COVID-19 vaccination clinical information

The information on this page will assist health professionals delivering the COVID-19 Vaccination Program in South Australia. Information contained in these documents is correct at the time of release. As information is continually evolving some documents will be updated if related information and recommendations change in the future.

Advice from ATAGI

The Australian Technical Advisory Group on Immunisation (ATAGI) advises the Minister of Health on the immunisation programs and provides clinical guidance on the vaccines available in Australia.

ATAGI advice on vaccination for people with certain conditions

ATAGI recommends that vaccination with the Pfizer vaccine is recommended for people who have a history of the following rare conditions (advice may be updated as further information is available):

  • a past history of cerebral venous sinus thrombosis (CVST)
  • a past history of heparin-induced thrombocytopenia (HIT)
  • a past history of idiopathic splanchnic (mesenteric, portal and splenic) venous thrombosis
  • anti-phospholipid syndrome with thrombosis
  • people with contraindications to COVID-19 Vaccine AstraZeneca:
    • anaphylactic reaction to a previous dose of COVID-19 Vaccine AstraZeneca, or to an ingredient of the vaccine
      Thrombosis with thrombocytopenia after the first dose of COVID-19 Vaccine AstraZeneca
    • other serious adverse events attributed to the first dose of COVID-19 Vaccine AstraZeneca

Read more information about the AstraZeneca COVID-19 vaccine for COVID-19 vaccination providers.

Access for Pfizer vaccine for people over 60 years

Referrals to access the Pfizer COVD-19 vaccine can be made by GPs for patients over 60 years who have a history of the below rare conditions:

  • people with a confirmed medical history of CVST
  • people with a confirmed medical history of HIT
  • people with a past history of idiopathic splanchnic (mesenteric, portal, splenic) vein thrombosis
  • people with antiphospholipid syndrome with thrombosis.

In line with the Australian Government's COVID-19 vaccine rollout, at this time there are no other health criteria for a person aged 60 years or over to receive the Pfizer vaccine.

Referrals can be made using the Request for access to Pfizer vaccine for people over 60 form (RTF 868KB).

Referring patients with a history of severe allergic reactions

The South Australian COVID-19 Specialist Immunisation Clinic (SACSIC) provides specialist services for those identified as at risk for adverse events following immunisation (AEFI) or those who experience AEFIs in the context of a COVID-19 vaccine.

Referral criteria

Referrals can be made by GPs to the SACSIC if patients have a history of:

  • Immediate (within 2 hours) and generalised symptoms of a possible allergic reaction (eg hives) to a previous dose of a COVID-19 vaccine.
  • Anaphylaxis or generalised allergic reaction (without anaphylaxis) to any component of the COVID-19 vaccine to be administered (eg PEG/macrogol in the Pfizer/BioNTech vaccine, polysorbate 80 in the Astra Zeneca vaccine).
  • Polyethylene Glycol (PEG, aka macrogol) or polysorbate 80 related reactions and/or a history of multiple allergic reactions to other medications containing PEG or polysorbate (please check the ingredients of the patient’s current/previously tolerated medications as they may contain PEG/polysorbate).
  • Mastocytosis with a raised tryptase and recurrent anaphylaxis.
  • Severe unexplained illness after receiving COVID-19 vaccination requiring hospitalisation for greater than 24 hours.

Please note any patient with a history of cerebral venous sinus thrombosis (CVST), heparin-induced thrombocytopaenia (HIT), idiopathic splanchnic vein thrombosis (mesenteric, portal or splenic), antiphospholipid syndrome with thrombosis and/or thrombosis with thrombocytopaenia (TTS) can be referred to a SA Health COVID-19 Vaccination Clinic for the Pfizer vaccine.

Referral process

All referrals to the South Australian COVID-19 Specialist Immunisation Clinic must be forwarded via fax or email using the SACSIC Referral Form (PDF 47KB).

Fax: 08 7074 6247

For more information on the SACSIC referral process see the SACSIC Clinical Referral Guide (PDF 272KB) or for information regarding the COVID-19 vaccination see the Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination FAQs developed by the Australasian Society of Clinical Immunology and Allergy (ASCIA).

Reporting adverse reactions (mandatory)

As of 13 April 2021, an adverse advent following immunisation (AEFI) is a notifiable condition in South Australia pursuant to section 63(2) of the South Australian Public Health Act 2011. Medical practitioners and diagnostic laboratories are legally required to notify AEFI.

An AEFI refers to any untoward medical occurrence that follows immunisation, whether expected or unexpected, and whether triggered by the vaccine or only coincidentally occurring after receipt of vaccine.

All immunisation providers should notify any serious or unexpected AEFI, or any AEFI which resulted in healthcare attendance to SA Health. Members of the public are also able to report.

The South Australian Vaccine Safety Surveillance System (SAVSS) monitors AEFI for South Australia. Information from all received reports are also sent to the Therapeutic Goods Administration (TGA).

Doctors are required to:

Be alert for any persistent, unexpected or severe AEFI, related to any vaccine.

Notify serious or unexpected AEFI, or any AEFI which resulted in healthcare attendance to SA Health:

  • Online: Use the online Vaccine Reaction Report Form. On completion of the online report form, a lodgement number will be issued. If you have provided an email address, the option to receive confirmation including your lodgement number by email, is available. There is also an option to print a copy of your report.
  • Telephone: Alternatively you can phone the COVID-19 Clinical Advisory Service; Immunisation Section, Communicable Disease Control Branch between 8.30 am – 5.00 pm Monday to Friday on 1300 232 272. Serious AEFI related to COVID vaccines can also be reported on this number outside of business hours.

Reporting program errors

COVID-19 Vaccine Program errors, including, cold chain error, incorrect vaccine count, incorrect dosage or vaccine given, can be reported via:

Vaccine safety surveillance

AusVaxSafety is the national system for monitoring vaccine safety in Australia and will actively follow up people who receive a COVID-19 vaccine by sending them an SMS or email with a short survey that asks if they experienced an AEFI.

SA Health vaccination clinics will encourage participation in active surveillance by a QR Code system that is integrated with VaxTracker surveillance tool.

Active vaccine safety surveillance clinic information

Workforce training

To ensure the workforce is competent in the safe management and administration of COVID-19 vaccines, health practitioners must undertake specific mandatory training prior to order or administering any COVID-19 vaccinations.

For further information visit the Immunisation provider training and education page.

Resources for COVID-19 vaccine providers

Related SA Health Policies