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COVID-19 Vaccine

Latest Recommendations

Screenshot 2023 09 12 184024

Latest Resources

1. COVID-19 UPDATES

COVID-19 reference documents

Following the conclusion of the CVTP training platform, two reference documents are avaialble to support providers :

COVID-19 Vaccination Training Program ending soon

From 1 October 2023, the COVID-19 Vaccination Training Program (CVTP) will be coming to an end. Read article.

 

ATAGI September 2023 update: additional booster

On 1 September 2023, ATAGI released recommendations about an additional 2023 dose of a COVID-19 vaccine. Read article.

  • Recommend an additional 2023 dose for all adults aged 75 years and over if 6 months has passed since last dose
  • Consider an additional 2023 dose for the following groups after discussion with a healthcare provider, if 6 months have passed since their last dose. Groups: all adults aged 65 to 74 years, and/or adults aged 18 to 64 years with severe immunocompromise.

 

Bivalent vaccines preferred for primary course

On 30 May 2023, ATAGI advised that a bivalent COVID-19 vaccine is now preferred over original (ancestral) vaccines for primary vaccination in people aged 12 years or older. Read article.

 

ATAGI February 2023 update: booster advice

On 8 February, ATAGI released recommendations about a 2023 booster dose for adults if their last COVID-19 vaccine dose was 6 months ago or longer, or their last confirmed infection was 6 months ago or longer. Read article.

  • Recommend a 2023 booster dose for all adults aged 65 years and over; and at risk adults aged 18-64 years.
  • Consider a 2023 booster dose for all adults aged 18-64 years without risk factors; at risk children and adolescents aged 5-17 years.
2. COLD CHAIN BREACH (CCB)

COVID-19 Cold Chain Breach (CCB) Reporting Form

Steps to follow for a potential Cold Chain Breach (CCB)

All vaccines involved in a potential CCB, either within the clinical setting or during transit, must be reported to the Vaccine Operations Centre (VOC) as soon as possible.

  1. Place any affected vaccines in quarantine, secured within the appropriate cold chain storage requirements (2 to 8 DEGREE for refrigerated doses).
  2. Mark stock as ‘Do not use, Do not discard’
    Report the potential CCB to the VOC by emailing the completed Cold Chain Breach Reporting Form along with any temperature data to covid19vaccineoperationscentre@health.gov.au.
  3. Wait for the outcome of the assessment and advice on whether the vaccines are safe to use.

Do not use or discard the vaccines until you have been advised to do so.

If you require assistance, the VOC can be contacted on 1800 318 208 during operating hours, 9.00am to 5.30pm Monday to Friday (AEST).

2. CVAS – ORDER MANAGEMENT

CVAS Order Management | User guide

  • CVAS User Guide for COVID-19 vaccination sites – Dept of Health
    • How to complete registration
    • How to complete a site readiness declaration
    • How to submit a delivery acceptance
    • How to submit a stock management report
    • How to submit a wastage report

Update vaccine access in CVAS

Practices can submit a request to access to more vaccine products within CVAS. Check current access via the ‘View Existing Vaccine Access’ button which lists a summary of all vaccine products the site is currently approved to order.

How to submit a request to update vaccine access:

  1. log into the CVAS portal,
  2. navigate to the ‘Manage Account’ tab and
  3. click the ‘Update Vaccine Access’ button and follow the prompts.
3. Provider Information

COVID-19 vaccine administration errors

ATAGI guidelines on the management of a range of possible vaccine administration errors, including when a replacement (repeat) dose is recommended.

Sedation for vaccination

ATAGI advice on use of sedation for COVID-19 vaccination provides an overview of the use of sedation as one of a range of measures to assist in the safe administration of COVID-19 vaccines, in patients with anxiety disorders or needle-phobia.

Appointment Translation

The NSW Multicultural Health Communication Service’s online Appointment Reminder Translation Tool allows you to translate appointment details into your client’s language.

COVID-19 care in the community

Please refer to HealthPathways for the current definitions of low, medium and high risk. These definitions will be frequently updated and will differ between the two LHDs

Transfer of vaccines
  • Too much COVID-19 vaccine stock? Can’t use up vaccines before defrost expiry? Call CESPHN on 1300 986 991 option 7 for COVID-19 or email coronavirus@cesphn.com.au to notify us of excess vaccines available for redistribution.
  • Need more COVID-19 vaccine stock? Delivery delays? Not enough supply?Call CESPHN on 1300 986 991 option 7 for COVID-19 or email coronavirus@cesphn.com.au for assistance with accessing emergency vaccine supplies.

 

COVID-19 vaccine brand that is not available in Australia

ATAGI advice People who have received either a first dose or a full course of a COVID-19 vaccine that is not TGA-approved or TGA-recognised should be offered two doses of an alternative TGA-approved vaccine brand available in Australia to be considered fully vaccinated. People should begin their full course of a TGA-approved or recognised COVID-19 vaccination at an interval of 4 to 12 weeks after their most recent COVID-19 vaccine dose.

 

Clinical support COVID-19 vaccines
ATAGI
Product Information
Mixed (heterologous) schedules
  • ATAGI recommends completing the vaccination course with the same vaccine. Mixed schedules using 2 different vaccines to complete the primary vaccination course are only recommended in special circumstances See page 17 – ATAGI Clinical Guidance
Consent
PPE
MBS items
  • 93624: Dose 1
  • 93644: Dose 2
  • 93644: Dose 3 (immunocompromised)
  • 93644: Booster
  • 90005: Flag fall (co-claim with 93624 or 93644)
  • 10660: In-depth assessment: GP attend to patient >10 mins (co-claim with 93624 or 93644)
  • 93666: Booster incentive (co-claim with 93644 – booster only)
  • 93715: Providing treatment to COVID-19 positive patients
VACCINE ADMINISTRATION ERRORS

COVID-19 vaccine administration errors

ATAGI guidelines on the management of a range of possible vaccine administration errors, including when a replacement (repeat) dose is recommended.

Don’t forget to check – Poster

Advice on Vaccine Errors

Advice relating to patient:

    • Open disclosure of the incident to the patient/parents of the patient.
    • Inform patient of any expected side effects and possible remedies to help with side effects.
    • Arrange follow up appointment for patient with GP – mainly as a health check, but also to maintaining the GP/patient relationship.
    • Give the Patient/Parents HCCC contact details in case they want to report a complaint:

 

Advice relating to practice:

      • Usual incident reporting process within the practice
      • Inform the practice Insurer
      • Review practice policies/process to avoid error in future
      • Send an error report to Vaccine Operations Centre (VOC)

 

Clinical advice:

  • Send patient to ED if patient clinical unwell
    • Call NSWISS (Specialist Immunisation Clinic) if clinical advice re patient symptoms is required
    • Report AEFI if patients has symptoms – download the AEFI TGA Reporting Form
    • For accidental overdose see below.

Accidental overdose

  1. If an accidental overdose occurs, it is recommended to observe vital signs and, if symptomatic, to treat the symptoms. There are no specific overdose symptoms to be aware of.
  2. Follow the above Advice on Vaccine Errors – This error must be recorded through your normal jurisdictional medication error reporting systems.
  3. For more information, the Poisons Information Centre may be contacted on 131 126.

Revaccination following vaccine error

If an error has occurred during vaccine preparation or vaccine administration, resulting in an inadequate two-dose primary course, another dose may be recommended. The aim of replacement doses is to attain a level of immune response that is comparable to that expected following completion of a two-dose primary course of a COVID-19 vaccine according to the recommended dosage and schedule (ATAGI, 2021u).

Vaccine Administration Error ATAGI Recommendation

Less than half of the vaccine dose volume (estimated) was administered

Give a replacement dose a minimum of 1 week after the invalid dose, and a subsequent dose as indicated

Incorrect diluent (such as sterile water for injection) used to dilute Pfizer (COMIRNATY) (For Age 5 to <12 Years) vaccine dose

Give a replacement dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) a minimum of 1 week after the invalid dose, and a subsequent dose as indicated

Only the diluent of Pfizer (COMIRNATY) (For Age 5 to <12 Years) was administered (i.e. no Pfizer (COMIRNATY) vaccine ingredient)

Give a replacement dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) as soon as feasible, and a subsequent dose if indicated

If the 2nd dose of Pfizer (COMIRNATY) (Age 5 to <12 Years) is administered less than 14 days after the first dose, it is considered an invalid dose.

An additional dose of Pfizer (COMIRNATY) (For Age 5 to <12 Years) should be administered as a replacement dose. The interval between the invalid 2nd dose and the replacement dose is flexible, recommended at 4 to 12 weeks after the invalid 2nd dose (ATAGI, 2021u).
8. Communication Materials
Multicultural communication materials

Translated resources 

Supporting communication for the COVID-19 vaccination program – This glossary was developed to help community organisations, translators and interpreters, bilingual workers, and community leaders to better understand and communicate about vaccine development and implementation.

COVID-19 communication materials

Information for teens/kids

Guidance to help people make informed decisions

Information for Aboriginal and Torres Strait Islander peoples

9. VAX AT HOME PROGRAM

CESPHN Vax at Home program 

The CESPHN Vax at Home Service is ONLY for those people who are housebound and not able to leave their house to receive a COVID-19 vaccination or booster (their carers will also be able to be vaccinated).  

Patient self-referrals will NOT be accepted. Patients should speak with their GP for referral to this program if appropriate. Referrals will be accepted from general practitioners and from Local Health Districts. More information.

The Vax at Home Service will accept referrals for people 16 years and over. For children 12-16 years with special circumstances and may require further support, referrals will be reviewed on a case by case basis.

Referrals

Referrals MUST be sent through this Vax at Home Service Online Form – for people who are housebound and reside in the Sydney Local Health District or South Eastern Sydney Local Health District regions.

For further information (no referrals) on the program, please email vaxathomeservice@cesphn.com.au

10. Aged Care | Indigenous | Disability

RACF

See CESPHN Immunisation – RACF webpage

Aboriginal and Torres Strait Islander

See CESPHN Immunisation – Indigenous webpage

Disability 

Provider resources

Access to COVID-19 vaccines

Submitting an Expression of Interest for Commonwealth in-reach (VAPP)

Disability service providers may submit an expression of interest to the Department of Health for Commonwealth in-reach support, where this is still the most appropriate vaccination service. Disability Service Providers should submit the form; or, for individuals in need of in-home support, the PHN can submit the form on their behalf.

Once received, a VAPP provider will be allocated to support the disability service provider or individual with their vaccination needs. Where to go for more information More information on the Winter dose, vaccination options, and the in-reach program for people with disability are available on the Department of Health’s website. Enquiries can also be sent to DisabilityCovidVaccineDelivery@health.gov.au

In-home and community aged care recipients and workers

COVID-19 vaccination – COVID-19 vaccine information for in-home and community aged care recipients and workers

Aged 60 years and over

  • GP clinic
  • Commonwealth Vaccination Clinic (GP respiratory clinic)
  • Aboriginal and Torres Strait Islander Community Controlled Health Service
  • State or territory AstraZeneca vaccination clinic

Aged under 60 years

  • State or territory Pfizer vaccination clinic

Visit website to find out how to book your vaccination appointment.

13. CONTACTS

Support Contacts 

Need support? See COVID-19 Q&A April 2020

NSWISS clinical Support: NSW Immunisation Specialist Service

VOC: Vaccine Operations Centre

VCF connect

CVAS: COVID-19 Vaccine Ordering System

Department of Health COVID-19 support: 

Translating service

  • For translating and interpreting services, call 131 450.
State vaccine centres 
  • NSW Health COVID-19 Vaccination Program hotline 1800 571 155
  • Sydney Local Health District COVID-19 Vaccination Program hotline on 1800 955 566

GPRC support

  • GPRC Hotline: 02 6289 8822

CESPHN COVID-19 support:

RESOURCES

Latest resources

Posters:
• Pfizer Bivalent Comparison poster
• AIR Codes Table
• Don’t Forget to Check
• COVID-19 Vaccine Storage poster

Other:
• COVID-19 Vaccine Transfer Policy
• Service Finder and Online Bookings
• MBS Payments
• Australian Immunisation Register (AIR) for COVID-19 Vaccine

Vaccine Factsheets:

• Pfizer 6 months to 4 years (Maroon Cap)
• Pfizer 5-11 years (Orange Cap)
• Pfizer Bivalent BA.1 18 years+ (grey cap)
• Pfizer Bivalent BA.4-5 12 years+ (grey cap)
• Moderna Bivalent BA. 4-5 PFS
• Novavax

COVID-19 vaccines for Children

All immunisation providers must complete the additional age specific COVID-19 vaccine for children training modules.

Resources 

Patients resources

Vaccine Champion Certificate (1)

Community resources

Provider resources

Paediatric Pfizer – 5 to 11 years  

Provider training

Provider information

Patient information

Moderna – 6 to 11 years

Provider training

Novavax

Provider information

Patient information

Pfizer 12+ (adult)

Patient information

Pericarditis and Myocarditis

Moderna

Provider information (adult)

 

Provider resources (children)

Patient information (children)

Patient information (adult)

AstraZeneca 

Patient information

Thrombosis with thrombocytopenia syndrome (TTS)

ATAGI RECOMMENDATIONS

ATAGI clinical guidance for COVID-19 vaccine providers

Additional 2023 booster – ATAGI update September 2023

On 1 September 2023, ATAGI released recommendations about an additional 2023 dose of a COVID-19 vaccine. More information.

  • Recommend an additional 2023 dose for all adults aged 75 years and over if 6 months has passed since last dose
  • Consider an additional 2023 dose for the following groups after discussion with a healthcare provider, if 6 months have passed since their last dose. Groups: all adults aged 65 to 74 years, and/or adults aged 18 to 64 years with severe immunocompromise.

Bivalent vaccines for primary course – ATAGI update May 2023

On 30 May 2023, ATAGI advised that a bivalent COVID-19 vaccine is now preferred over original (ancestral) vaccines for primary vaccination in people aged 12 years or older. Read full article.

COVID-19 VACCINE AVAILABILITY

COVID-19 discontinued vaccines

  • Moderna Bivalent BA.1 vaccine – final delivery 2 June 2023
  • Pfizer 12 years+ vaccine (purple) – final delivery 23 June 2023

COVID-19 recalled vaccines

  • Novavax recall – batch 4302MF031

Novavax vaccines with Lot No. 4302MF031 has been recalled due to a potential issue with the batch. There are no patient safety concerns associated with the recalled vaccine, however it is still recommended not to use the affected batch.

June 2023 update on vaccine availability

The following COVID-19 vaccines are no longer available in Australia:

  • Moderna 6 months to 5 years formulation (blue cap/purple stripe)
  • Moderna ≥6 years formulation (red cap)
  •  AstraZeneca COVID-19 vaccine.
DISPOSAL OF VACCINES

What is vaccine wastage?

Vaccine wastage refers to the loss of vaccine doses due to cold chain breaches, expired vials or other damage.

How do you dispose of COVID-19 vaccines?

The COVID-19 Vaccination Training gives details on how to dispose of vaccines:

  • Prior to disposal, the outer packaging (carton) should be defaced by striking through at least one panel of the carton with a sharpie or similar marker.
  • Any unused vaccine or waste material should be disposed of in accordance with local requirements in a clinical waste bin – vials must be disposed of in the provided sharps container to ensure they cannot be accessed.

Reporting requirements for vaccine wastage:

Remember to notify wastage to the Vaccine Operations Centre (VOC) through the COVID-19 Vaccine Administrative System (CVAS):

  • wastage less than 5 vials should be reported in your “Vaccine Stock Management Report”
  • wastage of 5 vias and over should also be reported within the “Wastage Report”
  • wastage “incidents” (e.g. damaged vials or breach of cold chain requirements), of 5 vials and over must be reported immediately (within 2 hours of the incident occurring) by calling the VOC on 1800 318 208

Shelf life extension

Pfizer 12+ shelf-life extension – some batches of Pfizer with manufacturer expiry 28 Feb 2022 have had their shelf life extended. Check information sheet before discarding vials.

MEDICAL EXEMPTIONS

Medical exemptions for COVID-19 vaccines

AUSTRALIAN IMMUNISATION REGISTER (AIR)

Reporting overseas vaccines in AIR

COVID-19 vaccines given overseas that have been recognised by the Therapeutic Goods Administration (TGA) can now be recorded on the Australian Immunisation Register (AIR).

  • Covishield (AstraZeneca)
  • Coronavac (Sinovac)
  • Covaxin (Bharat Biotech)
  • BBIBP-CorV (Sinopharm)
  • Sputnik V (Gamaleya Research Institute)

It is important that country of immunisation and batch number are recorded. A list of all vaccines currently able to be reported to AIR is available on the AIR vaccine code page which is updated regularly.

AIR042 report – COVID-19 Vaccination Status 

The AIR042 report identifies patients:

  • aged over 5 years who have not yet received a COVID-19 vaccination, and
  • people aged 16 and over due for a booster dose.
  • See guidelines on how to download AIR042 report.

Air042a A

Dose number in AIR

  • When entering directly onto the AIR site, there is no requirement for entering a dose number for adults.  AIR record all adult doses as V (valid). The immunisation history statement does not list doses for adults.
  • If you are required to enter a dose number, it can be entered as ‘3’ but AIR will count them according to date given so it does not need to be changed if it automatically defaults to ‘1’ in practice software.

Further information:

MBS ITEMS & PIP PAYMENT

Practice Incentives Program COVID-19 in-reach vaccination

The Practice Incentives Program (PIP) COVID-19 in-reach vaccination payment is a time-limited payment to support general practices that undertake in-reach COVID-19 vaccination services for residential aged care and disability support workers in their workplace.

This payment is only available for Medicare Benefits Schedule (MBS) COVID-19 vaccine suitability assessment services (for primary vaccine course and subsequent booster vaccine doses) that are administered via an in-reach COVID-19 vaccination clinic between 29 April 2021 to 30 June 2022. See payment guidelines.

VACCINE HESITANCY
Addressing vaccine hesitancy

Tool to address vaccine concerns: CoRiCal

Covid Risk Calculator (CoRiCal)

 

  • What is my chance of getting COVID-19?
  • If I get COVID-19, what are my chances of dying?
  • What is my chance of getting myocarditis?
  • What is my chance of dying from myocarditis?

Understanding and addressing vaccine hesitancy

Resources to address vaccine hesitancy 

Communication tools to address vaccine hesitancy

Hesitancy

INFECTION CONTROL
COVID-19 exposure

NSW Health is currently responding to a number of COVID-19 outbreaks all across NSW. Healthcare workers are at high risk of exposure to COVID-19.

  • Cleaning post COVID-19 positive case: Guidelines
COVID-19 Safety Plan

The following guides should be adapted to suit your practices procedures and workflows:

 

Subscribe to Sydney Health Weekly to receive immunisation updates

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