Reminder – expediting access to oral antiviral treatments
It is critical that COVID-19 oral antiviral treatments Lagevrio® (molnupiravir) and Paxlovid® (nirmatrelvir and ritonavir), are urgently accessible to every eligible resident who has tested positive for COVID-19, particularly those aged 70 years or older, regardless of risk factors and whether they have symptoms or not.
People over 50 with two risk factors for developing severe disease, First Nations people who are aged 30 years or over, with one risk factor and people aged 18 years or older, with moderate to severe immunocompromise are also eligible.
To expediate residents’ access to antivirals, aged care providers should pre-assess residents for consent, discuss the administration of the medicine with residents, staff and primary care and have clear and established pathways with community pharmacies.
Residents should be guided by primary care providers, who play a fundamental role in determining eligibility, discussing risk factors and prescribing the best clinically appropriate treatment. This is really important as antivirals need to be administered within 5 days of symptom onset, and the sooner the better, for the best outcome.
There should be no barriers to accessing medication and if you need access to a GP then you can call HealthDirect's free helpline on 1800 022 222 or use the Service Finder to search for one near you.
The Australian Government is actively encouraging pharmacists to stock these medicines. The Pharmacy Guild of Australia’s Find a Pharmacy service enables you to search for pharmacies near you that have stock of oral treatments.
To support prompt treatment of patients medical practitioners and nurse practitioners are able to add Lagevrio® and Paxlovid® to their Prescriber Bag supplies.
Alternative access channels include local hospitals, public health units or Aboriginal Community
Controlled Health Services. if you are in outbreak and are unable to access antivirals quickly, please email the Department at AgedCareCOVIDEnquiries@health.gov.au.
COVID-19 Vaccine booster dose
Providers are encouraged to work with primary care providers to plan for residents to receive the COVID-19 booster dose as soon as they are eligible. Administration of a 2023 COVID-19 booster dose should aim to occur prior to June 2023 and at a time of 6 months or greater following the most recent COVID-19 vaccine dose or confirmed infection.
The recommended booster dose will bolster residents' protection from severe illness, hospitalisation, or death from COVID-19 over the winter season. Providers are strongly encouraged to arrange for your residents to receive this new booster as soon as they become eligible, rather than waiting for all residents to become eligible at the same time. Primary care providers (general practitioners, registered nurses in general practices, community pharmacies) are best placed to provide this service. If your facility is experiencing difficulty in arranging vaccinations, the Department will facilitate linkages to providers to arrange vaccinations for new residents or existing residents as they become eligible and no minimum number of residents is required.
For the next 12 months, COVID-19 vaccines will continue to be principally administered in residential aged care homes by primary care providers. These primary care providers delivered the majority of COVID-19 vaccinations in residential aged care in 2022 and are well placed to continue this important work.
Where available, we strongly encourage the bivalent vaccine as this offers additional protection against the original COVID-19 virus and the most recent Omicron variants.
If you don't already have a vaccine provider, the Department will be able to assist in organising a primary care provider to deliver the COVID-19 booster vaccines dose. For assistance, please email RACFVaccineClinics@health.gov.au.
COVID-19 Vaccination consent form
As with all vaccines, valid consent is required before administering a COVID-19 vaccine dose. While written consent is not mandatory for residents, vaccination providers should ensure they record that an individual has given their consent for a COVID-19 vaccination according to the requirements of their state/territory.
The Australian Government has prepared written consent forms which can be used to provide consent to participate in the vaccination program, including to receive a booster dose. You can also use your own form, but it must capture the necessary information to show that the person consents to a COVID-19 vaccine. For some residents, consent will need to be sought from a substitute decision-maker and through a supported decision-making process.
The consent form should be used in combination with the ATAGI COVID-19 clinical guidance, which will assist in discussions around consent and any medical contraindications or issues that may arise in your conversations with patients.
Moderna (Spikevax) Bivalent Original/Omicron BA.4-5 COVID-19 vaccine
On 17 February 2023, the Therapeutic Goods Administration (TGA) provisionally approved the Moderna’s COVID-19 Bivalent (Original/Omicron BA.4/BA.5) booster dose vaccine. Following this, ATAGI has provided the following recommendations:
- the Moderna Bivalent BA.4-5 vaccine can be used in eligible adolescents and adults aged 12 years and older who are recommended (or advised to consider) a COVID-19 booster dose according to ATAGI 2023 Booster Advice.
- all currently available COVID-19 vaccines are anticipated to provide benefit as a booster dose, however bivalent booster vaccines, including the Moderna Bivalent BA.4-5 vaccine and Pfizer Bivalent BA.4-5 vaccine, are preferred over other vaccines.
The Australian Government has secured 3 million doses of the Moderna COVID-19 Bivalent BA.4-5 vaccine to ensure an adequate portfolio of COVID-19 vaccines is available in Australia.
The Moderna Bivalent BA.4-5 formulation is not currently available in Australia. These Moderna doses are expected to be available in Australia from April 2023.
For the current ATAGI recommendations for a 2023 booster dose please visit ATAGI 2023 booster advice.
COVID-19 Guidance for Aged Care
The Department has a number of reference documents available to assist aged care providers preparing for and managing COVID-19, as mentioned during the most recent webinar on 23 February 2023.
The National COVID-19 Health Management Plan for 2023 (the National Plan) - aims to guide Australia’s transition toward managing COVID-19 like any other respiratory illness. The clear priority is to minimise the incidence of death and severe illness, particularly focusing on those most at risk.
The National Statement of Expectations on COVID-19 Management in Aged Care Settings - Provides specific guidance to aged care providers and services on your responsibilities for responding to and managing COVID-19.
It will support the ability of aged care services to ensure older Australians, at home or in residential settings, receive appropriate protection from and management of any COVID 19 infections in their surrounds. The National Statement of Expectations applies to all aged care providers, residential and in-home care providers, where workers provide close personal care and forms part of the National COVID-19 Health Management Plan for 2023.
The Communicable Disease Network of Australia (CDNA) guidelines for acute respiratory illness (COVID-19 and Influenza) - Contains valuable information to support a risk-based approach for the early identification of acute respiratory infection and management of outbreaks, supported by specific resources and tools provided by jurisdictions and guidance from local public health unit.
Top 3 Questions from our Webinar on 23 February 2023
Question 1 - Is weekly COVID-19 vaccination reporting still mandatory for residential aged care providers and home care providers? If not when can we stop reporting in the My Aged Care portal?
Yes. Under Aged Care Legislation, all aged care providers are required to report weekly or when there has been a change to the COVID-19 vaccination status of residents and workers through My Aged Care portal. If there has been no change, updated reporting is not required. Vaccination continues to be important in managing the risk related to COVID-19 in high-risk settings such as residential aged care. Aged care workers are strongly encouraged to stay up to date with their COVID-19 vaccinations to aid protection against both infection and severe disease for themselves and the people they care for.
We are considering these arrangements and will provide further advice in due course.
Question 2 – What are the booster dose or bivalent dose requirements and will this be mandatory?
On 14 February 2023 the Ministers wrote to aged care providers confirming the Australian Governments acceptance of ATAGI’s recommendation for a 2023 COVID-19 vaccine booster dose or the Bivalent booster.
This applies to all adults aged 65 years and over and adults aged 18-64 years who have medical comorbidities that increase their risk of severe COVID-19. Regardless of the number of prior doses received, we encourage all adults over 18 to have the 2023 COVID-19 vaccine booster if your last vaccine dose or most recent COVID-19 infection were more than 6 months ago. This is recommended regardless of what dose your last vaccine was – this is why we are referring to it simply as a booster dose.
The 2023 COVID booster dose is not a requirement, but we encourage all residents and workers, that are eligible, to consider this booster dose to protect them, their families, and people they care for from severe illness or hospitalisation. Where available, we strongly encourage the bivalent vaccine as this offers additional protection against the original COVID-19 virus and the most recent Omicron variants.
Question 3 - What information is available for Home Care and CHSP providers?
Due to the nature of COVID-19 and the ease to which COVID-19 spreads, residential aged care homes are more at risk of COVID-19 outbreaks and residents are at higher risk of severe illness and hospitalisation and the Australian Government continues to support residential aged care homes through outbreaks.
It is important to note, advice given by the Department applies to all contexts of aged care, which includes Home Care and CHSP and recognises the particular vulnerability of older people due to their age. Some of this advice includes:
- oral antiviral treatments and encouraging care recipients to be assessed for suitability
- applying IPC practices and following the hierarchy of control for minimising the risk of COVID-19 transmission
- maintain COVID-19 safe behaviours:
- doing regular rapid antigen tests (RAT) to screen for infection
- wearing a mask if indoors to help slow infection
- washing your hands frequently
- staying up to date with vaccinations and
- staying home if unwell or COVID-19 positive. For workers that provide close personal care, they should not be attending work for 7 days if testing positive to COVID-19 or until you no longer have symptoms applies in all aged care settings.
Contact the Department
If you are unable to locate the information you need on our website, you can email your queries to the Department.
The new centralised contact point to request Commonwealth supports is AgedCareCOVIDEnquiries@health.gov.au. This replaces the previous case management teams and can assist you with the following queries:
- Surge workforce - residential aged care homes that need temporary surge workforce support
- Rapid Antigen Test (RAT) kits - if you wish to opt out of receiving RAT kits or alter the quantity and/or frequency of supply
- PCR Testing - request for in-reach PCR testing for residents and staff during an outbreak
- Oral Antiviral treatments - if you are in outbreak and are unable to access antivirals quickly
- PPE enquiries - requests for additional PPE must continue to be submitted through the My Aged Care Provider portal.
For all other general enquiries, please email agedcarecovidliaison@health.gov.au.