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Administering the vaccines and managing side effects

Information about administering the COVID-19 vaccines and managing side effects.

How to get the vaccine

Vaccination centres are open to people who are eligible to receive a COVID-19 vaccine.

Administering the COVID-19 vaccines

The COVID-19 vaccines available in Australia require injection into muscle and are usually given into the deltoid muscle in the upper arm. This is similar to many other vaccines, including seasonal influenza vaccines.

It is very important that people receive two doses of the same brand of vaccine, with adequate spacing between doses as recommended by the manufacturer. This helps ensure the efficacy of the vaccines.

Standard pre- and post-vaccine procedures will apply, including a checklist and a minimum 15-minute observation period following vaccination. Supporting documents and information to share with vaccine recipients can be found on the Australian Government Department of Health webpage.

COVID-19 vaccine and other vaccines

The COVID-19 vaccine should not be administered with other vaccines.

If a dose of COVID-19 vaccine is inadvertently administered within 7 days of another vaccine, doses do not need to be repeated for either vaccine.

Influenza vaccine

Victorians are encouraged to get a flu vaccine this year to protect themselves against influenza. This will help protect our health system and our most vulnerable populations during the COVID-19 vaccine rollout.

The recommended minimum interval between COVID-19 vaccine and other vaccines (including influenza vaccine) is 7 days, but can be shortened (including same day administration) in special circumstances. 

This interim recommendation from the Australian Technical Advisory Group on Immunisation (ATAGI) is based on the lack of direct data demonstrating absence of any safety issues or interference of immune responses after co-administration of influenza and COVID-19 vaccines. As further information becomes available, this recommendation may change to permit routine co-administration.

Resources for vaccine providers

As with all other vaccines, informed consent is required before administering each COVID-19 vaccine dose. Consent can be verbal or written.

Clinical guidance and advice  

FAQs for vaccination providers 

Resources for people about getting vaccinated

Adverse reactions after vaccination

As with all medicines, people may experience minor symptoms following vaccination. These are expected and are related to the body’s immune response to the vaccine. Most side effects are mild and self-limiting and people will recover without any problems.

In the setting of community spread of COVID-19, a person is much more likely to be seriously impacted by COVID-19 than by the vaccine. 

Normal and very common reactions to vaccination include:

  • pain, redness and/or swelling at site of injection 
  • tiredness 
  • muscle aches 
  • headache 
  • fever and chills 
  • joint pain. 

As the COVID-19 vaccines are given by injection into the muscle, usually in the upper arm, many people will be sore at the injection site straight away. In the hours following vaccination, some people may also have mild and temporary fever, fatigue, headache and muscle aches. This type of reaction will normally only last for one or two days at the most.

These sorts of mild, expected side effects are not a contraindication to receiving the second dose of vaccine.

Serious reactions like allergic reactions are possible but extremely rare. Advise patients to seek medical advice straight away if:

  • their body reacts in an unexpected way
  • there is an onset of the TTS symptoms  4-20 days after vaccination. Symptoms of TTS are described below.
  • they have any concerns about potential side effects of vaccines.

Everyone must be monitored for at least 15 minutes after receiving the COVID-19 vaccine to ensure care is given if there are any serious adverse reactions such as anaphylaxis. 

It is recommended that individuals with a history of anaphylactic reaction to vaccines be monitored for 30 minutes after vaccination, rather than 15 minutes. 

People with an immediate allergic reaction to the first dose of a COVID-19 vaccine should not receive additional doses of that vaccine. An immediate allergic reaction to a vaccine or medication includes any hypersensitivity-related signs or symptoms consistent with urticaria, angioedema, respiratory distress (for example wheezing, stridor), or anaphylaxis that occur within four hours of administration. People can receive a second dose of AstraZeneca within the recommended interval of 12 weeks if they did not have a serious adverse effect to their first dose. This is safe and recommended by ATAGI. Learn more about AstraZeneca vaccine

Reporting side effects 

Common symptoms following vaccination may include injection site pain, fever, chills, tiredness, and headache. For most people, side effects last no longer than 1-2 days. These side effects do not need to be reported.  

Vaccine providers should attempt to determine whether reactions reported following vaccination are consistent with immediate allergic reactions versus other types of reactions commonly observed following vaccination, such as a vasovagal reaction or post-vaccination side effects (which are not contraindications to receiving the second vaccine dose). 

In Victoria, clinicians must report severe adverse effects through  SAEFVIC. This should be done whether you think the side effect was related to the vaccine or not. People who have received the COVID-19 vaccine should be encouraged to report any adverse reactions following vaccination by responding to the SMS they receive after the vaccine or by contacting the Victorian SAEFVIC Line. The Melbourne Vaccine Education Centre has developed a video on how to report an adverse event to SAEFVIC.

The VicSIS (Victorian Specialist Immunisation Services) network has been created to enhance adult immunisation services in Victoria to address queries and safely vaccinate under supervision, if required. To determine whether a referral to VicSIS is appropriate or not, refer to the clinician referral guide to VicSIS.

The ATAGI has released guidelines to assist health care workers assess if their patient should receive the COVID-19 vaccine.

Updated advice on the 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. 

There has been a link between the AstraZeneca vaccine and a condition involving thrombosis (blood clotting) with thrombocytopenia (low blood platelet counts). This is a very rare condition. It is currently estimated to affect about 1 in every 100,000 people who receive the first dose of AstraZeneca vaccine. It is even more rarely reported after the second dose.  

The onset of reported cases was between 4 to 28 days after vaccination with the first dose of the AstraZeneca COVID-19 vaccine. 

Pfizer is the preferred COVID-19 vaccine for adults under 60 years of age at this time. However, adults under 60 years of age may still choose to receive the AstraZeneca vaccine if they have considered their individual benefits and risks, and following discussion and providing informed consent. More information is available in the factsheet - Information on AstraZeneca vaccine

Symptoms of thrombosis with thrombocytopenia 

Possible symptoms of thrombosis with thrombocytopenia can include: 

  • a severe persistent headache with additional features: 
    • appears at least 4 days after vaccination 
    • does not improve with simple painkillers 
    • may be worse when lying down 
    • may be accompanied by nausea and vomiting 
  • neurological symptoms such as: 
    • blurred vision 
    • difficulty with speech 
    • confusion 
    • drowsiness 
    • seizures 
  • shortness of breath 
  • chest pain 
  • swelling in your leg 
  • severe persistent abdominal (belly) pain 
  • tiny (pinpoint) blood spots or bruising under the skin away from the site of injection. 

People should seek medical attention immediately if they experience these symptoms. 

Resources

Safety and managing side effects of vaccines

Administering vaccines

Reviewed 17 June 2021

Coronavirus Victoria

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