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COVID-19: GP Alert (19 October 2021)

October 19, 2021

Third COVID-19 dose for immunocompromised people - Updated forms and guidance

The National COVID Vaccine Taskforce (Taskforce) has updated a range of documents on the Department of Health’s website to support vaccination providers in administering third COVID-19 vaccine doses to individuals who are severely immunocompromised:

You can also find more information about ATAGI’s statement on third doses as part of the primary course on the Department’s website. Please remember this statement is not about boosters for the general population. ATAGI is anticipated to provide further advice about boosters shortly.

TGA Update - Updated forms and guidance

On 1 October 2021, the Prime Minister, the Hon Scott Morrison MP, announced that the Therapeutic Goods Administration (TGA) is reviewing international COVID-19 vaccines for the purposes of determining ‘recognised vaccines’ as part of the new anticipated quarantine arrangements for the Australian Government’s plan to re-open Australia’s international borders.

The TGA has now recognised Coronavac (Sinovac) and Covishield (AstraZeneca/Serum Institute of India) as ‘recognised vaccines’ in Australia. The TGA will continue its assessment of other vaccines for the purpose of determining ‘recognised vaccines’ based on the available data and data that is provided. The Australian Immunisation Register (AIR) will be updated to allow these vaccines to be registered.

AIR - Medical contraindications

Medical contraindications can be reported to AIR for COVID-19 vaccines. Medical contraindications can be assessed and reported to the AIR by eligible health professionals, including GPs. There are very few situations where a vaccine is contraindicated and, as such, medical exemption is expected to be rarely required.

Medical contraindications include:
  • Anaphylaxis to any component of the vaccine, including Polythylene Glycol (PEG); and
  • Serious adverse event attributed to a previous dose of a COVID-19 vaccine (and without another cause identified) that has been determined following review by, and/or on the opinion of, an experienced immunisation provider/medical specialist taking into account whether the repeat vaccine doses would be associated with a risk of recurrence of the serious adverse event.

Temporary medical exemptions may be considered for those:

  • with a PCR-confirmed history of SARS-CoV-2 infection in the last 6 months; or
  • recent or complex cardiac illness.

Permanent and temporary contraindications should only be reported for individuals where there is no suitable alternative COVID-19 vaccine available. To report a medical contraindication for COVID-19 vaccines, providers need to select all COVID-19 vaccines listed and approved for use in Australia.

ATAGI have developed supporting clinical guidance for reporting medical contraindications for COVID-19 vaccines. In line with ATAGI guidance, vaccination providers are no longer able to report a medical contraindication to a COVID-19 vaccine for pregnancy in the AIR.

More information can be found on the Department’s website.

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.

In the meantime, individuals who have a medical contraindication reported for COVID-19 vaccines can use their Immunisation History Statement (IHS) as vaccination evidence. The IHS displays all vaccinations, or medical contraindications, that have been reported to the AIR.

Checking AIR before administering COVID-19 vaccines

It is important that you check each patient’s record in the AIR before administering any COVID-19 vaccines to prevent administration errors.

The AIR provides GPs and other medical practitioners with information on how many doses a patient has received, when they were administered and what vaccine brand was given. This will inform what services the individual requires.

Please remember that individuals who are do not have severe immunocompromise should receive:
  • two doses of a COVID-19 vaccine;
  • both doses should be of the same vaccine brand (unless they have had an adverse reaction to the first dose); and
  • the dose interval is dependent on the vaccine brand and should be at least 7 days or more after any other type of vaccination (including flu).

Pfizer Expansion - Ongoing Pfizer transition process

Based on a review of available supply, new general practices joining the COVID-19 Vaccination Program (Program) from late October will be provided with both a Pfizer and Vaxzevria (AstraZeneca) allocation from their commencement in the Program.

The Taskforce is also able to transition existing general practices to Pfizer on a weekly basis, as they express their interest. If you are interested in administering Pfizer and have yet to receive an ongoing allocation, please contact your Primary Health Network (PHN).

Dose allocation increase

On 11 October 2021, the Taskforce was able to increase dose allocation for over 600 general practices that had requested dose increases through their PHN to 1,170 and 1,470 doses a fortnight.

If you would like to be considered for a dose allocation increase for Pfizer, please contact your PHN. PHNs will be collating this information for the Taskforce’s modelling and consideration.