Latest Updates on Coronavirus COVID-19 Vaccinations

There are currently numerous COVID-19 vaccines already in use across the globe and others have been granted emergency use authorisation through the WHO for more widespread distribution. More vaccine candidates are in development or undergoing trials. More information from GAVI.

Vaccine Updates
Vaccine Development
COVID-19 Vaccinations
Vaccine Types
FAQs
Learn More

COVID-19 Vaccine Updates in Australia

The Australian Government entered various agreements for the supply of COVID-19 vaccines, conditional on evaluations undertaken into their safety, quality and efficacy - CSL announced the closure of trials into the University of Queensland vaccine in early December due to vaccine interference in HIV diagnostic tests. So two vaccines are currently in use - Pfizer/BioNTech's Comirnaty and COVID-19 vaccine AstraZeneca, however as other pharmaceutical companies provide updates to their vaccine trials, we will add a summary of the information to this page.

Do we have a COVID-19 vaccine in Australia?

ON Jan 25, 2021 the Therapeutics Goods Administration (TGA) granted provisional approval for the Pfizer mRNA vaccine, Comirnaty, for use in individuals 18 years of age and older (Read more) and in mid-February it gave provisional approval for the use of COVID-19 Vaccine AstraZeneca in people aged 18 years and above (Read more). It remains important to maintain the recommended precautions needed to prevent spread of the coronavirus: hand washing/ hand sanitiser, physical distancing and the wearing of masks if this is difficult to achieve, cough etiquette and prompt testing of respiratory symptoms.

When were the first vaccinations administered?

It was always going to be subject to supply, but the federal government rolled out vaccinations of the Comirnaty in late February, starting with phase 1a, as outlined in the national strategy announced on Jan 7, 2021. 

List of COVID-19 Vaccine Companies & Latest Vaccine Trial Updates

  • Biocelect/Novavax vaccine – Mar 11, 2021; Phase 2b trial in South Africa/Phase 3 in UK update, plus efficacy against B.1.351 variant in May 5, 2021 press release
  • University of Oxford/AstraZeneca vaccine, COVID-19 vaccine AstraZeneca – Nov 23 update on vaccine trial results
  • Pfizer/BioNTech vaccine, Comirnaty – Nov 18 trial results
  • University of Queensland/CSL – Dec 11 CSL announces trial abandoned

 

LATEST UPDATES –

June 9, 2021 - Joint statement between RANZCOG and ATAGI about COVID-19 vaccination for pregnant women: Read more

June 9, 2021 - Updated ATAGI advice on administering seasonal influenza vaccines in 2021: Read more

May 27, 2021 - Doctors have learnt a lot about how to treat rare blood clots induced by the AstraZeneca vaccine: ABC News

May 21, 2021 - Complete Trial Results Manuscript of Novavax COVID-19 Investigational Vaccine Posted to Preprint Server medRxiv: Novavax press release

May 13, 2021 - Australia will purchase a second mRNA vaccine, Moderna COVID-19 vaccine (mRNA 1273) - 10 million doses in 2021 and 15 million in 2022. Read more from the SMH and the WHO Interim recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19 which were issued on Jan 25, 2021.

May 11, 2021 - Novavax chief ‘not able to predict’ Australian approval date for vaccine. Read more from the SMH.

April 27, 2021: The most promising coronavirus vaccine you’ve never heard of. Read more about Novavax 

April 22, 2021 -  The National Cabinet met today and agreed that access to the AstraZeneca COVID-19 vaccine for phase 2a eligible people aged 50–69 years would commence on 3 May, starting with General Practice Respiratory Clinics (GPRCs) and state and territory COVID-19 vaccination sites, to be followed by and General Practice (GP) clinics from 17 May 2021. Read more

Apr 19, 2021: 10 next-gen Covid-19 vaccines in the race for approval. Read more in Clinical Trials Arena

Apr 13, 2021 - The TGA has issued a statement after a likely second case of thrombosis with thrombocytopenia linked to the AstraZeneca vaccine. Common side effects which last for 1-2 days include fever, sore muscles, tiredness and headache, however the agency advised –‘Consumers should seek immediate medical attention if, a few days after vaccination, they develop symptoms such:

  • as a severe or persistent headache or blurred vision
  • shortness of breath, chest pain, leg swelling or persistent abdominal pain
  • unusual skin bruising and/or pinpoint round spots beyond the site of injection.’

Apr 9, 2021 - Updated safety advisory – rare and unusual blood clotting syndrome (thrombosis with thrombocytopaenia) - TGA

Feb 16, 2021 - TGA provisionally approves AstraZeneca's COVID-19 vaccine (TGA)

Feb 16, 2021 - The WHO has listed two versions of the AstraZeneca/Oxford COVID-19 vaccine for emergency use, giving the green light for these vaccines to be rolled out globally through the COVAX facility, which makes vaccines accessible to low- and middle-income countries. (WHO media release)

Feb 15, 2021 - Pfizer COVID-19 vaccine doses arrive in Australia, first doses due to be rolled out from Feb 22. ABC News

Feb 10, 2021 - The Strategic Advisory Group of Experts convened by the WHO have released their interim findings on the AstraZeneca vaccine, stating it should be deployed widely - given in a 2-dose schedule 8-12 weeks apart for the age groups 18 years and above. The TGA is still to finalise its review of the vaccine. Read more 

Feb 4, 2021 - Novavax Announces Start of Rolling Review by Multiple Regulatory Authorities for COVID-19 vaccine
authorisation - the reviews will continue while pivotal Phase 3 trials are completed in the UK and US. (Novavax press release)

Jan 28, 2021 - Novavax says its Covid-19 vaccine is 90% effective, but far less so against one variant: STAT News

Jan 25, 2021 - The Therapeutic Goods Administration (TGA) has granted provisional approval for the Pfizer mRNA COVID-19 vaccine, COMIRNATY, making it the first COVID-19 vaccine to receive regulatory approval in Australia. The approval is for individuals aged 16 years of age and over. (TGA news release)

Jan 19, 2021 - Novavax: 'early data released in December suggests it is likely to offer strong protection against COVID-19' (SMH)

Jan 7, 2021 - Australian COVID-19 vaccine rollout to be brought forward to mid-to-late-February but it's hinged on several important factors, including final TGA approval and the delivery of the vaccines from the suppliers. (ABC News)

Jan 4, 2021 - Therapeutic Goods Administration (Australia) still waiting for 'further data' on AstraZeneca vaccine (SMH)

Jan 2, 2021 - Australia to trial 'backup' COVID-19 vaccines that can be modified to fight virus mutations (ABC News)

Dec 31, 2020 - The WHO has listed the Pfizer/BioNTech COVID-19 mRNA vaccine (non-proprietary name of tozinameran and branded as Comirnaty) for emergency use, making it the the first to receive emergency validation from WHO since the outbreak began a year ago. (WHO news release)

Dec 30, 2020 - Oxford-AstraZeneca vaccine approved for use in UK (BBC News)

Dec 21, 2020 - The European Medicines Agency has recommended the Pfizer/BioNTech vaccine, Comirnaty, receive 'conditional marketing authorisation' ahead of planned vaccination campaigns across the region next week (EMA)

Dec 18, 2020 - FDA grants emergency use authorisation for second COVID-19 vaccine in USA. 

Dec 15, 2020 - Australia has secured an extra 20 million Astra Zeneca vaccines for onshore manufacturing and a further 11 million Novavax vaccines (Aust Dept. of Health)

Dec 11, 2020 - UQ/CSL trial abandoned due vaccine interference in the HIV diagnostic test. 'There is no possibility the vaccine causes infection, and routine follow up tests confirmed there is no HIV virus present.' (CSL)

Dec 3, 2020 - Australian government plans to start roll-out of vaccines in March, 2021 (ABC News)

Dec 2, 2020 -  PfizerBioNTech vaccine approved for use in the UK  for adults aged 16 years and above; also due for consideration by the FDA (USA) for emergency use authorisation approval on Dec 10, with Moderna's application due on Dec 17 (STAT News

Dec 2, 2020 - TGA statement on UK government emergency use authorisation related to the COVID-19 vaccine BNT162b2 supplied by Pfizer and BioNTech

Nov 30, 2020 - Results of Moderna vaccine's Phase 3 trials on 30,000 participants explained in an article from Science.

Nov 23, 2020 -The AstraZeneca vaccine has been shown to be well tolerated in older adults with more results due next month

Nov 18, 2020 - News on the outcome of efficacy trials of the Pfizer/BioNTech vaccine as summarised by STAT News.

Nov 16, 2020 Press release on the first interim analysis of the Phase 3 study for the Moderna mRNA-1273 vaccine

How Many COVID-19 Vaccines Are Being Developed & Tracked Globally?

The World Health Organization (WHO) is currently tracking the vaccine development of around 170 candidate vaccines globally and they are in various stages of progress – from pre-clinical phases to large-scale human trials and to widespread distribution in some countries. Once a coronavirus vaccine trial results prove successful, the sponsoring company formally applies to regulatory bodies to have their vaccine approved for use in the general public.

COVID-19 Vaccine Timeline Phases

The pathway to developing a successful vaccine follows several stages - not all may apply: Pre-clinical testing, Phase 1, 2 and 3 trials – sometimes a combination of 2 phases, early approval or emergency use only, approval granted by each country’s regulators, post-approval surveillance, and of course a pause in a trial in response to a concern over a side effect or safety issue.

Research & Testing

Unprecedented international scientific cooperation geared towards a single topic, the SARS Coronavirus-2, has boosted vaccine research which built on work started in response to the SARS outbreak in 2002-3. This has meant a faster vaccine development process than the usual, which can take years or even decades without always resulting in an approved therapeutic. The Australian government is ‘supporting world-leading research activities to speed up the development and manufacture of COVID-19 vaccines and treatments’. Read more from the Australian Dept. of Health and the WHO COVID-19 R&D Blueprint.

Phase 1

Prior to entering into Phase 1 clinical trials, a vaccine first undergoes a pre-clinical assessment or exploratory studies with a fractional dose given to a very limited group of people. Once this stage is successfully passed, a small number of healthy adults are given the vaccine in different dosages (to find a safe dosage range) and subsequently tested for an immune response and checked for any safety issues. Read more

Phase 2

The trial is expanded to a much larger and more diverse group of people – from a wider age range – to test how well it performed under controlled conditions, assessing the immune response to the vaccine, and for further evaluation of what could be any more common side effects, plus any safety issues. Read more

Phase 3

There can be many thousands of people in Phase 3 trials which are undertaken in the community. Volunteers are either given the trial vaccine or a placebo and a successful outcome is hinged on fewer people in the vaccine group becoming infected than the placebo group. During this trial, more uncommon side effects may also become apparent. This phase is followed by each country’s regulatory approval process and post-approval surveillance. Read more 

Early Approval

The TGA has been reviewing preliminary data from the various vaccine trials while also working in cooperation with international counterparts to ensure that information on clinical trials, manufacturing and safety is shared, allowing a speedy but safe regulatory process for Australia and our region. 

Approval

In Australia, the approval of vaccines is undertaken by the TGA  from advice provided by the Advisory Committee on Vaccines, an independent committee composed of members with expertise in science, medicine and public health. The TGA also oversees the quality of each batch of vaccine for distribution in Australia. Read more   

Facts About COVID-19 Vaccinations

The job of these vaccines is to imitate the SARS-CoV-2 virus (which causes the disease COVID-19), prompting a person’s immune system to produce antibodies which can fight the coronavirus. The most novel of vaccines are the mRNA vaccines, where genetically engineered pieces of the virus mRNA (such as the piece that codes for spike protein) are injected and taken up by muscle cells which then use this genetic material to generate the spike protein, so that our immune system can very rapidly generate an immune response including the production of antibodies. These antibodies will be produced by the body if it ever is threatened by the virus. No mRNA vaccine has yet been licenced for use

COVID-19 Vaccine Composition

Rigorous testing ensures that all components of any vaccine are as safe as possible while also producing the best possible immune response. These include some form of the antigen, adjuvants which enhance the actions of the vaccines to produce antibodies, plus stabilisers and preservatives that ensure vaccine potency from manufacture to when it is finally given to someone. In Australia, the Therapeutic Goods Administration (TGA) will assess and grant approval for any vaccines to be used once their safety, quality and effectiveness is proven. More on vaccine composition from the WHO.

Resistance to Vaccination Treatment

There was some early resistance to the idea of rapidly developed vaccines for COVID-19, at least here in Australia, which mainly centred on whether they would be safe. A poll commissioned by the ABC in late September revealed that of the 2,000+ respondents asked whether they would have a vaccine when it became available, only 12 percent said they were either very or somewhat unlikely to do so. More results emerging from vaccine trials showing high levels of protection with minimal side effects may well prove to be reassuring for most of us and pave the way for protective herd immunity.

Vaccine Distribution Strategy & Plan

On Jan 7, 2021, the federal government published Australia's COVID-19 vaccine national roll-out strategy which provides details on the prioritisation of different groups for vaccination against COVID-19. Quarantine and border workers, frontline health care worker sub-groups, aged care and disability care staff and aged care and disability care residents are those in the first, phase 1a of the roll-out. 

Possible Vaccine Side Effects & Reactions

Vaccines are like any medication in that they can cause side effects – the most common are usually mild and include a low-grade fever, headache, fatigue or pain or redness at the injection site which all settle within a few days without treatment. Allergic reactions to vaccines are minimised through pre-vaccination screening while severe or long-lasting side effects are extremely rare. Every vaccine is continually monitored by the TGA to ensure ‘acceptable safety, efficacy/performance and quality for its intended use’. 

COVID-19 Vaccine AstraZeneca has been associated with a rare but serious side effect (4-6 cases per million doses)  called Thrombosis with thrombocytopenia syndrome (TTS), also known as Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), which appears to be more frequently reported following the first dose. This thrombotic syndrome differs from common venous thrombo-embolic disease in that it is immune-mediated, rather than associated with the commonly known risk factors for thrombosis. It tends to occur in unusual sites resulting in cerebral venous sinus thrombosis and splanchnic vein thrombosis, both of which carry significant morbidity and mortality. TTS following COVID-19 Vaccine AstraZeneca vaccination has occurred mostly in younger vaccine recipients (under 60 years of age). Read more from ATAGI.

What symptoms may be associated with TTS? The TGA advises that if the symptoms such as the following develop a few days after vaccination, immediate medical attention should be sought - 

  • severe or persistent headache or blurred vision
  • shortness of breath, chest pain, leg swelling or persistent abdominal pain
  • unusual skin bruising and/or pinpoint round spots beyond the site of injection.

Types of COVID-19 Vaccines

More on the four types of COVID-19 vaccines (Whole virus, Protein subunit, Nucleic and Viral vector) and how they work from GAVI, the Vaccine Alliance.

The Australian government has various agreements for the supply of COVID-19 vaccines, conditional on TGA approval. 

  • AstraZeneca/University of Oxford - AZD1222 Viral vector vaccine (COVID-19 Vaccine AstraZeneca)       
  • Pfizer/BioNTech - BNT162b2 mRNA-based vaccine (COMIRNATY)
  • Novavax - NVX-CoV2373 Protein vaccine
  • Moderna - cx-024414 mRNA-based vaccine (Moderna COVID 19 vaccine)
  • Another 7 vaccines are included in the COVAX facility, which is a global effort to support fair access to COVID-19 vaccines for all countries. Aust. Dept. of Health

Currently there is guidance for the use of the Pfizer/BioNTech vaccine, which in Australia is recommended for use in people aged 18 years up to 50 years of age, while COVID-19 Vaccine AstraZeneca is for use in adults aged 50 years and older. More will be known about the recommended age groups and any potential side effects of other vaccines to be used in Australia as results of human trials are published.

More on the vaccines in development across the world from GAVI.

Frequently Asked Questions (FAQs)

FAQs

Why do we need a vaccine?

Prevention is always better than cure, particularly as we still lack therapeutics known to effectively treat COVID-19 in all its phases. An effective vaccine should enable international travel to be re-established and vaccinated travellers are more likely to be protected from contracting COVID-19 or at least protected from having severe disease. Currently data is lacking on how effective COVID-19 vaccines are at preventing disease transmission, but it is envisaged that the risk of disease transmission will be significantly reduced.

When will a vaccine be released in Australia?

The first COVID-19 vaccine, Pfizer's Comirnaty, was provisionally approved in Australia on Jan 25, 2021, and the second, COVID-19 Vaccine AstraZeneca, on February 16. The TGA performs batch testing of vaccine supplies before they are released for administration to the population and monitors vaccine safety after registration so that any safety concerns can be detected and then responded to. The commencement of Phase 1a of the national vaccination roll-out was in late February  and has now been followed by 1b, and from May 3, 2021 all adults 50 years and over became eligible for vaccination. (Australian Dept. of Health) (TGA 2020)

Who will receive vaccination first?

The target populations in the initial phases of vaccine roll-out were those considered at a higher risk of contracting COVID-19 disease or suffering severe outcomes, such as key workers in border control and quarantine, as well as those in front line healthcare and aged care. For further information see Australia's COVID-19 vaccine national roll-out strategy. (ATAGI 2020) 

 

VACCINE DEVELOPMENT

How are vaccines developed?

The pathway to developing a successful vaccine follows several stages - not all may apply: Pre-clinical testing, Phase 1, 2 and 3 trials – sometimes a combination of 2 phases, early approval or emergency use only, approval granted by each country’s regulators, post-approval surveillance, and of course a pause in a trial in response to a concern over a side effect or safety issue.

RESEARCH & TESTING

Unprecedented international scientific cooperation geared towards a single topic, the SARS Coronavirus-2, has boosted vaccine research which built on work started in response to the SARS outbreak in 2002-3. This has meant a faster vaccine development process than the usual, which can take years or even decades without always resulting in an approved therapeutic. The Australian government is ‘supporting world-leading research activities to speed up the development and manufacture of COVID-19 vaccines and treatments’. Read more from the Australian Dept. of Health and the WHO COVID-19 R&D Blueprint.

PHASE 1

Prior to entering into Phase 1 clinical trials, a vaccine first undergoes a pre-clinical assessment or exploratory studies with a fractional dose given to a very limited group of people. Once this stage is successfully passed, a small number of healthy adults are given the vaccine in different dosages (to find a safe dosage range) and subsequently tested for an immune response and checked for any safety issues. Read more

PHASE 2

The trial is expanded to a much larger and more diverse group of people – from a wider age range – to test how well it performed under controlled conditions, assessing the immune response to the vaccine, and for further evaluation of what could be any more common side effects, plus any safety issues. Read more

PHASE 3

There can be many thousands of people in Phase 3 trials which are undertaken in the community. Volunteers are either given the trial vaccine or a placebo and a successful outcome is hinged on fewer people in the vaccine group becoming infected than the placebo group. During this trial, more uncommon side effects may also become apparent. This phase is followed by each country’s regulatory approval process and post-approval surveillance. Read more 

EARLY APPROVAL

The TGA has been reviewing preliminary data from the various vaccine trials while also working in cooperation with international counterparts to ensure that information on clinical trials, manufacturing and safety is shared, allowing a speedy but safe regulatory process for Australia and our region. 

APPROVAL

In Australia, the approval of vaccines is undertaken by the TGA  from advice provided by the Advisory Committee on Vaccines, an independent committee composed of members with expertise in science, medicine and public health. The TGA also oversees the quality of each batch of vaccine for distribution in Australia. Read more   

What types of vaccines are we to have in Australia?

The initial agreements the federal government has in place are for 3 vaccines:

  • Pfizer/BioNTech vaccine (Comirnaty) – mRNA vaccine. The messenger RNA carries a genetic code for a piece of the SARS-CoV-2 virus, the spike protein, that is taken up by muscle cells. These cells use the code to make the spike protein and display it on the cells’ surface and, because it is foreign, this prompts our immune system to mount a response to the spike protein from SARS-CoV-2, the virus that causes COVID-19 disease.
  • Oxford/AstraZeneca vaccine – viral vector vaccine. This contains a non-replicating, harmless virus like a common cold virus (adenovirus, the vector) which is used to carry the genetic code for the coronavirus’ spike protein. The vector virus enters our cells allowing them to make the spike protein of SARS-CoV-2. It is then expressed on the cell’s surface for our immune system cells to recognise and mount a response to it.
  • Biocelect/Novavax - protein subunit vaccine. In this type of vaccine, virus-like nanoparticles are used as a base and then covered with genetically engineered pieces of the SARS-CoV-2 spike protein which are then recognised by our immune system cells to mount a response. More about protein sub-unit vaccines from GAVI.

 

VACCINE SAFETY

These vaccines have been developed very quickly, so are they safe?

Coronavirus vaccine research started in response to the SARS outbreak in 2002 and while real progress was made, once the outbreak ended in 2003 funding slowed and only very limited research continued. Now, unprecedented international scientific cooperation has boosted vaccine development and newer platforms now offer different types of vaccines. Testing of vaccine safety continues throughout the manufacturing process and the bottom line is that the risk of having a severe outcome from COVID-19 far outweighs any theoretical risk of a vaccine. (NCIRS 2020)

The vaccines which are being developed have had tens of thousands of people in their trials, totalling nearly 250,000 world-wide, providing researchers with a much larger amount of data than for many other vaccines routinely used. (NCIRS 2020)

Technology has advanced significantly and manufacturing of vaccines is much faster now, including sequencing of the genetic code of the virus. (NCIRS 2020)

What are the side-effects of COVID-19 vaccines?

As with all vaccines, some minor side effects can be expected and they are usually mild and temporary. Clinical trials have shown the most common side effects experienced were:

  • Injection site pain
  • Redness at the injection site
  • Fever, fatigue or muscle aches and pains
  • Headaches

These are signs that your immune system is being activated.

An observational study from the UK published in the medical journal the Lancet found that localized injection site pain and swelling was more common with the Pfizer vaccine, while diarrhoea, fatigue, headache, chills, nausea were more common following the administration of AstraZeneca vaccine.

Please refer to the Therapeutic Goods Administration (TGA) for further information on the different vaccines currently available. (Pfizer 2020)

Anyone who experiences a suspected side effect after vaccination is encouraged to report it to the clinic/provider where the vaccine was administered, or to contact the Therapeutic Goods Administration (TGA) directly. (https://www.tga.gov.au/reporting-problems

What about the clotting condition that has occurred in some people who have had the AstraZeneca vaccine? 

COVID-19 Vaccine AstraZeneca has been associated with a rare side effect (4-6 cases per million doses) called Thrombosis with thrombocytopenia syndrome (TTS), also known as Vaccine-induced prothrombotic immune thrombocytopenia (VIPIT), which appears to be more frequently reported following the first dose. This thrombotic syndrome differs from common venous thrombo-embolic disease in that it is immune-mediated, rather than associated with the commonly known risk factors for thrombosis. It tends to occur in unusual sites resulting in cerebral venous sinus thrombosis and splanchnic vein thrombosis, both of which carry significant morbidity and mortality. TTS following COVID-19 Vaccine AstraZeneca vaccination has occurred mostly in younger vaccine recipients (under 60 years of age). More from the Australian Academy of Science: 'What we know about the AstraZeneca vaccine and blood clots'.

What symptoms do I have to look out for with TTS?

The TGA advises that if the symptoms such as the following develop from 4 to 26 days after vaccination, immediate medical attention should be sought - 

  • severe or persistent headache or blurred vision
  • shortness of breath, chest pain, leg swelling or persistent abdominal pain
  • unusual skin bruising and/or pinpoint round spots beyond the site of injection.

Should I take paracetamol or ibuprofen pain relievers before or after having the COVID-19 vaccine?

It is not routinely recommended to take these medications after COVID-19 vaccinations, however they can be considered if you are experiencing some of the very common side effects such as pain, fever, headaches, fatigue or muscle aches. (ATAGI 2021)

Can I get COVID-19 infection from having the vaccine?

No, there is no live virus in the vaccine and it will not cause COVID-19 disease; the vaccine components are unable to reproduce and grow in your body to cause an infection. (CDC 2021)

The vaccines will not change your genetic code or DNA. mRNA vaccines such as the Pfizer/BioNTech vaccine instruct our cells to produce proteins which can fight the coronavirus and they do this without entering the human cell nucleus where your DNA is located. (CDC 2021)

You will not show a positive COVID-19 swab test after having the vaccine. What can occur, is a COVID-19 infection that results from being exposed to someone infected with the virus just prior to or after having a vaccine, and before the vaccine becomes effective. (CDC 2021)

Anyone who develops COVID-19 symptoms after vaccination will still need to be tested at a COVID-19 testing site.

Will vaccines be effective in protecting everyone?

We must wait for the results of human clinical trials which are underway to know the details of vaccine efficacy across different groups of people and for all emerging variants.

I am pregnant/breastfeeding, so can I get the COVID-19 vaccination?

On June 9, 2021, ATAGI and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) issued a joint statement in which they recommended that 'pregnant women are routinely offered Pfizer mRNA vaccine (Cominarty) at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby'. 

While the  timing of the vaccination during pregnancy should be discussed with your health professional, the joint statement states that 'Global surveillance data from large numbers of pregnant women have not identified any significant safety concerns with mRNA COVID-19 vaccines given at any stage of pregnancy. Furthermore, there is also evidence of antibody in cord blood and breastmilk, which may offer protection to infants through passive immunity'. 

Can COVID-19 vaccines affect fertility?

The ATAGI and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) joint statement issued on June 9, 2021, advised that 'Women who are trying to become pregnant do not need to delay vaccination or avoid becoming pregnant after vaccination'. If you are considering pregnancy, get the COVID-19 vaccine as soon as possible to ensure a safe and healthy pregnancy. It is well documented that pregnant women are at higher risk of severe COVID-19 compared than women of childbearing age who are not pregnant. COVID-19 has also been linked to an increased risk of pre-term birth.

Can the influenza vaccine be given at the same time as the COVID-19 vaccine?

The Australian Technical Advisory Group on Immunisation (ATAGI) has advised that any vaccines, including influenza, should be given at least 7 days before or after the Pfizer/BioNTech or COVID-19 Vaccine AstraZeneca vaccines, based on the current lack of data relating to any safety issues or interference with immune responses when given together. There are some occasions where on clinical advice the interval can be shortened or even allow for co-administration. (ATAGI 2021)

Once I’ve had the vaccine, does that mean I can stop wearing masks and avoid close contact with other people?

We are still learning how much protection the COVID-19 vaccines will provide for you and your contacts under real-life conditions, so for everyone’s safety it is still important to follow the public health guidelines in your community. All COVID-19 preventative measures such as wearing masks, social distancing and frequent handwashing should still be followed. (NCIRS 2020)

As we learn more about COVID-19 and the vaccines we will know more on whether herd immunity can be achieved. Herd immunity occurs through a high enough percentage of a population being vaccinated and immune to prevent the onward spread of a particular disease from person to person. (NCIRS 2020)

 

VACCINE CHARACTERISTICS

Will COVID-19 vaccination be mandatory?

COVID-19 vaccination will be voluntary. The Australian government will be providing COVID-19 vaccines free of charge to citizens, permanent residents and most visa holders. Australians have a great record in taking up immunisation so the federal government hopes to vaccinate as many of our population as possible. (NCIRS 2020)

When will I get a COVID-19 vaccine?

The Australian Government proposes to vaccinate most of our population against COVID-19 in 2021. Advice on the prioritisation of vaccine administration to at-risk groups and the general community has been provided by the Australian Technical Advisory Group on Immunisation (ATAGI) and details of the different phases are outlined in the Department of Health’s COVID-19 Vaccines National Rollout Strategy.

Which vaccine will I get?

Currently the only vaccines approved by the TGA are the Pfizer/BioNTech vaccine Comirnaty and COVID-19 Vaccine AstraZeneca. The third vaccine planned for use in Australia is the Novavax vaccine, but it is not expected to become available until a little later in the year. It is now projected that, depending on phase of roll-out and age group, most Australians will be offered either Comirnaty or COVID-19 Vaccine AstraZeneca (which has a greater ease of handling and storage, and it is produced here).

Which vaccine is better?

In Australia, the approval of vaccines is undertaken by the TGA from advice provided by the Advisory Committee on Vaccines, an independent committee composed of members with expertise in science, medicine and public health. The TGA also oversees the quality of each batch of vaccine for distribution in Australia. Read more 

The vaccines approved in Australia have been shown to be safe and effective in preventing COVID-19 disease for their recommended age groups. Individuals will not be able to choose which vaccine will be offered to them, but can be assured that any vaccine will have been through all the safety processes before being approved and all recipients will make an informed decision based on all available information before it is administered.

Will the vaccine prevent COVID-19 or just prevent me from having a severe illness?

The effectiveness of the vaccines in preventing COVID-19 symptoms and disease is being continuously evaluated. The results indicate that the vaccines are effective in preventing COVID-19. (NCIRS 2020)

Current evidence shows that the vaccines appear to prevent severe COVID-19 disease, however it may still be possible to be infected with and transmit the virus that causes COVID-19 to other individuals. This reinforces the message that it is important for anyone who develops COVID-19 symptoms to be tested, even after they are vaccinated.

Over the coming months and years, scientists and manufacturers will gather data on the duration of this protection and whether the effectiveness is dependent on the age of the individual and their health status. (NCIRS 2020)

If I have had COVID do I still need to get vaccinated?

Yes, you will still need to be vaccinated even if you have already had COVID-19. Although you may have some level of immunity, this can vary and may not last very long, however the full benefits of vaccinating individuals who have been infected with SARS-CoV-2 is yet to be established.

Will the COVID-19 vaccines be effective on new coronavirus variants?

At this time it appears that the vaccines which have completed late stage trials do induce varying levels antibodies which are able to respond to a variety of mutations, some more than others. These developments are being closely monitored.

How many doses of COVID-19 vaccine will be needed?

Most of the vaccines currently in use overseas and those forecast for use in Australia require 2 doses of vaccine administered several weeks apart (ranging from 3 weeks to 12 weeks depending on vaccine). 

Why are multi-dose vials being used for the vaccines?

Due to the extremely large amounts of vaccine that are being manufactured and distributed, the most efficient way of storing the vaccines is in multi-dose vials. Just before administration, the healthcare worker will dispense the exact amount into a separate syringe ready to be injected.

Can I drink alcohol after having the vaccine?

Consuming alcohol just before or after having the vaccination is not expected to impact the effectiveness of the vaccines but this has not been thoroughly tested and so is not recommended.

Does the flu or pneumococcal vaccine protect me against COVID-19?

No, the pneumococcal and flu vaccines protect you from a different illness to COVID-19. It is important to have those vaccines if offered.

Can children have the vaccine?

Vaccine trials are underway to determine their safety and efficacy in children and the advice may change in the future. Some countries have authorised the use of specific COVID-19 vaccines in adolescents from 12 to 16 years of age, but this is not yet the case in Australia. 

Who can’t have the coronavirus vaccine?

Currently in Australia there are no approved COVID-19 vaccines for use in children and adolescents under 18 years of age for COVID-19 Vaccine AstraZeneca and 16 years of age for Pfizer/BioNTech vaccine Comirnaty (the preferred vaccine for adults under 50 years of age - ATAGI advice). A COVID-19 vaccine is also contraindicated in those people who have a history of anaphylaxis to any component of the particular vaccine - there may be an alternative vaccine which is appropriate in these cases. In addition, anyone with an acute febrile illness (body temperature over 38.5°C) should defer vaccination until the fever has subsided.

What is in the vaccine?

The Pfizer vaccine contains highly purified single-stranded, 5’-capped messenger RNA (mRNA) as its active ingredient.

The inactive ingredients are chemicals needed to make up the vaccine solution. They are: ALC-0315 = (4-hydroxybutyl) azanediyl)bis (hexane-6,1-diyl)bis(2-hexyldecanoate); ALC-0159 = 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide; 1,2-Distearoyl-sn-glycero-3-phosphocholine; cholesterol; potassium chloride; potassium dihydrogen phosphate; sodium chloride; disodium hydrogen phosphate dihydrate; sucrose; and water. An ingredient to note is polyethylene glycol/macrogol (PEG) as part of ALC-0159.

The Oxford/AstraZeneca vaccine contains a modified harmless form of a different virus as its active ingredient. It contains genetically modified cells.

The inactive ingredients are chemicals to make up the vaccine solution. They are: L-Histidine; L-Histidine hydrochloride monohydrate; magnesium chloride hexahydrate; polysorbate 80; ethanol; sucrose; sodium chloride; disodium edetate dihydrate; and water.

Read more about how the Oxford vaccine works

Is the vaccine compatible with my religion?

There is some guidance for a variety of faiths:  

  • The Catholic Church says: ‘all clinically recommended vaccinations can be used in clear conscience’ Read more
  • The Church of England has declared that all clinically recommended vaccines can be used. Read more
  • The   British   Islamic   Medical   Association   (BIMA) has   consulted   various   experts   in   infectious   diseases, the pharmaceutical industry, clinical medicine, commissioning, inequalities research, public health, and bioethicists to produce the following statement on the Pfizer/BioNTechCovid-19vaccine: ‘We recommend the Pfizer/BioNTech Covid-19 vaccine for eligible at-risks individuals in the Muslim community.’ Read more
  • Orthodox Jewish groups in England and the USA have encouraged their community members to be vaccinated. Read more

Do the COVID-19 vaccines contain animal products?

The approved vaccines do not contain any ingredients derived from pigs, cows or other animals. (Green book 2020)

Do the COVID-19 vaccines contain human foetal cells?

The AstraZeneca vaccine uses a harmless, weakened form of an adenovirus, which is grown in human embryonic stem cells. It is important to know these were not taken directly from human embryos but are copies of stem cells which originally date back to 1970. The vaccine does not contain any embryonic cells. (Green book 2020)

How much would vaccines cost?

The Australian government will be providing COVID-19 vaccines free of charge for citizens, permanent residents and most visa holders, with the medical consultation for administration of the COVID-19 Vaccine AstraZeneca to be provided in a bulk bill visit for those who are eligible at participating GP clinics. (NCIRS 2020)

Can I get a COVID-19 vaccine earlier through the private system?

COVID-19 vaccines will be free for all Australian citizens, permanent residents and most visa-holders.

Early supplies are expected to be limited and, as per the Australian Vaccination Policy, priority groups will be offered the vaccines first at designated vaccination sites. Where these vaccines will be administered will vary from state/territory, but it includes hospital-based clinics for hospital staff and other workplaces, including aged care facilities.

Once more supplies become available, vaccines will be available to the broader population through usual immunisation providers, such as general practice clinics, general practice respiratory clinics and pharmacies.

It is possible that some vaccine candidates may eventually become available on the private market, meaning they will not be free of charge as with as those to be provided to eligible Medicare card holders in Australia. More information will be forthcoming as more vaccines are granted approval and supplies are assured.

 

VACCINES AND MEDICAL CONDITIONS

Is the vaccine safe for people with heart and circulatory conditions?

It is even more important for some people with existing medical conditions to have the vaccinations so as to prevent COVID-19 infection. People with certain underlying pre-existing medical conditions are reported to be at increased risk of severe outcomes with COVID-19 compared with healthy individuals of the same age. Provided the individual does not have a severe allergy to any of the vaccine components, generally they are able to have the vaccination. If you have any concerns regarding your medical condition and COVID-19 vaccines please discuss these with your specialist.

Some of the heart and circulatory conditions which put the individual in a priority group for earlier vaccination are as follows (this is not a comprehensive list):

Is the vaccine safe for people taking heart medications?

Yes, COVID-19 vaccines are safe for people taking heart medications. The medications won’t stop the vaccine from working and at this time there are no concerns that these types of drugs will interact with the vaccine.

Is the vaccine safe for people taking blood thinners like warfarin or other anticoagulants?

The vaccine is generally safe in individuals on warfarin or other anticoagulants, however it is important that healthcare providers are made aware of individuals taking these medications. (Green book 2020)

Injections for COVID-19 are injected into the muscle and it is possible that someone on blood thinners may experience some bleeding and this may take a little longer to stop, or a bruise may develop at the injection site.  

If an individual’s warfarin INR level is > 3.0, vaccination should be delayed and the result discussed with your medical practitioner. For anyone on anti-factor-Xa-treatment, such as low molecular weight heparin (i.e. Clexane), vaccination should be delayed if the 4 hours post-dose level is > 0.5 units/ml. (Australian Immunisation Handbook).

Is the vaccine safe for people with immune deficiency or autoimmune disorders?

None of the vaccines under consideration is live-attenuated vaccines. They are generally safe for people with immune system disorders, however it is advised that anyone being treated for these disorders should consult with their specialist treating doctor for specific advice. (Green book 2020)

I have a number of allergies, can I still get the vaccine?

In the case of allergies that you are aware of, a pre-vaccination assessment will determine if the vaccine is suitable or if an alternative formulation may be possible. 

The Australasian Society of Clinical Immunology and Allergy (ASCIA) states that ‘There is no evidence that people with allergic conditions such as asthma, hay fever, food allergy or insect sting allergy are at any greater risk of vaccine allergy compared to the general population. Unlike some other vaccines, there is no food, gelatin or latex in the COVID-19 vaccines that are currently available, and they are not grown in eggs. If a person has had an allergic reaction to another vaccine, this does not mean that they will also be allergic to the COVID-19 vaccine.’(ASCIA 2021)

Do allergy treatments need to be stopped to have a COVID-19 vaccine?

Regular allergy treatments, such as those for hay fever, asthma and eczema, should be continued, but there are conditions placed on those people receiving allergen or venom immunotherapy which means that the injections shouldn’t be given within 48 hours of COVID-19 vaccination. The reason being a risk of confusing vaccine side effects with allergic reactions from the immunotherapy. (ASCIA 2021).

Do immunodeficiency or autoimmune treatments need to be stopped to have a COVID-19 vaccine?

Ceasing treatments for autoimmune conditions and immunodeficiencies can increase the risk of COVID-19 disease complications. Advice should be sought from the treating specialist as it may be recommended for vaccination to occur on a different day to regular infusion treatments. Once again, the risk of confusing vaccine side effects with allergic reactions is a consideration. (Green book 2020)

Lastly, 'the Australian Academy of Science has launched a new guide about the science of immunisation to help counter misinformation and uncertainty surrounding vaccines for COVID-19 and other diseases'. The guide offers answers to common questions, such as: 

► What is immunisation? 
► What is in a vaccine? 
► Who benefits from vaccines? 
► Are vaccines safe? 
► What does the future hold for vaccination?

The guide is available online as web content, as a downloadable PDF and in print, and there are short easy-to-understand videos to watch and share. 

 

REFERENCES:

Australian Technical Advisory Group on Immunisation [ATAGI]. (2021c). Interim Clinical Guidance on use of COVID-19 vaccines in Australia in 2021 (version 1.0). https://www.health.gov.au/resources/publications/atagi-preliminary-advice-on-general-principles-to-guide-the-prioritisation-of-target-populations-in-a-covid-19-vaccination-program-in-australia

Australian Technical Advisory Group on Immunisation [ATAGI]. (2020c). Preliminary advice on general principles to guide the prioritisation of target populations in a COVID-19 vaccination program in Australiahttps://www.health.gov.au/sites/default/files/documents/2020/11/atagi-preliminary-advice-on-general-principles-to-guide-the-prioritisation-of-target-populations-in-a-covid-19-vaccination-program-in-australia_0.pdf.  

Australian Technical Advisory Group on Immunisation [ATAGI]. (2018). Australian Immunisation Handbook, Australian Government Department of Health, Canberra, https://immunisationhandbook.health.gov.au/.

Australasian Society of Clinical Immunology and Allergy (ASCIA) Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Frequently Asked Questions (FAQ) (2021) https://www.allergy.org.au/patients/ascia-covid-19-vaccination-faq

Centres for Disease Control and Prevention [CDC]. (2021, January). Facts about vaccinationhttps://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html.  

Guidance: COVID-19: the green book, chapter 14a. Coronavirus (COVID-19) vaccination information for public health professionals (2020). https://www.gov.uk/government/publications/covid-19-the-green-book-chapter-14a

National Centre for Immunisation Research and Surveillance [NCIRS]. (2020). COVID-19 vaccines: Frequently asked questionshttps://www.ncirs.org.au/covid-19/covid-19-vaccines-frequently-asked-questions.   

Pfizer Australia. (2021b). Australian product information – ComirnatyTM (BNT162b2 [mRNA]) COVID-19 vaccine. TGA. https://www.tga.gov.au/sites/default/files/auspar-bnt162b2-mrna-210125-pi.pdf.  

Therapeutic Goods Administration [TGA]. (2020). COVID-19 vaccine approval processhttps://www.tga.gov.au/covid-19-vaccine-approval-process.   

Australian Immunisation Handbook, Australian Government Department of Health, 2018: Vaccination for people with bleeding disorders https://immunisationhandbook.health.gov.au/vaccination-for-special-risk-groups/vaccination-for-people-with-bleeding-disorders

Learn More About Coronavirus COVID-19

The Australian Department of Health has developed a number of resources on the coronavirus: how Australia is monitoring and responding to COVID -19, how we can help stop the spread of coronavirus and what to do if we have any symptoms. On the vaccine front, the situation is changing and developments are moving quickly. 

Travelvax resources: Coronavirus information

Other resources:  

Aust. Dept of Health:

o   COVID-19 vaccine hub

o   COVID-19 vaccine and treatment strategy

o   Australian COVID-19 vaccination policy

o   Coronavirus - COVID-19 Vaccines information translated into 60+ languages

o  COVID-19 vaccines ⁠–⁠ Is it true? Read more

Therapeutics Goods Adminstration: COVID-19 vaccines

NCIRS: COVID-19 vaccine development landscape

NCIRS: COVID-19 Vaccines Frequently Asked Questions

The Australian Government has agreements for the supply of COVID-19 vaccines, if they are proved to be safe and effective, with:

 University of Oxford/AstraZeneca

 Novavax

 Pfizer/BioNTech

 COVAX Facility

STAT News: COVID-19 drugs and vaccine tracker

World Health Organisation:

Australian Academy of Science:

GAVI: 5 ways scientists are ensuring safety of COVID-19 vaccines Read more 

 

Glossary of terms

Herd immunity: Protection against a disease either through immunity gained from having the infection (with the inherent risk of severe illness, long-last effects or even mortality) or receiving a vaccine. When the majority of people are immune, it is much less likely that the disease will spread as there are so few susceptible people left to infect. These susceptible people may not be able to have a vaccine either due to their age (too young or too old) and immune deficiencies (i.e. cancer or autoimmune disease).

Efficacy vs effectiveness: Efficacy is measured during a vaccine trial when all conditions are ideal and strictly controlled, whereas effectiveness is determined on how well a vaccine performs when used under normal, real-life situations. 

Pandemic vaccines 101: Do you understand the medical terms used to explain COVID-19 vaccines? ABC