Patient vaccination – COVID-19
COVID-19 vaccines are recommended for everyone aged five years and older, as well as children aged from six months to under five years in at risk population groups. The Australian Technical Advisory Group on Immunisation (ATAGI) provides advice on recommended COVID-19 vaccine doses.
The RACGP website contains a COVID-19 information hub for GPs and practice staff which is regularly updated with latest clinical guidance, practice information, MBS item number updates, links to patient resources, information on supporting specific communities, vaccine exemptions and more.
The Healthdirect Service Finder allows patients to find local COVID-19 vaccine service providers.
Each state and territory provide local guidance and assistance on booking your COVID-19 vaccine or booster.
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Co-administration with COVID-19 vaccines
All COVID-19 vaccines can be co-administered (given on the same day) with a flu vaccine. COVID-19 vaccines can also be co-administered with other vaccines if required. Combination COVID-19 and influenza vaccines currently are not available in Australia.
Although you are under no obligation to bulk bill patients receiving a flu vaccination, patients who receive a COVID-19 vaccination in 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 that 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.
Patients presenting for their COVID-19 booster or seasonal flu vaccination provides an opportunity to check whether the patient may be eligible or overdue for other vaccines.
RACGP’s COVID-19 vaccine information for GPs provides up to date information on COVID-19 clinical guidance, MBS item code information, patient resources and more.
For more information on the MBS COVID-19 vaccine suitability assessment items, visit MBS Online.
Addressing vaccine hesitancy in general practice
Widespread community vaccination of against COVID-19 remains central to Australia’s public health strategy, particularly in the context of higher rates of cases and deaths among the unvaccinated population when compared to vaccinated or partially vaccinated populations1.
Providing continuity of care to unvaccinated patients may facilitate ongoing opportunities to discuss the importance of vaccination with these patients. Many patients who are hesitant may decide to have the vaccine following a discussion with their GP or the practice nurse who are a trusted source of information.
Desborough et al1 have compiled a table of strategies practice teams and community leaders may use to help improve vaccine uptake in their patient population.
| Table 1. Strategies to optimise COVID-19 vaccine uptake across the health system |
| Strategy |
Public health |
Primary care |
Community settings (residential care, home care) |
Acute care
(eg emergency departments) |
| Collaboration and trust |
Co-leadership with local community leaders
Development of trust and trustworthiness
Multilingual materials and those accessible for people with disabilities |
Using existing trusting relationships between patient and primary care providers |
Relationships with local community leaders, facilitating solutions that meet local preferences and needs |
Co-leadership with local community leaders
Development of trust and trustworthiness
Multilingual materials and those accessible for people with disabilities |
| Communication and information |
Emphasis on importance and benefits of vaccination using a broad range of voices
Information about where to be vaccinated |
Information delivered by trusted/known health care provider
Locally relevant information and resources provided |
People see themselves represented in locally relevant information and resources |
Emphasis on importance and benefits of vaccination using a broad range of voices
Information about where to be vaccinated |
| Countering misinformation |
Collaborative development of appropriate information from trusted messengers and available in multiple languages |
Conversations with trusted/known health care providers |
Conversations with trusted/known health care providers |
Conversations with healthcare providers, and in multiple languages |
| Supporting people to shift from uncertain to vaccinated |
Messaging that addresses people’s concerns
Choice of vaccine brand |
Using multiple contacts to inform thinking |
Conversations with trusted/known health care providers |
Contextually relevant information provided opportunistically |
| Access – make it easy to get vaccinated |
Mass vaccination centres/home-based care, walk-in clinics, mobile vaccination teams, pop-up clinics |
Vaccines available where usual care is accessed – planned and opportunistic |
Offering planned and opportunistic vaccines (eg during home visits) |
Opportunistic vaccines (eg in emergency departments and outpatient clinics) |
| Mandates and incentives |
Public health initiatives have supported workplaces to increase vaccine uptake |
Most general practices require staff to be vaccinated |
Many healthcare settings in the community require staff to be vaccinated |
Many acute care settings require staff to be vaccinated |
Reproduced from: Desborough J, Wright M, Parkinson A et al. What strategies have been effective in optimising COVID-19 vaccine uptake in Australia and internationally? Aust J Gen Pract 2022;51(9):725–730, with permission from RACGP.
Considering mandatory patient COVID-19 vaccination
If your practice decides that patients are required to be vaccinated against COVID-19 to attend face-to-face consultations, that decision should be made in the context of your individual practice. Considerations include (but are not limited to):
- the health and vaccination status of clinicians (and self)
- the needs of the local population
- alternate points to access primary health care in the area
- stocks of PPE
- whether the patient is presenting with or without respiratory symptoms
- continuity of care needs for the patient
- the current outbreak setting in your location
- your practice’s capability to provide telehealth as an alternative.
In the absence of Public Health Orders mandating COVID-19 vaccination of patients before attending a health service, the RACGP urges GPs and practices to carefully consider practice concerns as well as patient needs. While determining vaccination policies for your practice, consider whether there are alternative ways of continuing to provide care to your patients. This may include improved infection prevention and control processes, adequate ventilation with an aim of 6 – 8 fresh air changes per hour, and the use of telehealth consultations.
If you or your practice implement a requirement for vaccination as a mandatory pre-requisite for care, 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, professional conduct complaints or complaints to the Human Rights Commission or equivalent state bodies. This is particularly relevant where a person cannot be vaccinated because of a medical condition, their age (i.e., children under 5 are currently not eligible), or their religious beliefs.
As per the guidance from Australian Health Practitioner Regulation Agency (AHPRA) and the National Medical Board's 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.
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 a mandatory vaccination policy, that you have a conversation with your medical defence organisation to discuss your practice’s particular circumstances.