RACGP updated home-care guidelines:
The Royal Australian College of General Practitioners (RACGP) has released new home-care guidelines for patients with COVID-19. These updated guidelines include information and advice on the following:
- Supporting patients through a COVID-19 diagnosis
- Determining medical and social risk factors and disease severity
- Determining home-care suitability and the appropriate monitoring protocol
- Escalating care where necessary
Updated guidelines can be found at the following link: RACGP - Home-care guidelines for patients with COVID-19
Department of Health resources:
The Department of Health has published several collections of resources about COVID-19 vaccination, vaccine rollout, and clinical guidance from the Australian Technical Advisory Group on Immunisation (ATAGI). These resources are updated when new information is available, so GPs should ensure they have access to the latest versions.
The Australian Technical Advisory Group on Immunisation (ATAGI) has released a statement on the emergence of a new SARS-CoV-2 (COVID-19) variant of concern.
At this stage, there is no evidence to suggest that earlier booster doses, before six months after the second primary course dose, will augment protection against the Omicron variant. ATAGI will continue to closely monitor the epidemiology and emerging data on the likely impact of vaccination on this variant and update recommendations shortly.
More information is available on the Department’s website.
Interval for Booster doses
A booster dose is available to anyone in Australia aged 18 years and over who has completed their primary course of vaccination at least six-months ago.
The ATAGI has advised that in special circumstances, the six-month interval may be shortened to five months when needed for logistical reasons.
Vaccination providers may choose to administer a booster dose a few weeks earlier than the six - month interval for logistical reasons, for example:
- for patients with a greater risk of severe COVID-19 in outbreak settings
- if an individual is travelling overseas and will be away when their booster dose is due
- in outreach vaccination programs where access is limited.
Providers should use their clinical judgement to determine whether it is appropriate to administer the dose early It should be noted that there are very limited data on benefit for boosters given prior to 20 weeks after completion of the primary course, and the duration of protection following boosters is not yet known. More information is available in ATAGI's clinical guidance on COVID-19 vaccines.
Difference between boosters and third doses
There have been a number of enquiries about the difference between a booster dose and a third primary course dose.
A booster dose is available to anyone in Australia aged 18 years and over who has completed their primary two-dose course of vaccination at least 6 months ago. Individuals remain fully vaccinated with the primary two-dose vaccination course and the booster is not mandatory.
A third primary dose is available as part of the primary course in individuals aged 12 years and over, who are severely immunocompromised, to address suboptimal or non-response to the standard two- dose schedule. These doses are provided as part of the primary course, they are not boosters.
The table below provides a summary of the key differences:
||Comirnaty (Pfizer) is the only approved COVID-19 vaccine that can be used as a booster, regardless of the initial vaccines provided.
However, individuals who cannot receive Pfizer due to medical contraindications, can receive a primary dose of Vaxzevria (AstraZeneca).
The Theraupertic Goods Administration (TGA) is currently evaluating Spikevax (Moderna)’s application to use its vaccine as a booster.
|An mRNA vaccine is preferred:
Individuals who received two
AstraZeneca doses or who cannot receive mRNA vaccines due to medical contraindications can receive a third dose of AstraZeneca.
||Boosters are available for any individual aged 18 years and older who completed their primary course dose at least 6 months ago. Boosters are not currently recommended for those with severe immunocompromise (i.e. as a fourth dose).
||Third primary doses are available to individuals aged 12 years and older with severe immunocompromise.
||6 months after completion of the primary two-dose course. May be shortened to 5 months.
||2 to 6 months after completion of the two-dose course.
||ATAGI statement on booster dose
TGA approval of booster dose
|ATAGI statement on third dose (this includes a list of immunocompromising conditions for which a third dose is recommended)
Resources for third doses for the immunocompromised
On 8 October 2021, the Australian Technical Advisory Group on Immunisation (ATAGI) released advice recommending a third dose of COVID-19 vaccine as part of the primary course in individuals who are severely immunocompromised. These resources will assist GPs with patients requiring a third dose:
Requirements for workers in health care settings who are exposed to COVID-19
The Australian Health Protection Principal Committee (AHPPC), with advice from the Communicable Diseases Network Australia (CDNA) and the Infection Control Expert Group (ICEG), has endorsed a Worker Permissions and Restrictions Framework for Workers in Health Care Settings.
The framework outlines nationally agreed recommendations that will support safe decision making when determining appropriate workplace restrictions and permissions for a worker exposed to COVID-19. The framework provides guidance on how GPs and practice staff can avoid having to isolate after a patient who attended the practice later tests positive to COVID-19.
The Worker Permissions and Restrictions Framework is available here.
Vaccine product information
- ATAGI and the Cardiac Society of Australia and New Zealand (CSANZ) have released joint guidance on the risk of myocarditis and pericarditis following Pfizer vaccination following an observed risk in overseas studies, especially in males under 30 years of age after the second doses. The Pfizer Product Information has been updated to reflect this.
- The Product Information (PI) for the AstraZeneca vaccine has been updated to include Capillary Leak Syndrome (CLS) as a contraindication for the AstraZeneca vaccine. Providers should be aware of the information contained in the PI and individuals with a known history of CLS should not be vaccinated with AstraZeneca.
- Consent form: https://www.health.gov.au/resources/publications/covid-19-vaccination-consent-form-for-covid-19-vaccination
Patient information sheets
- Information on AstraZeneca: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-covid-19-astrazeneca-vaccine
- Information on Pfizer: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-covid-19-pfizer-comirnaty-vaccine
- After your AstraZeneca: https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-astrazeneca-vaccine
- After your Pfizer: https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-pfizer-comirnaty-vaccine
- Provider information on consent: https://www.health.gov.au/resources/publications/covid-19-vaccination-consent-information-for-providers-covid-19-vaccination-consent-and-faqs
- Frequently asked questions on the Taskforce Ivermectin recommendation: https://covid19evidence.net.au/wp-content/uploads/NC19CET-Ivermectin-FAQs-20210826.pdf
Clinical guidance and decision guides
- ATAGI Clinical guidance: https://www.health.gov.au/resources/publications/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021
- COVID-19 vaccine – Clinical considerations: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/information-for-covid-19-vaccination-providers/covid-19-vaccine-clinical-considerations
- Selection of second dose in specific circumstances: https://www.health.gov.au/resources/publications/covid-19-vaccination-clinical-advice-on-the-use-of-a-different-covid-19-vaccine-as-the-second-dose
- Shared decision making guide – pregnancy: https://www.health.gov.au/resources/publications/covid-19-vaccination-shared-decision-making-guide-for-women-who-are-pregnant-breastfeeding-or-planning-pregnancy
- Shared decision making guide – frail older people: https://www.health.gov.au/resources/publications/covid-19-vaccination-shared-decision-making-guide-for-frail-older-people-including-those-in-residential-aged-care-facilities
- Shared decision making guide – palliative care: https://www.health.gov.au/resources/publications/covid-19-vaccination-shared-decision-making-guide-for-people-receiving-palliative-care-or-end-of-life-care
- Shared decision making guide – immunocompromise: https://www.health.gov.au/resources/publications/atagi-covid-19-vaccination-shared-decision-making-guide-for-people-with-immunocompromise
- Provider guide on immunocompromise: https://www.health.gov.au/resources/publications/atagi-provider-guide-to-covid-19-vaccination-of-people-with-immunocompromise
- Primary care guide on TTS: https://www.health.gov.au/resources/publications/covid-19-vaccination-primary-care-approach-to-thrombosis-with-thrombocytopenia-syndrome-after-covid-19-astrazeneca-vaccine
- Provider information – TTS: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-for-immunisation-providers-on-thrombosis-with-thrombocytopenia-syndrome-tts-following-covid-19-vaccination
- Patient information – TTS: https://www.health.gov.au/resources/publications/patient-information-sheet-on-astrazeneca-covid-19-vaccine-and-thrombosis-with-thrombocytopenia-syndrome-tts
- COVID-19 vaccination – Guide to engage and support aged care workers to get a COVID-19 vaccine: https://www.health.gov.au/resources/publications/covid-19-vaccination-guide-to-engage-and-support-aged-care-workers-to-get-a-covid-19-vaccine
Resources for doctors working with Aboriginal and Torres Strait Islander patients
- Updated guidance on TGA advertising restrictions, explaining how you can inform your patients about different vaccine brands availability in your clinic. This includes social, posters and web content.
- A video animation in plain English that could be sent to your patients’ emails or used in your clinic waiting room explaining what to expect on your vaccination day, side effects and the need for two doses of the COVID-19 vaccine.
- A suite of talking points designed for healthcare workers, to assist them with having conversations with patients about COVID-19 vaccines.
- Updated social resources with suggested captions to use across your social media networks
Resources for doctors about pregnancy
Members are also reminded that if you are part of the vaccine roll out and have any problems, the key point of contact in the Commonwealth to raise these is the Vaccine Operations Centre (VOC) that can be contacted on:
Phone: 1800 318 308
Note: The VOC hours of operation are between 7am to 10pm (AEDT).