COVID-19 vaccine – Advice for vaccine providers

The latest COVID-19 vaccine program-related advice for vaccine providers.

Corminaty (Pfizer) eligibility

The Australian Technical Advisory Group on Immunisation (ATAGI) recommends that the Pfizer vaccine is preferred for individuals under 60.

ATAGI has also released a statement on immunisation in the setting of transmission of the Delta variant of concern, including strategies to maximise first dose vaccine coverage (and the importance of second doses for durable protection). You can find further information in the ATAGI statement on vaccination in in the setting of transmission of the Delta variant of concern.

Access to the Pfizer vaccine is prioritised for those whom the Pfizer vaccine is the only COVID-19 vaccine currently recommended.

Vaccination providers can administer Pfizer to people aged 12 to 59.

Vaccination providers can also administer Pfizer to people aged 60 and over with:

  • past history of cerebral venous sinus thrombosis (CVST)
  • past history of Heparin-induced thrombocytopenia (HIT)
  • past history of idiopathic splanchnic (mesenteric, portal, splenic) vein thrombosis
  • antiphospholipid syndrome with thrombosis
  • contraindications to COVID-19 vaccine Vaxzervira (AstraZeneca). That means:
    • anaphylaxis to a previous dose or to an ingredient of the vaccine,
    • thrombosis with thrombocytopenia occurring after the first dose of AstraZeneca, or
    • other serious adverse event attributed to the first dose of AstraZeneca.

People aged 60 and over who do not have one of the conditions listed above are eligible to receive the AstraZeneca vaccine.

Transfer of COVID-19 vaccine stock

Primary care COVID-19 vaccination sites may choose to transfer COVID-19 vaccines from one participating vaccination site to another for a range of reasons. For example to support unmet demand at another site or to manage an oversupply of stock.

Primary care COVID-19 vaccination sites include:

  • general practice
  • Commonwealth Vaccination Clinics (CVCs)
  • Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHS)
  • community pharmacies.

Participating COVID-19 vaccination sites can only transfer vaccine stock with other participating sites who have completed the relevant declaration form. Vaccination sites should transfer only full, unopened vials and the receiving site must agree and accept the amount.

Vaccination sites cannot transfer stock to a site not registered with the COVID-19 Vaccination Program.

AstraZeneca doses can be transferred between general practices, CVCs, ACCHS, community pharmacies or state and territory clinics.

Pfizer doses can be transferred between general practices, CVCs, ACCHS or state and territory clinics.

Both transferring and receiving vaccination sites will need to record the transfer of COVID-19 vaccines. They should record this within their Vaccine Stock Management Report by 9pm Friday on the week the transfer occurred. This includes COVID-19 vaccine stock received from state and territory clinics.

Both parties should agree to the transportation arrangements. This includes for sending an appropriate amount of consumables, such as syringes, needles and sharps collectors, with vaccines to the receiving site. Sites should refer to the National Vaccine Storage Guidelines (Strive for 5) for information on advice on vaccine storage, including transportation.

National coronavirus and COVID-19 vaccine helpline

For information about COVID-19 or COVID-19 vaccines, patients should call the National Coronavirus Helpline on 1800 020 080. The helpline can help patients locate a vaccination clinic and give them the contact information to make a booking themselves. The helpline cannot make a booking on a person’s behalf.

COVID-19 information for patients

There are a number of resources available to patients and vaccinators.

Our COVID-19 vaccines website includes information about getting vaccinated and weighing up the potential benefits against risk of harm from COVID-19 Vaccine AstraZeneca.

Patients can use the COVID-19 Vaccine Eligibility Checker to find out when and where they can receive a COVID-19 vaccine. The eligibility checker is regularly updated to align with the most recent advice and guidance on eligibility.

Some states and territories have specific arrangements for vaccination based on their local COVID-19 situation and vaccine availability. Patients should also stay up to date with information from their state government and health department.

Handouts for patients

The Provider Kit for General Practices includes a number of communication materials, including patient fact sheets.

Language assistance

To assist your conversations with patients who do not speak English or need translated information, resources are available in 63 languages.

For phone or on-site interpreting, call the Translating and Interpreting Service on 13 14 50. Medical practitioners (including nurses, reception and other practice support staff) and pharmacists are eligible for the Free Interpreting Service (FIS) when delivering Medicare-rebateable services. Therefore GPs do not need to pay for the costs of using an interpreter service. Some GPs may need to register for the FIS to ensure they have access.

ATAGI advice on the Vaxzevria (AstraZeneca) vaccine

On Thursday 8 April 2021, the Australian Government received advice and recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI) about the AstraZeneca vaccine. ATAGI noted a link between the AstraZeneca vaccine and a syndrome called thrombosis with thrombocytopenia (TTS). This is a very rare blood clotting syndrome. It is very serious and can cause long-term disability and death. Find information for vaccine providers about TTS.

On 17 June 2021, ATAGI recommended Pfizer as the preferred vaccine for people under the age of 60 years except where:

  • the benefit is likely to outweigh risk, and
  • the patient has given informed consent.

People of any age considering vaccination with the AstraZeneca vaccine should be aware of this rare potential complication as part of providing informed consent. Those who choose to have a vaccine other than AstraZeneca COVID-19 vaccine should be aware that it may be many months before an alternative vaccine is available. They should also be aware that they will not have protection from COVID-19 during this time.

This advice may be revised as more information becomes available or if the epidemiological situation changes. Particularly if there is, or is likely to be, significant community transmission.

If clinicians suspect TTS after vaccination, it is important to refer the patients to hospital for further investigation and specialist consultation, including with a hematologist.

Updated patient factsheets are available in English and other languages about the AstraZeneca vaccine and TTS and the COVID-19 vaccine rollout advice from 17 June.

Importance of informed consent

Any person wishing to receive the AstraZeneca vaccine should be fully informed about TTS as a rare but serious side effect before vaccination.

The Department of health has developed an optional written consent form as an aid for providers who choose to use it. Translated consent forms are available.

The vaccine provider should record consent.

Off-site vaccinations

The Government supports general practices, Commonwealth Vaccination Clinics and Aboriginal and Torres Strait Islander Community Controlled Health Services to undertake off-site vaccinations. For example  pop-up clinics, drive-through clinics, in-reach/out-reach clinics, as well as vaccinations conducted in a person’s place of residence. The following advice is not relevant for participating community pharmacies.

Vaccine providers that choose to administer COVID-19 vaccines off-site need to consider the following:

  • the claiming GP or other medical professional is responsible for satisfying all requirements when claiming Medicare Benefits Schedule (MBS) items
  • program requirements are followed, including vaccine eligibility criteria and relevant site requirements
  • an appropriate model of care and clinical governance for vaccine administration is in place, in accordance with the Australian Immunisation Handbook. That includes:
    • determining the patient’s clinical suitability to receive the COVID-19 vaccine on this date. This includes identification of any precautions or contraindications and checking the Australian Immunisation Register (AIR) to confirm their vaccination history
    • obtaining informed consent
    • appropriate post-vaccination observation period, and
    • clinical escalation processes for any vaccine-related adverse events including reporting to the appropriate organisation (where required).
  • all reporting requirements are met. This includes uploading administration data into the AIR, maintaining appropriate medical records per vaccination assessment/administration, and stock reporting within the online ordering portal, and
  • minimising vaccine wastage and maintaining vaccine cold-chain integrity during transport and at the site of administration to ensure vaccine potency.

Please note, vaccination providers who choose to administer COVID-19 vaccines offsite retain all legal responsibility for ensuring staff, patient and community safety. Please consider if your practice has the appropriate medical indemnity insurance to undertake activities off site. 

Pre-drawing considerations

COVID-19 vaccines are in multi-dose vials which may make it challenging to administer vaccines off-site. Practices are encouraged to vaccinate patients in the practice itself where possible to ensure vaccine shelf-life is maintained.

If you choose to administer COVID-19 vaccines off-site, you may either:

  • transport the vial and draw up the dose at the site of administration. For the Pfizer vaccine, you can either dilute the vaccine in your practice or at the site of administration, or
  • transport pre-drawn doses if you can appropriately store the vaccine and deliver it promptly. This means protecting the vaccine from light and maintaining appropriate cold chain. This also means delivering the vaccine within one hour if kept at room temperature, or six hours if stored at 2-8°C. If you cannot ensure these conditions, you should transport the vial and draw up the dose on site.

You must store each vial or dose at the recommended temperature without exceeding the total maximum storage period specified in the Product Information.

Home visits

The Government encourages general practices, Commonwealth Vaccination Clinics and Aboriginal and Torres Strait Islander Community Controlled Health Services to undertake home visits to administer COVID-19 vaccinations for eligible vulnerable priority populations.

GPs and other medical professionals can claim a flag-fall fee. This is for COVID-19 vaccine suitability assessment services conducted in a residential aged care facility (RACF), a residential disability setting, or a patient’s residence. A patient’s residence may also include emergency accommodation, rehabilitation centres, and other residential facilities. The aim of this flag-fall is to help with transport costs in attending to a patient in their residence. For more information, see the factsheet at MBS online – Flag-Fall Arrangement for COVID-19 Vaccine Suitability Assessment Services.

Drive-through clinics

Participating general practices in the COVID-19 Vaccination Program may set up drive-through clinics with their existing ongoing COVID-19 vaccine allocation.

If you choose to establish a drive-through vaccination site, it is strongly recommended that you follow the advice in the ATAGI statement on considerations for establishing drive-through COVID-19 vaccination clinics sites. Considerations include:

  • identifying a suitable site with sufficient space to meet site requirements (ideally identified in consultation with local government)
  • planning traffic flow, ideally in consultation with logistics experts
  • implementing clear processes for clinic flow, particularly identifying patients at higher risk for reactions immediately post-vaccination
  • ensuring all requirements for post-vaccination precautions and observations regarding safety are met in principle and are implemented
  • ensuring sufficient IT equipment and support, and
  • planning for contingencies and incidents.

COVID-19 vaccines will continue to be delivered to the site address in the COVID-19 Vaccine Administration System (CVAS). You cannot change your delivery address to the proposed drive-through vaccination site.

Vaccine providers who are interested in establishing drive-through vaccination sites will be required to sign a drive-through declaration in CVAS and should contact their Primary Health Network.

COVID-19 vaccinations for Department of Veterans’ Affairs (DVA) clients

The COVID-19 vaccine is free for everyone in Australia. Administering the COVID-19 vaccine to DVA clients is the same as for the general public. This includes arrangements for billing through the Medical Benefits Schedule (MBS).

For Medicare-eligible DVA clients, general practices can use the same MBS item numbers used for the general public.

DVA clients can use their Veteran Card as per usual DVA arrangements for:

  • using a Veteran Gold Card
  • using a Veteran White Card if it relates to an accepted condition. Services Australia will accept the clinical judgement of the general practitioner to determine what accepted condition requires administration of the COVID-19 vaccine.

General practices should invoice DVA for COVID-19 vaccination administered to eligible DVA clients.

DVA clients can access an Immunisation History Statement (IHS) from the Australian Immunisation Register (AIR) by using either:

  • a Medicare number
  • an Individual Healthcare Identifier (IHI).

DVA clients will have an IHI if they receive a DVA pension or benefit.

Veterans and Defence personnel can call the following number for information on updating their Medicare records or accessing their IHI number: 1800 653 809 (Option 4).

Veterans can also call this number to have a hard copy of their IHS sent to them. It can take up to 14 days to arrive. For translating and interpreting services call 131 450.

DVA has further information on COVID-19 vaccinations for DVA clients.

Vaccinating staff

Your practice staff are eligible for the COVID-19 vaccination. This includes non-clinical staff. Practices vaccinating their own staff should take into account these factors:

  • ATAGI recommends Pfizer as the preferred vaccine in adults aged under 60 who have not already received a first dose of AstraZeneca vaccine.
  • minimising wastage. For example, consider using unused doses at the end of a session to vaccinate staff.
  • stagger doses to minimise staff disruption that may occur if some staff experience a reaction to the vaccine. This might include local reactions such as injection site tenderness or systemic reactions such as headaches. Reactions may impact their ability to work in the day(s) following vaccination.

It is recommended that you don’t vaccinate all your staff in one day.

Second doses

Both the Pfizer and AstraZeneca vaccines require two doses for full vaccination.

Vaccination sites are strongly encouraged to book patients in for their second dose at the same time as they receive their first dose.

Vaccination sites should give a second dose of AstraZeneca vaccine to people who have had the first dose of the AstraZeneca vaccine without any serious adverse effects. This includes adults under 60 years.

Excess dose policy (GPs, CVCs, ACCHs and Community Pharmacy)

Excess doses are COVID-19 vaccine doses which will expire before the next scheduled vaccination clinic/ patients booked for COVID-19 vaccine.

Please note that storage advice differs for COVID-19 vaccines depending on whether it has been pre-drawn into a syringe or remains in the vial.

Where possible, vaccination sites should aim to minimise excess doses through batching bookings within a vaccination session to match the number of doses they are able to extract in a vial. However, there will be occasions where excess doses will remain at the end of a session that might expire before the next scheduled session. For example, due to cancellations or no shows for vaccine appointments.

In this situation, clinics should use the following strategies to prioritise others for vaccination to minimise vaccine wastage:

  • Maintain a reserve/cancellation list of eligible patients who:
    •  have not been able to secure a vaccine appointment, or
    • booked later but would be able to come in at short notice.
  • Use excess doses for other patients or staff who fit the eligibility criteria and who are present in the practice when you identify excess doses.

Where neither of these options are available, then vaccination sites should use identified excess doses for other patients or staff who are interesting in being vaccinated to maximise doses and minimise wastage. 

Practices should note and plan for second doses for any individuals receiving the excess doses.

Clinical model – mixed vaccine delivery

The Pfizer COVID-19 vaccine is a more complex vaccine to manage within a clinical setting than the AstraZeneca vaccine. This is due to its specific requirements for storage and handling.

Where clinics are administering more than one brand of COVID-19 vaccine, it is important to ensure:

  • individuals receive the appropriate vaccine and at the recommended interval
  • vaccines are stored and prepared correctly, and
  • waste is minimised.

To support this, clinics require a strong clinical governance framework, including workflows and processes for separating the vaccines either by time or space.

Practices should separate the administration of different vaccines by time or space. This can be done either through two separate clinics operating concurrently or a single clinic from the same location at different times.

Clinics should develop processes to ensure patients are booked into the correct clinic, and the registration systems and consent questions align to the specific vaccine the person is receiving. Pre-vaccination information provided to the patient should clearly identify which vaccine the person is receiving.

Information relating to pre- and post-vaccination care should be specific to the vaccine that the person receives.

Observing patients after the vaccine

Your practice can observe patients in the practice’s waiting room or another safe observation area.

Qualifications for observing patients

Following COVID-19 vaccination, people require a period of observation by someone who must be able to summon help if required. There are no additional staff capability requirements above the usual general practice accreditation requirements.  

Making bookings

In line with the advice of the Australian Technical Advisory Group on Immunisation (ATAGI), certain population groups are prioritised for vaccination. Please ensure your clinic stays up to date with the eligibility criteria as you should only book patients who meet the eligibility criteria.

Your practice can manage the bookings you make, including booking patients based on:

  • vaccine availability
  • local priority populations, and
  • your practice capacity.

You can also reach out to your own patients who are currently eligible. These are decisions your practice can make according to your situation and capacity.

Stockpiling

Your practice should not stockpile vaccines. You should vaccinate priority populations as quickly as possible and use your full allocation each week (where possible).

Your vaccine ordering and reporting provides full visibility of stock flow and will be monitored. Your practice will need to demonstrate vaccine stock usage before placing future orders to ensure there isn’t a large discrepancy between vaccine ordering and administration. If your site holds large amount of stock on site, your ordering ability may be paused until you have utilised your stock on hand.

COVID-19 vaccine – eligibility

You can learn more about who is eligible for vaccination here.

Note that COVID-19 vaccines are free for everyone in Australia regardless of Medicare or visa status. This includes:

  • refugees
  • asylum seekers
  • temporary protection visa holders
  • people on bridging visas, and
  • those whose visas have been cancelled or who have overstayed their visas.

This table shows how someone can prove their eligibility. Your practice should make a simple record of the proof provided.

Healthcare workers

Proof of occupation (ID card, letter from employer) or eligibility Declaration Form

Critical and high risk workers

Proof of occupation (ID card, letter from employer) or eligibility Declaration Form

Aged based

All standard forms of identification (drivers licence, passport) are accepted

Aboriginal and Torres Strait Islanders over 12 years

Self-identification as an Aboriginal and/or Torres Strait Islander Person (remember to ask the question)

People with an underlying medical condition, including NDIS participants

Medical records (for example, a clinic record, MyHealth Record, printout of chronic disease plan); a referral from a GP or treating specialist; NDIS eligibility.

Carers and disability workers

Carer’s documentation or proof of occupation (ID card or letter from employer/centre-based support provider).

Travellers with a travel exemption

Travel exemption letter from the Australian Border Force which includes a statement saying the traveller is eligible for COVID-19 vaccination.

Providers do not need to obtain eligibility proof for the second vaccination.

You need to obtain consent both times.

If a patient does not have proof of their underlying medical condition (and is not eligible otherwise), they can complete an eligibility declaration form.

View or download the COVID-19 vaccination – Eligibility declaration form

You should only book patients who meet the eligibility criteria.

Many patients who make a booking will self-check their eligibility before making a booking using the COVID-19 Vaccine Eligibility Checker. Through this process they are advised to bring proof or evidence of their eligibility to their appointment.

If a patient attends your practice and your practice assesses them as not eligible to receive the vaccine, you should not vaccinate them.

If you are a general practice and you complete the vaccine suitability assessment, you can claim the appropriate MBS item regardless of the assessment outcome. If the patient returns at a later date, you will need to complete another vaccine suitability assessment to determine if the patient is now eligible for a COVID-19 vaccine.

Individuals who do not have a Medicare card

COVID-19 vaccines are free for everyone in Australia regardless of Medicare or visa status. This includes refugees, asylum seekers, temporary protection visa holders, people on bridging visas and those whose visas have been cancelled.

Individuals who meet the current eligibility criteria and do not have a Medicare card, or are not eligible for Medicare, can receive their vaccinations for a free at:

  • Commonwealth Vaccination Clinics;
  • state or territory COVID-19 vaccination clinics; and
  • community pharmacies that are administering COVID-19 vaccines.

If patients are not eligible for Medicare, providers can still supply COVID-19 vaccines to these patients, but cannot bill for this service (Medicare or otherwise).

Patients can find and book an appointment at these clinics through the COVID-19 Vaccine Eligibility Checker.

Vaccination providers must record COVID-19 vaccinations administered to all individuals, including those not eligible for Medicare.

This information is recorded on the Australian Immunisation Register (AIR), using existing practice software, even if an individual is not eligible for Medicare.  

If a vaccination provider is unable to use their software to record the vaccination, it can be entered using the AIR Secure Site.

The AIR Secure Site can record new patients, including those without a Medicare number. Further information on how to do this can be found on the Services Australia website.

Health professionals should add as much detail as possible to these records to allow for future matching including:

  • first and last names (if known)
  • address
  • date of birth
  • postcode.

These individuals will be recorded on the AIR and given a supplementary identification number (SIN). This record can be used to record future immunisations, or until the individual has completed a Medicare registration.

Services Australia has a number of matching routines in place for when an individual becomes registered on Medicare. Services Australia allocates them a personal identification number (PIN) so that their immunisation history can be placed on the correct record from the original report (SIN to PIN matching).

If a vaccination provider requires assistance in completing this, they can call Services Australia’s dedicated AIR hotline on 1800 653 809.

Health professionals can also access education modules on using the AIR Secure Site, which are also available on the Services Australia website.

Individuals without a Medicare card can get proof of vaccination by:

  • asking a vaccination provider to print a copy of their Immunisation History Statement on their behalf
  • calling the AIR on 1800 653 809 to have an IHS sent in the post. It can take up to 14 days to arrive. For translating and interpreting services call 131 450.

Online systems

Booking appointments

The public can check their eligibility and find out where to get a COVID-19 vaccine online through the COVID-19 Vaccine Information and Location Service (VILS). The Department of Health manages the VILS in collaboration with Healthdirect Australia.

People can access the VILS through the COVID-19 Vaccine Eligibility Checker to confirm their eligibility. If eligible, they can find a vaccination site near them using the COVID-19 Vaccine Clinic Finder.

The Vaccine Clinic Finder provides the details of clinics offering vaccine appointments and how to make an appointment.

The Eligibility Checker is regularly updated based on the changing eligibility criteria.

Updating practice details in the Vaccine Clinic Finder

For general practices and Commonwealth Vaccination Clinics, Primary Health Networks (PHNs) are helping with updating the Vaccine Clinic Finder (VCF). Please contact your local PHN to provide any updated details. The PHN will feed these changes through to the Department of Health to update the VCF.

You need to work with your online booking system vendor to set up appointments so that they can be displayed in the VCF. Healthdirect Australia works directly with booking system vendors to ensure booking links are appropriately integrated and displayed in the VCF.

Listings in the VCF give eligible patients sufficient lead time to make a booking prior to the appointment date.

Reporting vaccine administrations into the Australian Immunisation Register (AIR)

Your practice should report each patient’s COVID-19 vaccination to the AIR within 24 hours if possible. Real-time or end-of-day reporting are both appropriate, as determined by your practice procedures.

Before administering a vaccine, please make sure you check the AIR for any previous vaccinations. This will ensure you are providing the correct vaccine and adhering to the correct timeframe between vaccinations.

AIR reporting penalties

New laws commenced on 20 February 2021 which make AIR reporting mandatory. This allows the Australian Government to track and trace every COVID-19 vaccine administered in Australia. It also allows the Government to pursue a civil penalty for vaccination providers that do not report.

Together with Services Australia, we will provide education and support in the first instance to assist providers who are not meeting the new reporting requirements.

Civil penalties are a last resort, where the failure to report is deliberate and ongoing, even after we have provided ongoing education and support.

Barcode scanner

Barcode scanners are not essential.

The batch number of each vaccination must be uploaded into the AIR. This is short enough to enter by hand (8 digits). This is mandatory.

Some clinical software will be able to automatically upload serial numbers into the AIR. If you have a barcode scanner, and your clinical software has this enabled, you can opt to scan the barcode for upload to the AIR. This is optional. (The barcode includes the GTIN, batch number, expiry date and serial number if it exists).

Training

COVID-19 training certificates

Before administering COVID-19 vaccines, all vaccine administrators must complete the training and provide a copy of their certificate to their employer as proof of completion.

Vaccination providers must complete the core modules and additional vaccine specific modules for each vaccines they will be administering. Providers will receive a separate certificate for the additional vaccine specific modules.

Your clinic must maintain a record of completion for all vaccine administrators.

Completing the training

A supervising GP must accept full responsibility for services provided under the COVID-19 vaccination suitability assessment MBS items. They must have completed any mandatory Commonwealth training associated with the delivery of COVID-19 vaccination services.

Written resources for the COVID-19 Vaccination Training Program

To ensure practices are referring to the most up to date content, you cannot print the training. You can review the training content by going into the relevant module and navigating to the section of interest.

Updates to training

The COVID-19 Vaccination Training Program is updated regularly to reflect the latest advice from:

  • Australian Technical Advisory Group on Immunisation (ATAGI)
  • Therapeutic Goods Administration (TGA), and
  • the Department of Health.

It is vitally important that all vaccination providers log back into the training platform to review the updates. Providers can find a summary of the updates in the announcement board, located at the top of the main page. All changes within the modules are also identified as 'NEW' in the modules.

Training and Continuous Professional Development (CPD)

The training is accredited by:

  • Health Education Services Australia
  • Pharmacy Guild of Australia
  • Royal Australian College of General Practice, and
  • Australian College of Rural and Remote Medicine.

Health professionals should check with their relevant professional organisation for further information on claiming CPD points.

Experiencing technical issues with the training platform

If professionals are having any technical issues they can contact Australian College of Nursing (ACN) through the webchat function on the training platform.

You can find the webchat on the bottom right-hand corner of the webpage. The webchat is staffed by ACN from 8.30am-5.00pm Monday to Friday.

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