Info on COVID-19 Vaccination Program

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Key Points about Covid Vaccinations from the Australian Technical Advisory Group on Immunisation (ATAGI)

·       The overarching goal of Australia’s COVID-19 vaccination program is to protect all people in Australia from the harm caused by SARS-CoV-2, through preventing serious illness and death, and, as much as possible, disease transmission.

·       Delivery of vaccine has been prioritised initially for population groups at increased risk of exposure to SARS-CoV-2 or of severe COVID-19, or occupational groups critical to societal functioning. These are: quarantine and border workers; frontline healthcare workers; aged care and disability care staff and residents; older adults (initially ≥80 years with progression to lower age brackets); people aged ≥12 years with underlying medical conditions associated with an increased risk of severe COVID-19; Aboriginal and Torres Strait Islander adults and adolescents and critical and high-risk workers, including defence, police, fire, emergency services,  operators of critical infrastructure and others.

·       COVID-19 vaccine is currently recommended for all people aged ≥ 16 years, and for the following groups:

·       Children aged 12-15 years with specified medical conditions that increase their risk of severe COVID-19

·       Aboriginal and Torres Strait Islander children aged 12-15 years

·       All children aged 12-15 in remote communities, as part of broader community outreach vaccination programs.

·       Comirnaty (Pfizer Australia Pty Ltd) is provisionally registered by the TGA in people aged ≥12 years and is given in a two-dose schedule. Efficacy against symptomatic COVID-19 is about 95% from seven days after the second dose.  

·       Spikevax (Moderna Australia Pty Ltd) is provisionally registered in people aged ≥18 years and is given in a two-dose schedule. Efficacy against symptomatic COVID-19 is approximately 94% from two weeks after the second dose.

·       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%.

·       The effectiveness of all 3 vaccines against symptomatic infection with the Delta strain of SARS-CoV-2 is reduced compared with earlier strains, however protection against hospitalisation is maintained.

·       ATAGI recommends completing the vaccination course with the same vaccine. Mixed (heterologous) schedules using 2 different vaccines to complete the primary vaccination course are only recommended in special circumstances such as for those with serious vaccine-attributed adverse events after the first dose and in those who were partially vaccinated overseas with a brand not available in Australia.

·       COVID-19 Vaccine AstraZeneca is associated with a rare risk of thrombosis with thrombocytopenia syndrome (TTS). The risk of TTS appears higher in younger adults than in older adults, and is higher after the first dose than the second. Comirnaty and Spikevax are not associated with a risk of TTS.

·       mRNA vaccines (i.e., Comirnaty or Spikevax) are the preferred vaccines over COVID-19 Vaccine AstraZeneca in people aged <60 years, and in pregnant people. COVID-19 Vaccine AstraZeneca continues to be recommended in people aged 18 to <60 years when the benefits outweigh risks, including in outbreak settings.

·       Pregnant women and adolescents aged ≥12 years are a priority group for vaccination. Either Comirnaty or Spikevax should be routinely offered to pregnant people at any stage of pregnancy.

·       Either Comirnaty or Spikevax is recommended in people with a past history of certain precautionary conditions for COVID-19 Vaccine AstraZeneca; cerebral venous sinus thrombosis (CVST), heparin induced thrombocytopenia (HIT), idiopathic splanchnic (mesenteric, portal, splenic) vein thrombosis, and antiphospholipid syndrome with thrombosis. Comirnaty or Spikevax are recommended for the second dose for people in these groups who have received a first dose of COVID-19 Vaccine AstraZeneca.

·       Contraindications to COVID-19 Vaccine AstraZeneca include anaphylaxis to a previous dose or to an ingredient; history of capillary leak syndrome; thrombosis with thrombocytopenia after a previous dose, or any other serious adverse event attributed to a previous dose.

·       Contraindications to Comirnaty or Spikevax include anaphylaxis to a previous dose or to an ingredient of an mRNA COVID-19 vaccine; myocarditis and/or pericarditis attributed to a previous dose, or any other serious adverse event attributed to a previous dose.

·       Precautions to vaccination include a history of generalised (non-anaphylactic) reaction to a prior dose or an ingredient, past anaphylaxis to medications/vaccines which may contain polyethylene glycol (relevant for Comirnaty and Spikevax) or polysorbate 80 (relevant for COVID-19 Vaccine AstraZeneca), and a history of confirmed mastocytosis (a mast cell disorder) with recurrent anaphylaxis which requires treatment.

·       Precautionary conditions specific to Comirnaty and Spikevax include a recent history of inflammatory cardiac illness within the past 6 months, e.g., myocarditis, pericarditis, endocarditis; acute rheumatic fever (i.e., with active myocardial inflammation) or acute rheumatic heart disease; complex or severe congenital heart disease; acute decompensated heart failure or a history of cardiac transplant. People with these conditions can still receive Comirnaty or Spikevax, however consultation with a GP, immunisation specialist or cardiologist is recommended prior to vaccination to discuss the best timing of vaccination and to consider if any additional precautions are needed.

·       Co-administration of a COVID-19 vaccine with other vaccines is not routinely recommended. A minimum 7-day interval is advised between administration of a COVID-19 vaccine and any other vaccine, including influenza vaccine. This interval can be shortened (including to same day administration) in special circumstances.