Background

  • Anyone who experiences a significant reaction following immunisation should first seek medical attention from a health professional
  • While no vaccine is entirely free of potential side effects, the benefits of immunisation far outweigh the risks
  • Severe side effects from vaccines are rare and common side effects are usually mild and short lasting

Should all AEFIs (adverse events following immunisation) following COVID-19 vaccines be reported?

You do not need to routinely report:

  • Common/expected reactions
  • These may include pain, redness, swelling and tenderness at the injection site, tiredness, headache, muscle pain, nausea, fever and chills, feeling unwell, joint pain

You should report:

  • Any event felt to be significant following COVID-19 immunisation, regardless of whether you think the side effect was related to the vaccine or not
  • Any expected reactions that have not gone away after a few days
  • Any reaction to a vaccine which requires assessment by a doctor or nurse
  • Suspected shoulder injury related to vaccine administration (SIRVA)
  • Any vaccination administration errors

COVID-19 AstraZeneca side effects

Common side effects following vaccination with COVID-19 AstraZeneca include swelling, redness, pain or itch at the injection site, joint pain and malaise (feeling unwell). Less common side effects include abdominal pain, dizziness, decreased appetite, pain in limb or enlarged lymph nodes. These side effects are experienced in up to two-thirds of people who receive this vaccine, and mostly resolve within 1-2 days. Symptomatic relief is recommended, i.e. a cool compress at the injection site and simple analgesia such as paracetamol or ibuprofen.

Rare side effects include anaphylaxis and a rare clotting condition, thrombosis with thrombocytopenia (TTS). Symptoms of TTS may include a severe, persistent headache that does not settle with analgesia, abdominal pain, significant respiratory problems/distress, visual changes, vomiting, seizures, focal neurological deficits/changes, confusion/encephalopathy and usually occur 4-30 days after vaccination.

Comirnaty™ (Pfizer/BioNTech) side effects

Common side effects following vaccination with Comirnaty™ include swelling or pain at the injection site, fatigue, headache, myalgia (body aches), fever, chills or joint pain.

Less common side effects include redness or itching at the injection site, nausea, enlarged lymph nodes, malaise (feeling unwell), pain in limb or insomnia. These side-effects are usually mild and last 1-2 days and may require time off work. Systemic reactions are more common following the second dose of the vaccine. Symptomatic relief is recommended, eg. a cool compress at the injection site and simple analgesia such as paracetamol or ibuprofen.

Very rarely, anaphylaxis following Comirnaty™ has been reported.

Can a patient be referred to a specialist immunisation clinic after experiencing AEFI?

The Victorian Specialist Immunisation Services (VicSIS) will provide specialist vaccination services for people who have experienced an AEFI with a COVID-19 vaccine, or those who are identified as at risk of an AEFI (for example, people with a history of anaphylaxis). Most people are able to proceed with future vaccines following an AEFI. Clinical consults will be offered in which individual recommendations will be developed. VicSIS clinics will have the ability to vaccinate under extended observation.

For more information on how to refer to VicSIS, please refer to MVEC: Victorian Specialist Immunisation Services (VicSIS).

Resources

Authors: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Georgina Lewis (SAEFVIC Clinical Manager, Murdoch Children’s Research Institute)

Date: April 2021

Materials in this section are updated as new information and vaccines become available. The Melbourne Vaccine Education Centre (MVEC) staff regularly reviews materials for accuracy.

You should not consider the information in this site to be specific, professional medical advice for your personal health or for your family’s personal health. For medical concerns, including decisions about vaccinations, medications and other treatments, you should always consult a healthcare professional.