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Coronavirus Vaccine

 

What types of vaccines are being approved in Australia?

 

Currently The Australian government has four agreements for supply of vaccines if they are proven to be safe and effective. There are two which have now been provisionally approved:

 

1. The Pfizer/BioNTech vaccine called Comirnaty. It will be manufactured offshore and will be used in the phase 1 roll out of the vaccine through hospitals and aged care facilities (see more below).

 

2. The AstraZeneca vaccine by University of Oxford/AstraZeneca. It is being manufactured in Australia by CSL. This vaccine will be distributed through general practice.

Both vaccines have been given to millions of people in the UK.

Technologies new and old are being harnessed in the development of COVID-19 vaccines using the genetic code for a component of the virus. These technologies include:

 

1. mRNA vaccines (Pfizer vaccine), which use molecules that contain genetic information (genes) to generate proteins in the body which prompt an immune response. These technologies have been under development for decades.

 

2. Viral vector vaccines (AstraZeneca vaccine), in which a chemically weakened, harmless virus such as the common cold adenovirus (vector), is used to carry the genetic code for the spike protein from the Covid-19 virus. There are already vaccines which use this technology (e.g. the ebola vaccines) and for other gene therapy products.

 

3. Protein subunit vaccines, which use a very specific part (subunit) of the virus. The subunits can be proteins or sugars. Most vaccines on the childhood schedule are subunit vaccines (e.g. whooping cough, tetanus, diphtheria and meningococcal meningitis)

 

Why should I get the vaccine?

 

Vaccination is an important way to reduce the risk of catching an infectious disease, and helps stop it spreading in a community.

Immunity occurs after the vaccine stimulates a person’s immune system to make antibodies to help protect the body from future infections. This means that if a person is vaccinated their immune system will detect and kill the COVID -19 virus rapidly so in most cases the virus will NOT infect them. Even if a person does get infected it is likely to be milder illness.

 

How effective are the vaccines?

 

Both the currently available COVID-19 vaccines are 100% effective against developing severe COVID, this means that the few people that get infected despite having the vaccine, will not end up in hospital. The Pfizer vaccine works to completely stop COVID in around 95% of people, with the AstraZeneca vaccine it is around 82%.

 

What are the common side-effects of the vaccines?

 

Some people will develop short-term, mild side effects after being vaccinated.

Vaccines are usually given as an injection into the upper arm and common side effects include injection site reactions, such as local pain, redness and swelling. Other side effects include fever, joint pain, muscle aches, headache, and tiredness.

These common side effects indicate the start of an immune response, which helps prevent people from getting COVID-19. Side effects do not usually require any treatment, other than paracetamol for fever or discomfort.

 

Allergic reactions to vaccines are rare.

 

Some people may have allergic reactions to a substance found in the Pfizer vaccine (only available to phase 1 recipients) – Polyethylene Glycol (PEG), an ingredient found in tablets, laxatives, cosmetics and bath products. The AstraZeneca vaccine (all other recipients of the COVID vaccine will receive this), has Polysorbate 80 which is related to PEG, however initial data from 1 million doses in the UK has not shown any cases of anaphylaxis.

 

What happens if I have a reaction to the vaccine?

 

Both the Pfizer and Astra Zeneca vaccines require a second dose to achieve long-term protection from COVID-19.

· If you have a non-allergic reaction (side effect) to the first dose you can still receive a second dose. These reactions include those listed above in the common side-effect section, fainting and skin reactions other than hives

· If you have a mild or moderate reaction such as a skin reaction like hives (urticaria), you should receive the second dose, but with a longer observation period of at least 30 minutes

· If you have anaphylaxis to the first dose you should not consider a second dose until seeing an allergy specialist or immunologist.

 

Are COVID-19 vaccines safe for those with allergies?

 

Both vaccines are safe for those with allergies. There is no indication that people with conditions such as asthma, hay fever, food allergy or insect sting allergy have any greater risk of allergy than the general populations.

Unlike some other vaccines there is no food, gelatin or latex in the COVID-19 vaccines currently available, and they are not grown in eggs. An allergic reaction to another vaccine does not mean you will also be allergic to the COVID-19 vaccine.

If you have a known PEG allergy or previous anaphylaxis to multiple medications you should see an allergy specialist first to assess and confirm your allergy. The AstraZeneca Vaccine may be suitable as an alternative if PEG allergy is confirmed.

 

Are COVID-19 vaccines safe for those with immunodeficiencies or autoimmune conditions?

 

Both COVID-19 vaccines are safe for people with primary and secondary immunodeficiencies and autoimmune conditions who are not otherwise considered to be at greater risk of vaccine allergy already. In fact people with certain pre-existing medical conditions have been identified as some of the first to be vaccinated in the initial priority groups due to higher risks associated with contracting the COVID-19 illness.

Can I have the vaccine at the same time as the flu vaccine?

It is not recommended to have the flu vaccine and a COVID-19 vaccine on the same day. It is preferred that the minimum interval between a dose of flu vaccine and a dose of COVID-19 vaccine is 2 weeks.

 

Who can’t have the vaccine at this stage?

 

Routine use of COVID-19 vaccines during pregnancy and breastfeeding is not recommended. Based on clinical trials of similar vaccines it is unlikely that the COVID-19 vaccines will pose a risk, however as pregnant and breastfeeding women have not been included in the initial trials doctors advise you not to have the vaccine at this stage until more information is available.

At this stage children under the age of 18 years of age are not receiving the vaccine. This is due to:

· Children and young people being at low risk of COVID-19

· Trials in children have only just started

· The vaccines are not yet registered for use in children under 18

These recommendations may change as clinical trials are completed.

National rollout strategy

Phase 1a (expected to start late February)

· Quarantine and border workers

· Frontline health care workers

· Aged care and disability care staff

· Aged care and disability care residents

Phase 1b (expected to start by mid-late March)

· Elderly adults 80 years and over

· Elderly adults 70-79 years and older

· Other health care workers

· Aboriginal and Torres Strait Islander people >55

· Younger adults with an underlying medical condition, including those with a disability

· Critical and high-risk workers including defence, police, fire, emergency services and meat processing

Phase 2a

· Adults aged 60-69 years

· Adults aged 50-59 years

· Aboriginal and Torres Strait Islander people 18-54

· Other critical and high-risk workers

Phase 2b

· Balance of adult population

· Catch up any unvaccinated Australians from previous phases

 

References:

 

1. National Centre for Immunisation Research and Surveillance https://www.ncirs.org.au/public/covid-19-vaccines

2. Australasian Society of Clinical Immunology and Allergy https://www.allergy.org.au/patients/covid-19 3. Australian Government Department of Health https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines 4. World Health Organization https://www.who.int/emergencies/diseases/novel-coronavirus-2019/covid-19-vaccines