News

COVID-19 Vaccination information and resources for GPs

Published 17 March 2022

A range of information resources are provided here to support GPs as they vaccinate patients and care for COVID-19 patients in the community. 

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.  

Updated ATAGI recommendations on the use of a booster dose of COVID-19 vaccine 

The latest Australian Technical Advisory Group on Immunisation (ATAGI) recommendations on the use of booster doses of COVID-19 vaccine are available here.  

Vaccine deliveries in flood affected area 

The VOC is working with delivery partners to manage vaccine and consumable deliveries. Sites will be contacted where their deliveries are impacted. Redelivery of vaccines and consumables will be organised when it is safe to do so, and it is suitable for sites. 

The Department of Health is working with QLD Health to utilise available stock in nearby sites. QLD Health will be contacting and liaising with sites to discuss arrangements. It is expected that number of effected orders will grow.  

VCF Moderna Update 

From Monday 7 March, the Vaccine Clinic Finder (VCF) will display two vaccine types for sites administering Moderna nationally. These are Moderna (for people aged 6-11) and Moderna (for people aged 12+).  

If you do not wish to administer to the 6-11 age group, please let VCF Connect know and your service will be removed. 

To have a service removed, please contact pcdvcf@health.gov.au. If you have further questions about VCF Connect, please contact CV19.Products@health.gov.au or 1800 316 375. 

COVID-19 vaccine exemptions 

COVID-19 vaccines have been demonstrated to be safe and effective and are recommended for all people aged 5 years and over. However, there are very few situations where a COVID-19 vaccine may not be safe to use. Medical exemptions can only be granted if there are no suitable alternative COVID-19 vaccines available. For this reason, permanent medical exemptions to COVID-19 vaccination will be rarely required. This information outlines the circumstances in which a doctor can grant a medical exemption for receiving a COVID-19 vaccine. 

What is an exemption? 

An exemption is defined in a state or territory public health order and supporting information that sets out an acceptable reason that someone does not need to have a COVID-19 vaccine. Each state and territory’s public health order and/or published supporting information sets out the exemptions relevant to that jurisdiction. 

You should refer to your jurisdiction’s published information to understand the exemptions that apply in their state or territory. 

What qualifies for a COVID-19 vaccine exemption? 

If someone has a medical contraindication to one brand of COVID-19 vaccine, they will most likely be able to safely receive an alternate brand. A permanent medical exemption can only be granted where a person has medical contraindications to all available brands of COVID-19 vaccine. 

 Medical contraindications to COVID-19 vaccines include: 

  • Anaphylaxis (severe allergic reaction) to any component of the vaccine, which includes: 

  • For Vaxzevria (AstraZeneca) and Nuvaxovid (Novavax): polysorbate 80 

  • For Comirnaty (Pfizer) or Spikevax (Moderna): polyethylene glycol (PEG) 

  • A serious adverse event caused by a previous dose of the relevant COVID-19 vaccine (without anything else having been identified as causing the adverse event), and where it has been reported to a state/territory adverse event surveillance system or the TGA. You will need to make a clinical decision as to whether a second dose would risk the event occurring again. 

  • For AstraZeneca: history of capillary leak syndrome, cerebral venous sinus thrombosis, heparin-induced thrombocytopenia, idiopathic splanchnic thrombosis or antiphospholipid syndrome with thrombosis. 

What qualifies for a temporary COVID-19 vaccine exemption? 

The Australian Technical Advisory Group on Immunisation (ATAGI) has advised that a temporary medical exemption is suitable in the following situations: 

  • Inflammatory cardiac illness within the past 3 months; myocarditis or pericarditis; acute rheumatic fever or acute rheumatic heart disease (i.e., with active myocardial inflammation); or acute decompensated heart failure 

  • Vaccination can be temporarily deferred up to 4 months after infection with COVID-19 and once the acute infection has resolved. Please note prior infection with COVID-19 is not a medical contraindication 

  • Until recovery from a major medical condition (such as major surgery or hospital admission for a serious illness) 

  • Serious adverse event caused by a previous dose of a COVID-19 vaccine, with no acceptable alternative vaccine available 

  • Following treatment with a monoclonal antibody for COVID-19 

  • In some instances, where the patient may be a risk to themselves or others during the vaccination process 

People with prolonged symptoms from COVID-19 beyond 4 months should be vaccinated on a case by case basis. Chronic symptoms following COVID-19 (‘Long COVID’) are not a contraindication to COVID-19 vaccines but do warrant a clinical discussion with the patient. 

Pregnancy is not a valid reason for exemption in the absence of any of the criteria listed above. 

Temporary exemptions to COVID-19 vaccination are not recommended to exceed 6 months. 

If someone has not experienced one of the above conditions, you cannot grant them a medical exemption for COVID-19 vaccination.  

The issuing of a false or inappropriate medical exemption in contradiction to the current ATAGI advice could have serious ramifications for the health care provider. Providers could face medical sanctions, civil penalties or even criminal prosecution. 

The Australian Government, in collaboration with states and territories, is actively monitoring the data for COVID-19 medical exemptions. 

For detail on the public health order vaccination mandates that may apply in each state/territory, please visit the relevant health department or government website.  

The ATAGI temporary medical exemption advice: https://www.health.gov.au/resources/publications/atagi-expanded-guidance-on- temporary-medical-exemptions-for-covid-19-vaccines 

Lagevrio listed on PBS 

From 1 March 2022, the first oral treatment for COVID-19, Lagevrio® (molnupiravir), was listed on the Pharmaceutical Benefits Scheme (PBS) Section 85 program as an Authority Required (Streamlined) benefit for patients with mild-moderate COVID 19 who have a high risk for developing severe disease, reducing the need for admission to hospital.  

Some information related to PBS listing of Lagevrio® (molnupiravir):  

Oral treatments for COVID-19 

First oral treatment for COVID-19, Lagevrio (molnupiravir) and Paxlovid (nirmatrelvir + ritonavir), are now available for eligible patients. The two treatments were provisionally approved by the Therapeutic Goods Administration (TGA) on 18 January 2022. 

Lagevrio and Paxlovid have both been found to be effective in treating mild to moderate COVID-19 in adults aged 18 years of age and older, who do not require supplemental oxygen, and who are at increased risk of progression to hospitalisation or death.  
 
These medicines are available initially from the National Medical Stockpile for:  

  • residents of residential aged care facilities 

  • rural and remote communities particularly in regions with high Aboriginal and Torres Strait Islander populations, and  

  • state and territory governments for distribution to those at highest risk in the community, including people with disability.   

Working in partnership with the aged care sector, the Australian Government has preplaced Lagevrio®, a prescription only (S4) medicine which requires a prescription from a general practitioner, in residential aged care facilities. This will support timely administration to eligible patients, once prescribed by their usual doctor, pending a decision on listing of this treatment of the Pharmaceutical Benefits Scheme (PBS). 

The National COVID-19 Clinical Evidence Taskforce recommends Lagevrio® be considered for use as follows:   

  • within 5 days of symptom onset in adults with COVID-19 who do not require oxygen; and   

  • who are unvaccinated and have one or more risk factors for disease progression; or   

  • who are immunosuppressed or not immunocompetent regardless of vaccination status; or  

  • who have received one or two doses of vaccine and are at high risk of severe disease on the basis of age and multiple risk factors; and   

  • where other treatments (such as sotrovimab or nirmatrelvir plus ritonavir) are not suitable or available.    

Oral Solution Preparation for Lagevrio (Molnupiravir) 
While the recommendation to administer Lagevrio is to swallow the capsules, if this is not possible, and if alternative treatments are not available or not suitable, the manufacturer has advised that the procedure set out below allows preparation of an oral solution. Please note that this advice is based on preliminary data and should be limited to those circumstances where there is no other option.  

This is regarded as an “off label” use and it is recommended that this decision be documented in the patient record and consent should be obtained from the patient or their designated decision-maker for use of the treatment in this way. The instructions from the manufacturer are as follows: 

Dose Preparation  

  1. Open four capsules and transfer contents into a cup or syringe. Discard empty capsules per local procedures. 

  1. Add approximately 40 milliliters of water to the cup or syringe 

  1. Mix/stir the capsule contents and water for three minutes.  

  1. NOTE: Insoluble capsule contents may not dissolve completely. 

  1. Reconstituted solutions prepared according to directions may have visible undissolved particulates and are acceptable for oral administration. 

  1. Administration should occur as soon as possible after the preparation and no later than two hours after the preparation. 

Administration Procedure  

  1. Oral dose should be administered by staff wearing personal protective equipment required per local standards. 

  1. Stir the solution for one minute prior to administration to re-mix the suspension. 

  1. Follow local procedures for disposal of hazardous and/or biohazardous waste. 

  1. Wash hands following dose administration. 

Specific NG/OG Guidance  

  1. Mix/shake the administration syringe for one minute prior to administration to re-mix the suspension. 

  1. Flush NG/OG tube with five milliliters of water prior to administration. 

  1. Administer entire volume from the administration syringe. 

  1. Flush tube with five milliliters of water TWICE (10 milliters in total) after administration of the solution. 

Please note:  

  • Administration of Molnupiravir via an oral solution has not been evaluated in a clinical trial. 

  • There is limited experience with administration of oral solution via nasogastric / orogastric (NG/OG) tube. 

  • Molnupiravir is soluble in water and it is recommended to mix capsule contents with water before administration. 

  • Anyone preparing the solution should consider the risks of exposure (e.g. refer to the Product Information’s Section 4.6 Fertility, Pregnancy and Lactation). 

ATAGI advice on vaccination after testing positive for COVID-19 

ATAGI statement on the use of Novavax COVID-19 vaccine (Nuvaxovid)  

Resources on caring for COVID-19 patients in the community  

Medicare Support in Response to Omicron - GP and Other Medical Officer (OMP) Longer Telephone Consultation Factsheet– Information for the use of item numbers 92746 (for GPs) and 92747 (for OMPs). 

MBS COVID-19 Management Support Service Factsheet 

Managing COVID-19 at Home - Resources for patients and healthcare professionals 

With a highly vaccinated population, most COVID-positive people are unlikely to get severely unwell or require hospitalisation and will be able to manage their symptoms at home – where clinically safe and appropriate to do so. These tools can help people living with COVID to know what actions they may need to take and when they may need to seek further medical help.  

The Department of Health has also provided links to a range of clinical guidelines published by the RACGP and the National COVID-19 Evidence Taskforce to support GPs to manage and monitor their COVID-positive patients in the community. 

For everyone: 

National Coronavirus Hotline 

1800 020 080 

For information about COVID-19 or COVID-19 vaccines – 24 hours a day, 7 days a week. 

Vaccine Clinic Finder  

Book a COVID-19 vaccine at a clinic near you that suits your needs. 

COVID Symptom Checker 

Find out if you need to get tested or seek medical help. 

Restriction Checker 

Find out what you can and can’t do in your state or territory. 

Managing Mild COVID-19 at Home with Assistance from your GP 

For patients who have tested positive to COVID-19 and are being cared for at home with assistance from their GP. 

Healthdirect Australia 

Guidance for people that have tested positive to COVID-19, including links to specific information for states and territories. 

Vaccine Side Effect Checker 

Check any side effects after your vaccination. 

For healthcare professionals: 

Royal Australian College of General Practitioners (RACGP) 

Information for GPs and their patients to manage their ongoing health and social issues amid the pandemic, including home-based care guidelines. These guidelines include: 

Guidelines for assessment and risk stratification of  COVID-positive people - National COVID-19 Clinical Evidence Taskforce 

Evidence-based clinical guidelines for Australia’s healthcare professionals, including clinical flowcharts. 

Communicable Diseases Network Australia (CDNA) 

National advice and guidance for public health units responding to a notifiable disease event, including links to specific information for states and territories. 

Guidance on Ordering and PPE Distribution via PHNs 

For information on what PPE is available and how to order please contact your local PHN. 

Guidance on the use of PPE for Health Care Workers 

Guidance on the use of personal protective equipment (PPE) for health care workers in the context of COVID-19. 

Videos on PPE Usage: 

Guidance on Community Care Pathways and Patient Escalation 

For information on how to escalate COVID-positive patients in your care, please contact your PHN for details of their community care pathway. 

Find your local Primary Health Network 

Consent forms  

  1. Consent form: https://www.health.gov.au/resources/publications/covid-19-vaccination-consent-form-for-covid-19-vaccination  

  1. Information and consent form for parents and guardians of children aged 5 to 11 years: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-and-consent-form-for-parents-and-guardians-of-children-aged-5-to-11-years  

Patient information sheets 

  1. Information on AstraZeneca: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-covid-19-astrazeneca-vaccine  

  1. Information on Pfizer: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-comirnaty-pfizer-covid-19-vaccine  

  1. Information on Spikevax (Moderna): https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-spikevax-moderna-covid-19-vaccine  

  1. Information on Novavax: https://www.health.gov.au/resources/publications/covid-19-vaccination-information-on-covid-19-nuvaxovid-novavax-vaccine  

  1. After your AstraZeneca: https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-astrazeneca-vaccine  

  1. After your Pfizer: https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-pfizer-comirnaty-vaccine  

  1. After your Spikevax (Moderna): https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-spikevax-moderna-vaccine  

  1. After your Novavax vaccine: https://www.health.gov.au/resources/publications/covid-19-vaccination-after-your-nuvaxovid-novavax-covid-19-vaccination 

  1. Provider information on consent: https://www.health.gov.au/resources/publications/covid-19-vaccination-consent-information-for-providers-covid-19-vaccination-consent-and-faqs  

  1. 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  

  1. ATAGI Clinical guidance: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/advice-for-providers/clinical-guidance  

  1. Clinical recommendations for COVID-19 vaccines: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/advice-for-providers/clinical-guidance/clinical-recommendations  

  1. COVID-19 vaccine doses and administration: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/advice-for-providers/clinical-guidance/doses-and-administration  

  1. 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  

  1. 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   

  1. 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   

  1. Shared decision making guide – immunocompromise: https://www.health.gov.au/resources/publications/atagi-covid-19-vaccination-shared-decision-making-guide-for-people-with-immunocompromise  

  1. 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  

  1. 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   

  1. Patient information – TTS: https://www.health.gov.au/resources/publications/patient-information-sheet-on-astrazeneca-covid-19-vaccine-and-thrombosis-with-thrombocytopenia-syndrome-tts  

  1. 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  

Resources for doctors about immunocompromise 

Existing resources 

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 

Email: COVID19VaccineOperationsCentre@health.gov.au  

Note: The VOC hours of operation are between 7am to 10pm (AEDT). 

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