021 (updated 18 June)

Clinical guidance for COVID-19 immunisation providers and program staff.

COVID-19 vaccination – Weighing up the potential benefits against risk of harm from COVID-19 Vaccine AstraZeneca (updated 18 June)

Information about the AstraZeneca vaccine to help patients make informed decisions.

Patient information sheet on AstraZeneca COVID-19 vaccine and thrombosis with thrombocytopenia syndrome (TTS) (updated 18 June)

Patient information about the AstraZeneca vaccine and the COVID-19 vaccination program.

COVID-19 vaccination – Why should I get the COVID-19 vaccine? (updated 28 June)

This poster explains why you should get the COVID-19 vaccine.

COVID-19 vaccination – COVID Vaccination Allocations Horizons (23 June)

This document was provided to State and Territory Health CEOs by the Coordinator General of the National COVID Vaccine Taskforce on 19 June 2021, and outlines the National Vaccination Allocation Horizons by state and territory.

COVID-19 Vaccine resource webpage

Collection of the latest COVID-19 vaccine resources for immunisation providers and patients