COVID-19 vaccine information for GPs

mRNA COVID-19 vaccine dose intervals extended – 29 April 2022

The recommended dose interval for mRNA COVID-19 vaccines has been extended with ATAGI now recommending the dose interval between primary doses for both Pfizer and Moderna vaccines be extended to 8 weeks. Previously the interval was 3–6 weeks and 4–6 weeks, respectively.  

ATAGI note: 

The extended dose interval of 8 weeks has been shown to improve the immune response to vaccination and therefore may improve effectiveness. A longer dose interval may also reduce the risk of myocarditis and pericarditis. The longer dose interval is particularly recommended for groups at higher risk of this side effect (those under the age of 40 years)”. The Department of Health (DoH) guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines has been updated to align with this recommendation. 

 

Updated advice on COVID-19 vaccination post infection (all doses) – 29 April 2022

ATAGI have updated their advice on when people who have been infected with COVID-19 should receive a subsequent COVID-19 vaccine dose, now recommending a three month wait following confirmed infection before they receive their next dose, after which their next scheduled dose should then be given as soon as possible. 

ATAGI note: 

This updated advice reflects the lower risk of reinfection with the Omicron variant within the first 3 months following a confirmed infection, particularly if prior COVID-19 vaccine doses have been received. It also recognises the Delta variant is no longer circulating in Australia and in the past 3 months Omicron has been the dominant variant. This advice may change if future variants of SARS-CoV-2 emerge. 

Waiting for a 3-month period after infection before COVID-19 vaccination is intended to optimise protection for that person.  A longer gap between infection and vaccination is likely to lead to a better immune response and result in longer protection from reinfection. 

ATAGI does not recommend booster doses for adolescents 12–15 years – 8 April 2022

The TGA recently approved the Pfizer vaccine for use as a booster dose for use in adolescents aged 12-15 years.

However, ATAGI has released a statement following the announcement and does not recommend booster doses are administered to this cohort.

 

 

Department of Health (DoH):

From these pages you can access suites of resources to support you and your practice in delivering COVID-19 vaccinations.

• ATAGI clinical guidance for COVID-19 vaccine providers
• Guidance to help people make informed decisions
• Resources for COVID-19 vaccine providers
• Advice for COVID-19 vaccine providers and administrators

Australian Immunisation Register (AIR):

• Australian Immunisation Register (AIR) fact sheet 
• AIR immunisation medical exemption form (IM011)

​
The Australian Technical Advisory Group on Immunisation (ATAGI):

• ATAGI statements
• ATAGI weekly COVID-19 meeting updates

Australian Health Protection Principal Committee (AHPPC)​ resources

• Statements

 

Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ):

• Multidisciplinary vaccine-induced immune thrombotic syndrome (VITT) guideline

 

Melbourne Vaccine Education Centre:

• Thrombosis with Thrombocytopenia Syndrome (TTS) - Information, resources and explanatory video
• Discussion guide for medical exemptions 

Consumer Health Forum:

• Shared decision-making resources for GPs, practice nurses and community pharmacists

Also see the 'Where can I find the latest patient resources?' section of this website for resources written for consumers, including decision support guides. 

Australian Immunisation Register patient reports for practices

Practices can now extract updated reports from the Australian Immunisation Register (AIR), giving greater visibility of patients' vaccination status, and therefore improving the follow-up process.

You can now download a report by practice (rather than by practitioner) showing patients who have yet to receive any doses of COVID-19 vaccines or who are now eligible, due or overdue for a booster dose.

The next tranche of reporting changes will provide visibility to patients who have only received one dose.
 

Australian Immunisation Register reporting for children aged 5–11 years

Reporting a Pfizer vaccination for children aged 5–11 years in the Australian Immunisation Register is the same as for all other age cohorts.

When completing the report, use the vaccine code COMIRN.

Make sure to use the latest version of your clinical software to make sure it meets reporting requirements.

RACGP education kit: COVID Vaccine Booking Program

The RACGP Practice Essentials education kit: COVID Vaccine Booking Program will guide you and your practice team members on using the Vaccine Clinic Finder Connect. 

Integrating your practice’s online vaccine appointments and practice details with the Vaccine Clinic Finder (VCF) in real time ensures patients can connect with your practice to get their COVID-19 vaccinations and booster doses. The VCF is a national online system for patients to find and book vaccination appointments. VCF Connect is a secure, authenticated online portal that allows practice owners and managers to update your practice’s COVID-19 vaccination services information online.

The RACGP education kit covers:

• understanding the VCF and its role in improving access to COVID-19 vaccines and booster doses
• knowing the VCF patient journey
• integrating online booking systems
• ​keeping your VCF information updated with VCF Connect

A new webinar recording with fresh updates to help you use the Vaccine Clinic Finder Connect is now live. The on-demand webinar is your key to ensuring patients can seamlessly connect with your practice to book their COVID-19 vaccinations, including booster doses – Watch the webinar
 

Ongoing expression of interest in participating in the vaccine rollout in general practice

A standing expression of interest is open for new general practices interested in joining the COVID-19 vaccination program. To be eligible to join the program, your practice must either be:

• an accredited practice and hold a current and valid accreditation through the National General Practice Accreditation Scheme

OR

• a non-accredited practice administering vaccines under the National Immunisation Program.

If you want to join the program at any stage, contact your local Primary Health Network.
 

COVID-19 vaccination training program

As part of the rollout, authorised vaccine providers will need to complete mandatory COVID-19 vaccination training. Participants are notified by email when updates are made and are expected to log on and review the changes. 

If you are experiencing technical issues with the training modules, please use the chat function (Available Monday - Friday, 8.00 am - 6.00 pm (AEST)) or contact COVID19VaccinationTraining@Health.gov.au

 

 

The RACGP has prepared an overview of the MBS items available to assess patients for their suitability to receive a COVID-19 vaccine.

Visit RACGP's MBS webpage for full item descriptors and rebates. 
 

Winter dose funding and reporting for in-reach services  

The DoH are encouraging general practices to continue to support their local Residential Aged Care Facilities, Disability Support Services, and other priority populations to provide in-reach services to ensure eligible people received their winter dose of the COVID-19 vaccine.  

Payments for the winter dose remain the same as for the administration of other booster doses, as outlined in this DoH factsheet.   

When providing in reach services, to verify claims for the Practice Incentive Program (PIP) in-reach payment, you will need to complete the Clinic Summary Report, have it signed by a representative at the facility and scan/email to your PHN. Further information on reporting requirements is outlined in this DoH factsheet.  

Please contact you PHN if you require any assistance with facilitation, coordination, or reporting. 
 

Providing a COVID-19 vaccine and flu vaccine during the same consultation

ATAGI has advised it is no longer necessary to wait two weeks between a COVID-19 vaccination and an influenza vaccination; you can provide these services during the same consultation.

Although you are under no obligation to bulk bill a patient receiving a flu vaccination, a patient who also receives a COVID-19 vaccination during the same appointment must be bulk billed for the MBS COVID-19 vaccine suitability assessment component.

If another attendance is provided on the same day as the vaccine suitability assessment service, which is separate and/or unrelated to the vaccine service, the patient’s invoice/account or Medicare claim should be annotated (‘additional service [MBS item] is clinically relevant but not related to the vaccine suitability assessment service [MBS item]’) to help with the assessment of the claim.

For more information on the MBS COVID-19 vaccine suitability assessment items, visit MBS Online.

Additional funding announced for administration of third and booster doses 

Following National Cabinet on Wednesday 22 December 2021, Prime Minister Scott Morrison announced that general practices will receive an additional $10 per COVID-19 booster dose administered.  

As per MBS online:

• Commencing 23 December 2021, a new temporary Medicare Benefits Schedule (MBS) item has been made available to support medical practitioners providing vaccine suitability assessment services to patients who require booster vaccinations.
• MBS item 93666 provides an incentive payment of $10 per eligible vaccine suitability assessment service to patients receiving a COVID-19 third dose or booster vaccination.
• The incentive will be paid in conjunction with COVID-19 vaccine suitability assessment services provided to patients receiving a third dose or booster dose of a COVID-19 vaccine.
• The item will not be paid for patients receiving a second dose service.
• The MBS item is available until 30 June 2022.

Read the MBS Factsheet: COVID-19 Booster Incentive Payment
 

Remote supervision vaccine MBS items

On 1 January 2022, two new MBS items were introduced to allow qualified health professionals (eg nurses) to provide vaccine-suitability assessments outside a medical practice without onsite supervision by a medical practitioner.

Item 93660 is for MMM1 areas and item 93661 is for MMM2–7 areas. These new items target the provision of COVID-19 vaccines to vulnerable people who may have difficulty travelling to a medical practice. Like all MBS COVID-19 vaccine items, these items must be bulk billed.

The medical practitioner retains responsibility for the health, safety and clinical outcomes of the patient. They must be satisfied that the relevant health professional is appropriately qualified and trained to provide the service.

Billing COVID-19 vaccine appointments

MBS COVID-19 vaccination services cannot be made contingent on any other service or fee. This includes, but is not limited to:

• patient registration fees for patients new to a practice
• bookkeeping or registration fees for the appointment
• general health checks (these should be incorporated into the bulk billed patient eligibility assessment or bulk billed in-depth patient assessment)
• any other service which the practice or practitioner requires before any COVID-19 MBS item.

In almost all cases, co-claiming will only be permitted where another GP or other medical practitioner (OMP) service is provided that is unrelated to the vaccine assessment item. However, where a patient suffers a significant adverse reaction to a COVID-19 vaccine, the GP or OMP is permitted to provide another MBS-rebateable service in order to provide appropriate treatment.

A significant adverse reaction includes, but is not limited to, systemic reactions such as syncopal episodes and severe allergic reactions such as anaphylaxis. It may also include a strong, adverse mental/emotional reaction to the vaccination. Severe adverse reactions are expected to be rare.

Services provided to a patient suffering a significant adverse reaction should be bulk billed.

For more information on billing requirements for vaccine appointments, visit MBS Online.
 

Practice Incentives Program (PIP) – COVID-19 vaccine general practice incentive

An accredited general practice that has completed two vaccine suitability assessment services for the same patient is eligible for a $10 payment (payable only once per patient) under the Practice Incentives Program (PIP).

The Australian Government has released guidelines for the Practice Incentives Program (PIP) – COVID-19 Vaccine General Practice Incentive.

 

Educational resources for providers administering COVID-19 vaccines on MBS billing

Services Australia has published tailored infographics to support providers billing MBS COVID-19 vaccine suitability assessment items. 

The infographics clarify billing requirements for: 

• MBS items for the COVID-19 vaccine suitability assessment service 

• MBS items for in-depth patient assessments for the COVID-19 vaccine. 

A list of vaccine suitability assessment items for use by GPs and other medical practitioners can be viewed here. 

For more information on changes for health professionals during the COVID-19 response, visit the Coronavirus information for health professionals page. 

The Health Professional Education Resources Gateway has a designated page for the COVID-19 vaccine rollout. It contains a range of educational resources to support you with the rollout of the COVID-19 vaccine. Follow these steps to access the resources: 

1. In your browser search medicareaust.com/index 

2. Select play to continue 

3. Select the Health Professional Education Resources Gateway link 

4. Select the COVID-19 Vaccine Rollout menu tab on the left 

If you would like to provide feedback on any of these resources, you can email Medicare.Education@servicesaustralia.gov.au 

Patient resources:

Patients can access information on COVID-19 vaccines and the vaccine roll-out via the Department of Health (DoH) COVID-19 vaccine website. This is website is updated regularly as new information becomes available.

The DoH has developed resources that you can share with your patients. These are available from the DoH website and include:

• How to prepare for your COVID-19 vaccination
• Resources for Nuvaxovid (Novavax) vaccine
• Resources for Pfizer-BioNTech vaccine, COMIRNATY
• Resources for AstraZeneca vaccine
• Resources for Spikevax (Moderna)
• Resources for 5 to 11-year old vaccination

Easy Read resources:

A series of fact sheets are available in Easy Read format.
 

Translated resources:

A series of resources are available in Auslan and in 63 community languages

New patient resource: How can I get proof of my COVID-19 vaccinations?

Most Australian residents will be able to get proof of vaccination against COVID-19 themselves, without assistance from their GP or practice staff. However, time-poor practices have recently seen an influx of patients requesting their assistance.

In response, the RACGP has developed ‘How can I get proof of my COVID-19 vaccinations?’, a printable patient information sheet explaining how proof of vaccination can be acquired, depending on the patient’s situation.

The information sheet contains guidance for those who:

• have a Medicare online account
• have a Medicare card number, but not a Medicare online account
• are not eligible for Medicare
• do not have access to the internet or a smartphone
• are seeking proof of vaccination on behalf of their child.

Access the information sheet 

 

Mandatory COVID-19 vaccinations

State and territory Public Health Orders are in place mandating COVID-19 vaccination for healthcare workers, some of which include and some of which exclude GPs. Please check the local requirements in your area:

• Australia Capital Territory 

• Northern Territory 

• New South Wales 

• Queensland 

• South Australia 

• Tasmania 

• Victoria 

• Western Australia 

If team members are affected by these orders and refuse to be vaccinated, they are not legally allowed to work at the premise and may be terminated. Each public health order outlines the process for exemptions.
 

Vaccinations for general practice

The RACGP considers that vaccination of healthcare workers supports the medical profession’s duty of care and builds vaccine confidence in the community. While not mandatory for general practice in all jurisdictions, the RACGP strongly encourages all GPs and members of the practice team to be vaccinated against COVID-19, for their own protection and the protection of their patients.  

If you, or your practice wishes to implement vaccination requirements for team members and you are in a jurisdiction where it is not mandatory by public health order, you must do so with great consideration and within the workplace laws outlined by your state or territory. Due consideration must be taken as to the risk an unvaccinated staff member is to the practice, what their role involves, their contact with other team members and patients and their access to and willingness to wear appropriate PPE.

The RACGP’s Standards for General Practices (5^th edition) provide guidance on staff vaccination, but do not delve into legal requirements. Practices should seek individual legal advice from their MDO.

Avant and Safe Work Australia provide useful information regarding situations where staff refuse vaccination, however, both of these webpages reiterate that these situations are often intricate, and that legal advice is always recommended.

The RACGP recommends regularly updating practice staff immunisation policies to ensure any new recruits are aware of vaccination obligations and expectations during the recruitment process.

COVID-19 vaccination is mandatory for certain designated workers in some jurisdictions. Unvaccinated persons without a valid medical exemption may also have their access restricted to certain settings ie hospitality, large public gatherings. Each public health order outlines who may be exempt from the order and what documentation is required as evidence.

Under most public health orders mandating vaccination, exemption is strictly limited to people with a medical contraindication (see the ATAGI clinical guidance) to all available COVID-19 vaccines. Temporary exemptions may be warranted:

• inflammatory cardiac illness within the past 3 months for mRNA COVID-19 vaccines
• due to an acute major medical condition (eg undergoing major surgery or hospital admission for a serious illness)
• until complete recovery from COVID-19 illness (vaccination can be deferred up to four months following illness) 
• due to a serious adverse event attributed to a previous dose of a COVID-19 vaccine and without another cause identified
• if the vaccine recipient is a risk to themselves or others during the vaccination process.

GPs are authorised to record a patient’s permanent or temporary vaccination exemption to the Australian Immunisation Register (AIR) using the Immunisation medical exemption form (IM011). The ATAGI expanded guidance on temporary medical exemptions for COVID-19 vaccines supports decision making and documentation for vaccine exemptions.

ATAGI continues to advise that previous infection is not a contraindication to vaccination​.

Discussion guide for medical exemptions

The Melbourne Vaccine Education Centre website now features a new discussion guide to support GPs when approached for a vaccine exemption. The guide has suggestions for managing potentially difficult conversations and de-escalating conflict, including useful scripts to guide your conversations. It also references the RACGP’s resource on preventing and managing patient aggression and violence.

Vaccination exemption documentation requirements 

In addition to registering a medical exemption to AIR using the Immunisation medical exemption form, each state and territory has different requirements for documenting vaccine exemptions for the purposes of adhering to public health orders (PHO).
 

State / Territory	Documentation required for the purposes of the PHO
Australian Capital Territory	Completion of the ACT COVID-19 vaccine medical contraindication or temporary exemption form* Information and form available here *This form does not replace the AIR immunisation medical exemption form
Northern Territory	Medical certificate stating the individual is contraindicated to all available COVID-19 vaccines and as per ATAGI guidelines.  OR Completion of the AIR immunisation medical exemption form Information available here
New South Wales	Completion of the AIR immunisation medical exemption form Information available here
Queensland	Completion of the AIR immunisation medical exemption form Information available here
South Australia	Completion of Immunisation exemption application form (specific to healthcare worker mandate) Information and form available here
Tasmania	Completion of the AIR immunisation medical exemption form Information available here
Victoria	Completion of the AIR immunisation medical exemption form Information available here
Western Australia	Completion of the AIR immunisation medical exemption form Information available here

 

Can I, or my practice, refuse face-to-face consultations for unvaccinated individuals?

The RACGP has always believed in GP and general practice autonomy. Individuals and practices must prioritise protecting GPs and practice staff from COVID-19.

If you or your practice were to implement such a requirement, you must be mindful that you are subject to regulatory requirements such as the Medical Board’s code of conduct and may be inadvertently unlawfully discriminating against some patients.  This may make you subject to compliance investigations and/or professional conduct complaints or complaints to the Human Right Commission or equivalent state bodies. This is particularly relevant where a person cannot be vaccinated due to a medical condition, their age (i.e. children under 12 are currently not eligible), or their religious beliefs. As per Ahpra and the National Board's guidance on facilitating access to care in a COVID-19 environment, all health practitioners are expected to facilitate access to care regardless of someone’s vaccination status.

If you or your practice decide to require patients be vaccinated against COVID-19 in order to attend face-to-face consultations that decision should be made in the context of your individual practice. That includes the health status of clinicians (and self), the needs of the local population, alternate access points to receive primary health care in your area, stocks of personal protective equipment, whether the patient is presenting with or without respiratory symptoms, what continuity of care needs the patient has and what the current outbreak setting is in your location.

In the absence of a Public Health Order mandating vaccination before obtaining a health service, the RACGP urges GPs and practices to tread extremely carefully and consider whether other measures such as robust infection control processes, as well as considering whether a telehealth consultation is an appropriate alternative.

Continuing to provide services to these patients may provide you with ongoing opportunities to discuss vaccination with these patients. We believe that many patients who are hesitant may decide to have the vaccine after they have had a discussion with their GP who is a trusted source of information.

This is an emerging field in law and in the first instance the RACGP recommends that if you or your practice are wishing to pursue this avenue, you should have a conversation with your Medical Defence Organisation to discuss your, and your practices, individual circumstances. 

Read Ahpra and the National Board's guidance on facilitating access to care in a COVID-19 environment

People who have received an approved or recognised COVID-19 vaccine while overseas can have their vaccinations recorded in the Australian Immunisation Register (AIR) by an approved vaccination provider once they return to Australia.

Vaccination documentation must be provided in English (original or translated) and the person must be present during the consultation (either in person or via telehealth if eligible) to confirm the information provided.

You can request extra supporting information if you receive insufficient information or suspect fraudulent evidence has been provided. You are not required to report the vaccination to the AIR if you do not believe the evidence provided is sufficient.

You are encouraged to enter as much vaccine information as possible. You must report the:

• brand name
• dose number
• date of administration
• batch number
• country of administration (for overseas-administered vaccines).

If you cannot confirm the batch number, you should enter ‘not recorded’ in that field. If you are unable to record the country of administration using your clinical information system (CIS), you can enter this information directly into the AIR website. Using the latest version of your clinical information system will help ensure reporting requirements are met.
 

COVID-19 Vaccine Claims Scheme

On 28 August 2021, Minister for Health and Aged Care Greg Hunt announced details about the no-fault COVID-19 indemnity scheme. The scheme opened to potential claimants on 13 December 2021 and will be backdated to February 2021.

The scheme reimburses people who suffer a moderate-to-significant impact following an adverse reaction to an approved COVID-19 vaccine.

A key aim of the scheme is to reduce the risk of legal action against a healthcare practitioner involved in the vaccination rollout. The scheme does not prevent someone from taking action through the courts – it has been designed as a streamlined alternative to court proceedings.

A number of resources on the scheme are now available on the DoH’s website:

• Frequently asked questions
• Overview
• Policy
• Guidance for doctors: Conditions
• Guidance for doctors: Administration harm

 

Professional indemnity coverage through your MDO

Each of the major medical defence organisations has released information addressing professional indemnity coverage for members providing COVID-19 vaccinations.

• Avant
• MDA National
• MIGA
• MIPS

If you are insured by another provider, contact that company directly regarding your coverage.

In summary, if you hold a professional indemnity policy and your scope of practice includes prescribing or administering vaccines, you will be covered in a similar way to other vaccination programs in the event of an adverse reaction following vaccination. 

National webinars

Webinar	Date	Time	Host	Registration
Winter preparedness webinar for GPs (Recorded 2 May 2022)	On-demand	On-demand	Deputy Chief Medical Officer, Department of Health joined by RACGP President, Adj. Professor Karen Price and other panellists	Watch here
General Practice COVID-19 update	Every Thursday	11.30 am–12.00 pm (AEDT)	Deputy Chief Medical Officer, Department of Health	View upcoming and previous webinars

Department of Health (DoH) resources

• The Australian Immunisation Handbook
• ​National Vaccine Storage Guidelines ‘Strive for 5’

You can subscribe to receive the DoH 'COVID-vaccine updates' direct to your inbox.
 

Therapeutic Goods Administration resources

• COVID-19 news and updates
• COVID-19 vaccine approval process
• Information for consumers and health professionals

 

Give the world a shot – Supporting vaccine access in lower-income countries

UNICEF and the Immunisation Coalition are issuing an urgent plea to Australians to help close the global COVID-19 vaccination gap by making a tax-deductible donation to UNICEF Australia to deliver two billion vaccines in lower-income countries.
You can display these posters in your waiting room or pre/post-vaccine clinic spaces to encourage people to donate following their vaccination.

Give the world a shot poster (pre vaccination version)
Give the world a shot poster (post-vaccination version)