Vaccination After COVID-19 Infection
COVID-19 vaccinations are recommended for people with a past history of COVID-19. The ATAGI clinical guidance on COVID-19 vaccination (pp.15) recommends that vaccination is deferred by up to six months after acute infection with COVID-19. This is because after having had COVID-19, the risk of being re-infected may be reduced for at least six months. Patients who have experienced severe or prolonged symptoms (beyond six months) can be vaccinated on a case-by case basis.
Identifying TTS in Vaccinated Patients
Patients presenting with symptoms of thrombosis with thrombocytopaenia syndrome (TTS) in the 4 to 30 days after vaccination should be managed as per the latest ACEM and THANZ advice. HealthPathways details the investigation and management of TTS under the Vaccination Procedure Pathway (navigate to Management and reporting of side-effects). The Department of Health has collated information for clinicians.
Second Dose and Flu Vaccination Timing
The Australian Technical Advisory Group on Immunisation (ATAGI) clinical guidelines (20 August) recommends timing between COVID-19 vaccine doses is as follows:
- Pfizer/Cominarty: 21 days apart, with a minimum interval of at least 19 days
- AstraZeneca: 12 weeks apart, with a minimum interval of at least 4 weeks. A timeframe of 4-8 weeks is recommended in an outbreak setting.
On 3 June the ATAGI clinical guidelines revised the time between the administration of a COVID-19 vaccine and any other vaccine, including the influenza vaccine, to a minimum interval of 7 days. This interval can be shortened (including same day administration) in special circumstances.
It is important to check each patient’s immunisation history before administering any vaccines. Patients immunisation history can be viewed through The Australian Immunisation Register (AIR), Clinician Vaccine Integrated Platform (CVIP) and My Health Record. Based on current evidence, ATAGI recommends using the same COVID-19 vaccine for the two doses of the primary course.
Adverse Event Following Immunisation Symptom Checker and Reporting
Vaccination providers are reminded to report concerns regarding a suspected adverse event following immunisation (AEFI). All uncommon, unexpected or serious AEFI, must be reported to the local Public Health Unit on 1300 066 055 or by email using the TGA AEFI case notification form. Additional information on investigation, management support and reporting requirements are available on the NSW Health COVID-19 vaccination website.
healthdirect has developed a diagnostic symptom checking tool for recipients of COVID-19 vaccinations and health professionals, to check for common symptoms of the currently available COVID-19 vaccines.
The Australian Government has announced that it has secured 25 million doses of the Moderna COVID-19 vaccine. The agreement includes 10 million doses in 2021 and 15 million doses of Moderna’s updated variant booster vaccine in 2022. Supply in Australia will only commence once the vaccine is approved by the Therapeutic Goods Administration (TGA).
Pfizer/BioNTech Vaccine Approved by TGA
The Therapeutic Goods Administration (TGA) has provisionally approved the Pfizer/BioNTech COVID-19 vaccine for use in Australia under the product name COMIRNATY. This is the first COVID-19 vaccine to receive regulatory approval in Australia. This is the first COVID-19 vaccine to receive regulatory approval in Australia and is approved for use in people aged 16 years and older. Two doses will be required, at least 21 days apart.The Government’s latest advice remains that the first doses of Pfizer are expected to rollout in late February. The Therapeutic Goods Administration (TGA) has concluded that there is no specific risk of vaccination with the Pfizer-BioNTech COVID-19 vaccine in elderly patients.
AstraZeneca Excess Dose Policy
AstraZeneca Pre-Drawn Dosage Advice
The Australian Technical Advisory Group on Immunisation have released new guidance on the storage time for pre-drawn syringes of the COVID-19 AstraZeneca vaccine. The vaccine is able to stored at room temperature (<30 C) for up to one hour, or at 2-8 C for up to 6 hours.