Immunisation weekly update – 4 August 2021

4 August 2021

Clinical guidance on use of COVID-19 vaccine in Australia in 2021 (v6.0)

The updated clinical guidance provides recommendations on the use of the Comirnaty (Pfizer) COVID-19 vaccine and COVID-19 Vaccine AstraZeneca. Recent changes from previous versions of ATAGI Clinical guidance on COVID-19 vaccines in Australia include:

• Recommendations for children aged 12-15 years
• Mixed vaccination schedules in special circumstances
• Myocarditis and pericarditis following Pfizer vaccine
• New contraindication to AstraZeneca vaccine: history of capillary leak syndrome

Related COVID-19 vaccination resources:

• Clinical advice on the use of a different COVID-19 vaccine as the second dose (30 July)
• Guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines (30 July) 

Pfizer COVID-19 vaccine recommendations for at risk children aged 12-15 years

From Monday 9 August, the following groups of children aged 12–15 years will be eligible to receive Pfizer vaccine:

• children with specified medical conditions that increase their risk of severe COVID-19, including asthma, diabetes, obesity, cardiac and circulatory congenital anomalies, neuro developmental disorders, epilepsy, immuno-compromised and trisomy 21
• Aboriginal and Torres Strait Islander children aged 12–15 years
• all children aged 12–15 years in remote communities, as part of broader community outreach vaccination programs that provide vaccines for all ages (≥12 years).

This follows the ATAGI statement regarding vaccination of adolescents aged 12–15 years, which has recommended its use for children at a higher risk of severe illness if they contract COVID-19.

Pfizer vaccination for Year 12 students

NSW Health has organised the redistribution of Pfizer doses to south west and western Sydney due to the need to vaccinate Year 12 students in the LGAs most affected by the current COVID-19 outbreak. Year 12 student vaccination is the responsibility of NSW Health, unless the student also meets the eligibility criteria, and therefore would be able to book an appointment using the COVID-19 vaccine eligibility checker.

General practices participating in the COVID-19 vaccination roll out are advised that Year 12 students are not eligible to receive Pfizer vaccination in general practice, unless they also meet the eligibility criteria for 16-39 year olds. 

COVID-19 vaccines in the setting of the Delta variant in greater Sydney

ATAGI released a statement reiterating that all adults in greater Sydney should strongly consider the benefits of earlier protection with COVID-19 Vaccine AstraZeneca rather than waiting for alternative vaccines. ATAGI reaffirms previous advice that in a large outbreak, the benefits of the COVID-19 Vaccine AstraZeneca are greater than the risk of rare side effects for all age groups.

People who receive COVID-19 Vaccine AstraZeneca should be aware of the symptoms of thrombosis with thrombocytopenia syndrome (TTS), and when to seek prompt medical attention. Early detection of TTS means that people can get treatment and this can improve outcomes.

Adding overseas COVID-19 vaccinations to the AIR

A vaccination provider can record a patient’s overseas COVID-19 vaccinations on the Australian Immunisation Register (AIR) if both of the following apply:

• the vaccine is approved for use in Australia (i.e. AstraZeneca, Pfizer or Moderna) and
• the patient received it on or after the Australian approval date (1 October 2020)

Patients will need to provide proof of vaccination documents translated in English.

If a patient has received a COVID-19 vaccine overseas which isn’t AstraZeneca, Pfizer or Moderna or it was received prior to the Australian approval date, it cannot be added to the AIR. See Services Australia website.

Proof of COVID-19 vaccination

The Australian Immunisation Register (AIR) currently provides Australians with two options for providing evidence of their COVID-19 vaccinations:

• COVID-19 Digital Certificate – for individuals who have received all required doses of a vaccine as approved for use in Australia. See how to download COVID-19 digital certificate to a digital wallet.
• Immunisation History Statement – for individuals who have had one COVID-19 vaccination, different COVID vaccines, or at intervals not recommended by ATAGI.

Vaccination providers must report all COVID-19 vaccination information to the AIR.

Closure of AIR authentication files

Authentication file access to the Australian Immunisation Register (AIR) is being closed to all provider types on 30 September 2021. More information can be found here.

All providers need to transition to Provider Digital Access (PRODA) to maintain access. With a PRODA account, health professionals can access the AIR using Health Professional Online Services (HPOS). 

Pharmacists to administer AstraZeneca COVID-19 vaccine

On 30 July 2021, the NSW Pharmacist Vaccination Standards  was amended to include the administration of the COVID-19 AstraZeneca vaccine, to people aged 18 years and older. Authorised settings for pharmacists include:

• Retail pharmacies registered to participate in the COVID-19 vaccination program
• General Practices registered to participate in the COVID-19 vaccination program
• Aboriginal Medical Services registered to participate in the COVID-19 vaccination program
• Residential Care Facilities

See Minister for Health media release about the on-boarding of community pharmacies.

National Plan to transition Australia’s National COVID-19 Response

National Cabinet agreed to formulate a National Plan to transition Australia’s National COVID-19 Response from its current pre vaccination settings, focussing on continued suppression of community transmission, to post vaccination settings focussed on prevention of serious illness, hospitalisation and fatality, and the public health management of other infectious diseases.

The National Plan sets out four phases to effectuate this transition. Each phase will be triggered by the achievement of vaccination thresholds of both the nation, and the individual state or territory expressed as a percentage of the eligible population (16+).

NSWISS helpline for COVID-19 vaccine clinical advice

Immunisation providers are encouraged to check the NCIRS COVID-19 vaccines FAQ which provides answers to some of the most frequently asked questions about COVID-19 vaccines. The FAQs have been updated comprehensively and includes new questions and answers on topics such as:

• use of AstraZeneca vaccine in people under 60 years of age
• COVID-19 vaccination in pregnancy
• capillary leak syndrome
• myocarditis and pericarditis
• whether booster doses of COVID-19 vaccine will be required

For other clinical advice on immunisations including COVID-19, immunisation providers can contact the NSW Immunisation Specialist Service NSWISS helpline.

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. Get involved by submitting questions and comments!

Details: Thursday 5 August, 11:30am (AEDT) | Click link to join

Catch up on previous webinars 

New resources

• COVID-19 vaccination – Eligibility for the Pfizer vaccine
  This fact sheet outlines who is currently eligible to receive the Pfizer COVID-19 vaccine.
  
• COVID-19 vaccination – ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021
  Clinical guidance for COVID-19 immunisation providers and program staff.
• COVID-19 vaccination – Guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines
  This guidance has been developed jointly by the Australian Technical Advisory Group on Immunisation (ATAGI) and the Cardiac Society of Australia and New Zealand (CSANZ).
• COVID-19 vaccination – Clinical advice on the use of a different COVID-19 vaccine as the second dose
  ATAGI recommends to use the same COVID-19 vaccine for the 2 doses of the primary vaccination course, unless there are specific medical reasons not to do so, or the same vaccine brand is not available in Australia.
• COVID-19 vaccination – Geographic vaccination rates – 2 August 2021
  This report lists the percentage of people aged 15 and over who have been vaccinated against COVID-19, by state and territory. The percentages are further broken down by geographic regions and whether they’ve had one dose or are fully vaccinated.
• NSW Health – Requests for alternative COVID-19 Vaccines
  This fact sheet outlining who should receive the Pfizer and AstraZeneca vaccines. A referral form can be used for patients who have been recommended by their GP to receive the Pfizer vaccine due to a medical condition aligning with ATAGI’s recommendations.
• Medicare Support for COVID-19 Vaccinations
  Frequently Asked Questions updated 27 July 2021 about Medicare Benefits Schedule – Medicare Support for COVID-19 Vaccinations
• COVID-19 vaccination – Business kit
  This set of resources is to help businesses promote COVID-19 vaccination to their employees. Use the resources to help spread the message of the importance of vaccination, encourage people to look for accurate information from trusted sources and lead by example in promoting the vaccination