These COVID-19 vaccine FAQs have been designed to address common queries relating to COVID-19 vaccine allergies, pre-existing conditions and children.

Please also see our other COVID-19 FAQs for more information on other COVID-19 related topics:

For ease of reference, information has been categorised as per the below themes:

This page will be updated on a regular basis as further information becomes available regarding COVID-19 vaccines.

For questions that have not been addressed on this page or our dedicated COVID-19 resource page, please contact us here.

Allergies

  • Is it safe to administer COVID-19 vaccines to people with latex allergies?

    None of the COVID-19 vaccines used within Australia contain latex. They can safely be administered to people with latex allergies in routine settings followed by a 15 minute post-vaccination observation period.

    For more information please refer to the ASCIA: Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Position Statement.

  • My patient has a history of allergies, is it safe to administer a COVID-19 vaccine to them?

    The only two absolute contraindications to vaccination are anaphylaxis to a previous dose of the same vaccine or anaphylaxis to a component of the vaccine.

    For patients with a history of anaphylaxis to food, drugs, venom or latex, it is recommended a routine observation period of 15 minutes following COVID-19 vaccination is observed.

    Additional precautions are recommended for individuals with possible allergic reactions to a previous dose of a COVID-19 vaccine, allergic reactions to ingredients in the COVID-19 vaccine to be administered (including PEG in Comirnaty (Pfizer) and Spikevax (Moderna) and Polysorbate 80 in Vaxzevria (AstraZeneca)), or a known systemic mast cell activation disorder with raised mast cell tryptase that has required treatment.

    In these instances a specialist review by an immunology/allergy/vaccination specialist to undertake a risk/benefit assessment to assess suitability for vaccination should be undertaken.

    Pleaser refer to COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021 or the ASCIA: Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Position Statement for more information.

  • My patient has a history of allergy to Polyethylene Glycol (PEG), can I administer a COVID-19 vaccine to them?

    PEG is an ingredient contained in Comirnaty (Pfizer) and Spikevax (Moderna). It is also a commonly used ingredient of other medications, hand sanitisers, cosmetics, bathroom products and colonoscopy preparation products, routinely used within Australia. Whilst it is uncertain whether PEG contained in mRNA vaccines may trigger anaphylaxis, additional precautions are required.

    If your patient has a history of confirmed or suspected allergy to PEG it is recommended that they are referred to an immunology/allergy/vaccination specialist for advice regarding the safety of administering an mRNA COVID-19 vaccine.

    NB: Vaccination with the Comirnaty or Spikevax is contraindicated in people with documented anaphylaxis to PEG.

    To read more refer to COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021.

  • My patient has a history of allergy to Polysorbate 80, can I administer a COVID-19 vaccine to them?

    Polysorbate 80 is chemically related to Polyethylene Glycol (see question above) and is an ingredient in Vaxzevria (AstraZeneca).

    If your patient has a history of confirmed or suspected allergy to Polysorbate 80 it is recommended that they are referred to an immunology/allergy/vaccination specialist for advice regarding the safety of administering COVID-19 AstraZeneca.

    NB: Vaccination with Vaxzevria is contraindicated in people with documented anaphylaxis to Polysorbate 80.

    For further information please refer to ASCIA: Allergy, Immunodeficiency, Autoimmunity and COVID-19 Vaccination Position Statement and COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021.

  • Do COVID-19 vaccines contain gelatin?

    The COVID-19 vaccines available in Australia do not contain gelatin and are safe to administer to patients with gelatin allergies. A standard 15-minute observation period following immunisation is recommended.

  • What are the ingredients of COVID-19 vaccines?

    There are currently 3 COVID-19 vaccines with provisional registration in use in Australia.

    Each dose of Comirnaty (Pfizer) contains:

    • 30 mcg mRNA encoding the SARS-CoV-2 spike glycoprotein
    • (4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2- hexyldecanoate) (ALC-0315)
    • 2-[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide (ALC0159)
    • Distearoylphosphatidylcholine (DSPC)
    • Cholesterol
    • Potassium chloride
    • Monobasic potassium phosphate
    • Sodium chloride
    • Dibasic sodium phosphate dihydrate
    • Sucrose
    • Water for injections

    Each dose of Vaxzevria (AstraZeneca) contains:

    • 5×1010 viral particles of ChAdOx1-S
    • Histidine
    • Histidine hydrochloride monohydrate
    • Sodium chloride
    • Magnesium chloride hexahydrate
    • Disodium edetate (EDTA)
    • Sucrose
    • Ethanol absolute
    • Polysorbate 80
    • Water for injection

    Each dose of Spikevax (Moderna) contains:

    • 100 μg mRNA encoding the SARS-CoV-2 spike glycoprotein
    • Heptadecan-9-yl 8-[2-hydroxyethyl-(6-oxo-6-undecoxyhexyl)amino]octanoate
    • Cholesterol
    • Distearoylphosphatidylcholine
    • 1,2-dimyristoyl-rac-glycero-3-methoxypolyethylene glycol-2000 (PEG2000-DMG) – Trometamol
    • Trometamol hydrochloride
    • Acetic acid
    • Sodium acetate trihydrate
    • Sucrose
    • Water for injection

    Further information can be found in the Product Information for each vaccine:

  • What ingredients are NOT in mRNA COVID-19 vaccines?

    The following products are NOT ingredients in mRNA COVID-19 vaccines:

    • Animal products
    • Antibiotics
    • Blood products
    • DNA
    • Egg proteins
    • Foetal material
    • Gluten
    • Microchips
    • Pork products
    • Thiomersal
    • Soy
    • Latex
    • Aluminium

    Further information can be found in the Product Information for each vaccine:

  • What ingredients are NOT in Vaxzevria (AstraZeneca)?

    The following products are NOT ingredients in Vaxzevria (AstraZeneca):

    • Animal products
    • Antibiotics
    • Blood products
    • Egg proteins
    • Gluten
    • Microchips
    • Pork products
    • Thiomersal
    • Soy
    • Latex
    • Aluminium

    Further information can be found in the vaccine product information:

  • Is there an increased risk of anaphylaxis following COVID-19 vaccines?

    A true vaccine allergy (anaphylaxis), where a person is contraindicated from being immunised with the same vaccine in the future, is rare (in most studies reported as less than 1 case per million doses).

    Post-licensure surveillance of COVID-19 vaccines show anaphylaxis following administration of Vaxzevria (AstraZeneca) occurring at similar rates to routine vaccines. Anaphylaxis following Spikevax (Moderna) has been shown to occur at a rate of 2.5 cases per million doses and Comirnaty (Pfizer), while still extremely rare, occurs at a slightly higher rate of approximately 4.7 cases per million doses.

    For more information please refer to TGA: AstraZeneca ChAdOx1-S COVID-19 vaccine – Update – Expert review finds no evidence of increased risk of anaphylaxis or MVEC: COVID-19 vaccines and allergy.

  • How should patients experiencing delayed urticaria (hives) following a COVID-19 vaccination be managed?

    Acute urticaria can occur 1-2 weeks following vaccination. The symptoms can last on average 3-4 weeks but may resolve more rapidly. The urticaria can be generalised and intensely itchy. Symptoms can be managed with age-appropriate doses of non-sedating over-the-counter antihistamines (tablets or liquid) up to 4 times per day (such as cetirizine, loratadine, fexofenadine or desloratadine), best given in spaced intervals. This type of urticaria with onset that is delayed after the vaccination is generally not an indication of reproducible allergy to the vaccine and therefore investigations are not indicated. Future vaccinations can be given in a routine environment, with a 15-minute post vaccination observation period. If symptoms develop within 24 hours of vaccination, persist beyond two weeks, or there are additional concerns, then review by an immunisation specialist or allergist could be considered.

Pre-existing conditions

  • I have had a recent blood transfusion, can I have a COVID-19 vaccine?

    Vaccine recommendations following blood transfusion generally apply to live-attenuated vaccines, such as MMR (measles-mumps-rubella) or varicella vaccines. There are currently no live-attenuated COVID-19 vaccines planned for use in Australia. Comirnaty (Pfizer) and Spikevax (Moderna) are mRNA vaccines and Vaxzevria (AstraZeneca) is a non-replicating viral vector vaccine.

    For more information please refer to the CDC: COVID-19 Vaccine FAQs for Healthcare Professionals and MVEC: Live-attenuated vaccines and immunoglobulins or blood products.

  • When should people who have previously tested positive for COVID-19 disease be vaccinated?

    Evidence suggests that infection with COVID-19 will provide protection against reinfection for up to 6 months. There is no minimum interval recommendation between infection and vaccination however waiting approximately 6 months is considered appropriate. In patients who have fully recovered from acute illness, earlier vaccination may be considered noting there have been no safety concerns identified in immunising people with a history of past infection. Individuals suffering prolonged symptoms (longer than 6 months) can consider vaccination on a case-by-case basis following discussion with their GP.

    Side effects following vaccination for individuals with a history of past COVID-19 infection occur at either similar or decreased rates compared with recipients who have not been infected with COVID-19 disease.

    Please refer to COVID-19 vaccination – ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021 or Victorian COVID-19 vaccination guidelines for more information.

  • Can people with a history of breast cancer receive COVID-19 vaccines?

    Yes. COVID-19 vaccination is recommended for all immunosuppressed people (including those undergoing treatment for cancers) due to an increased risk of developing severe disease if infected with SARS-CoV-2. It is anticipated that the immune response to vaccination may be reduced in this patient group depending on the level of immune suppression.

    Lymphadenopathy has been reported as a side effect following vaccination. Given that changes in size and consistency of lymph nodes can also indicate a spread of breast cancer, the Society of Breast Imaging (SBI) has recommended breast screening take place either prior to COVID-19 vaccination or 4-6 weeks following the second dose of COVID-19 vaccines to avoid anxiety and unnecessary examination and diagnostic testing.

    For more information please refer to Health.com – Swollen Lymph Nodes Under Armpit After COVID-19 Vaccine May Mimic Breast Cancer Symptoms—Here’s What to Know and Peter Mac COVID:19 vaccination: frequently asked questions.

  • Are anthracycline therapies considered a contraindication to mRNA COVI-19 vaccines due to the association with myocarditis/pericarditis?

    Children who have been treated with chemotherapeutic agents including anthracyclines as part of their cancer therapy are not considered as higher risk of side effects from vaccination (including the development of myocarditis/pericarditis. Parents/guardians should speak to their treating team regarding COVID-19 vaccination based on current recommendations.

    For further information refer to COVID-19 Vaccination Guidance for children 12 years and older undergoing cancer treatment and children with non-cancerous blood disorders.

  • My patient has a history of Guillain-Barre Syndrome (GBS), is it safe to administer COVID-19 vaccines?

    Individuals who have previously been diagnosed with GBS can receive COVID-19 vaccines. Specialist advice from a treating neurologist or immunisation specialist may be considered to discuss the benefits and risks of vaccination.

    For more information please refer to MVEC: Guillain-Barre Syndrome and CDC: Vaccine Considerations for People with Underlying Medical Conditions.

  • Are there any concerns regarding COVID-19 vaccines and Bell's Palsy?

    People who have previously been diagnosed with Bell’s Palsy can receive COVID-19 vaccines. Cases of Bell’s Palsy following immunisation have been identified in participants in mRNA COVID-19 vaccine candidate clinical trials. However, as the rate of occurrence was not above the background rate expected in the general population, they are not considered to be caused by vaccination.

    For more information refer to CDC: Vaccine Considerations for People with Underlying Medical Conditions.

  • Is it safe for people with Multiple Sclerosis to be immunised against COVID-19 disease?

    Yes. Whilst there is minimal data on the safety and efficacy of COVID-19 vaccination in people with MS, there are no theoretical concerns relating to administration in this patient group.

    For more information please refer to MS Australia: COVID-19 vaccination guidance for people with MS and MVEC: COVID-19 vaccines in people with immunocompromise.

  • Can patients who are taking monoamine oxidase inhibitors (MAOI's) be safely immunised with COVID-19 vaccines given that they should generally avoid adrenaline? What would be the appropriate treatment if they experienced anaphylaxis?

    Yes, COVID-19 vaccines should be offered to this patient group. True vaccine allergy, or anaphylaxis, is an extremely rare adverse event following immunisation occurring in less than 1 case per million doses administered.

    Patients who take MAOI’s have a theoretical increased risk of developing hypertensive crisis if administered adrenaline (or other specific medications/foods) due to a potential for drug interaction. In the setting of anaphylaxis, resuscitation with adrenaline remains the most appropriate treatment regardless of medical history. The benefits of treating anaphylaxis effectively far outweighs any potential risk of hypertensive crisis.

    Ensuring the diagnosis of anaphylaxis is accurate is an important step to avoid unnecessary administration of adrenaline when not clinically indicated.

    For more information refer to Australian Immunisation Handbook: Adverse events following immunisation or MVEC: COVID-19 vaccines and allergy

    Yes, COVID-19 vaccines should be offered to this patient group. True vaccine allergy, or anaphylaxis, is an extremely rare adverse event following immunisation occurring in less than 1 case per million doses administered.

    Patients who take MAOI’s have a theoretical increased risk of developing hypertensive crisis if administered adrenaline (or other specific medications/foods) due to a potential for drug interaction. In the setting of anaphylaxis, resuscitation with adrenaline remains the most appropriate treatment regardless of medical history. The benefits of treating anaphylaxis effectively far outweighs any potential risk of hypertensive crisis.

    Ensuring the diagnosis of anaphylaxis is accurate is an important step to avoid unnecessary administration of adrenaline when not clinically indicated.

    For more information refer to Australian Immunisation Handbook: Adverse events following immunisation or MVEC: COVID-19 vaccines and allergy

  • I am over 60 years of age and have a history of deep vein thrmobosis (DVT's). Is it safe for me to receive Vaxzevria (AstraZeneca)?

    There is currently no evidence to suggest that having a history of DVT’s or other general thromboembolic disorders predisposes you to developing thrombosis with thrombocytopenia syndrome (TTS) following receipt of an adenoviral vector vaccine such as Vaxzevria (AstraZeneca). In contrast, there is strong evidence that COVID-19 disease is thrombogenic (promotes clot development) and may cause a variety of thromboembolic events. TTS is a unique condition involving the development of thromboses (blood clots) combined with thrombocytopenia (low platelets).

    Individuals with a history of DVT’s are encouraged to receive a COVID-19 vaccine when offered.

    Refer to the Joint statement from ATAGI and THANZ on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 Vaccine AstraZeneca for more information.

  • I am taking hormone replacement therapy. Am I at an increased risk of thrombosis with thrombocytopenia syndrome (TTS) if I am given Vaxzevria (AstraZeneca)?

    There is currently no evidence to suggest that taking certain medications or being prone to developing blood clots puts you at increased risk of developing TTS following receipt of Vaxzevria (AstraZeneca). In contrast, there is strong evidence that COVID-19 disease is thrombogenic (promotes clot development) and may cause a variety of thromboembolic events. TTS is a unique condition involving the development of thromboses (blood clots) combined with thrombocytopenia (low platelets).

    Individuals who are taking hormone replacement therapy are encouraged to receive a COVID-19 vaccine when it is offered.

    For more information please refer to: Joint statement from ATAGI and THANZ on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 Vaccine AstraZeneca.

  • I am over 60 years of age and have a history of atrial fibrilation putting me at a higher risk of blood clots. Is it safe for me to have Vaxzevria (AstraZeneca)?

    There is currently no evidence to suggest that having a medical condition which increases your likelihood of developing blood clots puts you at a greater risk of developing TTS following receipt of Vaxzevria (AstraZeneca).

    There is currently no evidence to suggest that having a history of atrial fibrillation predisposes you to developing thrombosis with thrombocytopenia syndrome (TTS) following receipt of an adenoviral vector vaccine such as Vaxzevria. In contrast, there is strong evidence that COVID-19 disease is thrombogenic (promotes clot development) and may cause a variety of thromboembolic events. TTS is a unique condition involving the development of thromboses (blood clots) combined with thrombocytopenia (low platelets).

    Individuals with a history of atrial fibrillation are encouraged to receive a COVID-19 vaccine when offered.

    Refer to the Joint statement from ATAGI and THANZ on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 Vaccine AstraZeneca for more information.

  • I have a history of capillary leak syndrome. Can I have Vaxzevria (AstraZeneca)?

    An extremely rare relapsing-remitting condition known as capillary leak syndrome has been reported overseas following vaccination with Vaxzevria. The syndrome results in fluid leaking from capillaries (small blood vessels) into surrounding tissue and can lead to severe organ damage or death if left untreated.

    In two of the reported cases there was a previous history of capillary leak syndrome. As triggers for relapse are not well understood, the manufacturer of Vaxzevria has updated the product information advising it is not recommended that the vaccine be administered to people with a history of capillary leak syndrome. Individuals with a history of capillary leak syndrome should be referred to their closest VicSIS clinic for further assessment.

    For further information refer to TGA: COVID-19 weekly safety report.

  • Can people with pre-existing cardiac (heart) conditions safely receive mRNA COVID-19 vaccines?

    The overwhelming majority of pre-existing cardiac conditions are not regarded as contraindications to vaccination with COVID-19 mRNA vaccines. Individuals with the following cardiac conditions can safely receive COVID-19 mRNA vaccines without the need for additional monitoring or precautions:

    • coronary artery disease
    • myocardial infarction
    • stable heart failure
    • arrhythmias
    • rheumatic fever
    • rheumatic heart disease
    • kawasaki disease
    • most congenital heart disease
    • those with implanted cardiac devices
    • congenital heart disease
    • cardiac transplant
    • cardiomyopathy.

    Those with a history of the following conditions can also receive COVID-19 mRNA vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:

    • current or recent (within the past 3 months) myocarditis or pericarditis due to causes other than vaccination
    • acute rheumatic fever or acute rheumatic heart disease (with evidence of active inflammation)
    • acute decompensated heart failure.
  • What are the vaccine recommendations for people who have previously been diagnosed with myocarditis or pericarditis?

    Individuals with recent (within 3 months) or current inflammatory cardiac conditions (including myocarditis, pericarditis and endocarditis) can still receive COVID-19 vaccines however should consult their treating specialist before doing so to determine the best time to be immunised.

    For individuals in whom the cause of inflammation is attributed to COVID-19 mRNA vaccination, future dose recommendations depend on the diagnosis (myocarditis or pericarditis), a person’s age and the level of certainty of diagnosis.

    For individuals who have experienced myocarditis (the more serious adverse event following immunisation) attributed to an mRNA COVID-19 vaccine, a report to SAEFVIC is indicated and referral to a cardiologist or specialist immunisation service to discuss prior to the administration of future doses.

    For individuals who have experienced pericarditis attributed to an mRNA COVID-19 vaccine a referral to a specialist immunisation service or cardiologist is not always required. Individuals who have a clinical diagnosis of pericarditis but normal clinical investigations (chest X-ray, troponin, ECG and echocardiogram) can receive further doses after they have made a full recovery and have been symptom free for at least 6 weeks.

    For more information please refer to COVID-19 vaccination- Guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines.

  • I am taking certain medications that have myocarditis listed as an uncommon side effect. Am I at greater risk of developing myocarditis/pericarditis after mRNA vaccination?

    Some patients will be taking prescribed medications that have myocarditis listed as an uncommon side effect (eg. antipsychotic drugs and biological chemotherapeutic agents). Treatment with these medications does not constitute a contraindication to vaccination with an mRNA COVID-19 vaccine.

    Vaccination remains the greatest protection an individual can have against severe COVID-19 disease, and mRNA vaccines remain the preferred option in Australia for those under the age of 60.

  • Are there impacts of other substances on the development of myocarditis/pericarditis after mRNA vaccines?

    If clinicians are aware that any individual uses recreational stimulants (particularly amphetamines), they should discourage patients from the use of these stimulants, especially in the week following their mRNA COVID-19 vaccine.

  • If myocarditis/pericarditis associated with mRNA COVID-19 vaccination is postulated to be immune mediated, would those with existing autoimmune disease be at an increased risk compared to the general public?

    Myocarditis/pericarditis following mRNA vaccines appears to be idiosyncratic at this stage, with no clear risk factors. Thus, there is no indication of increased risk in those with underlying autoimmune disease.

  • Can COVID-19 vaccines be given to immunosuppressed individuals?

    It is recommended that all individuals aged 12 and over with immunosuppression receive COVID-19 vaccines. Having a lowered immune system increases the likelihood of developing severe disease and complications if infected with SARS-CoV-2. Due to the restricted eligibility criteria in early vaccine clinical trials, there is currently minimal data on the safety and efficacy of COVID-19 vaccination in this group. In principle, there are no theoretical safety risks and no vaccine safety signals have been identified for people with immunocompromise to date.

    People with immunocompromise receiving COVID-19 vaccination should be counselled about the possibility of reduced efficacy and the need to continue other preventative measures such as social distancing, mask wearing and hand hygiene. Household contacts should be encouraged to receive the COVID-19 vaccine when it is offered because vaccination has also been shown to reduce transmission.

    Please refer to ATAGI – Provider guide to COVID-19 vaccination of people with immunocompromise for more information.

Children

  • What is the risk for children getting pericarditis/myocarditis following mRNA vaccination compared with adults?

    In the 12-17 year old age group, overseas data shows the risk of developing myocarditis from COVID-19 disease is up to 6.7 times higher than developing it from COVID-19 mRNA vaccines.

    For more information please refer to:

  • Are there any recommendations in regards to exercise following mRNA COVID-19 vaccination?

    Exercise is not thought to exacerbate the risk of myocarditis/pericarditis following mRNA COVID-19 vaccines.  It is not necessary to advise all individuals receiving an mRNA COVID-19 vaccine to avoid exercise following vaccination.

    However, if patients develop myocarditis/pericarditis post mRNA COVID-19 vaccination there is a concern that exercise may be pro-arrhythmic (i.e. will exacerbate the condition).

    As part of routine pre-vaccination education and consent, all vaccinees should be informed of the symptoms of myocarditis and pericarditis, and advised that should they develop symptoms, they must avoid exercise and seek medical attention.

    For more information please refer to COVID-19 vaccination- Guidance on myocarditis and pericarditis after mRNA COVID-19 vaccines

  • If a parent experiences myocarditis/pericarditis following COVID-19 vaccination is it more likely that their child will also experience this side effect?

    No. There is no current evidence to suggest that there is a hereditary link in myocarditis or pericarditis following COVID-19 mRNA vaccines.

  • Should children receive Vaxzevria (AstraZeneca) instead to avoid the risk of developing myocarditis/pericarditis following COVID-19 vaccination with mRNA vaccination?

    No. Vaxzevria (AstraZeneca) is not registered for use in individuals younger than 18 years.

    The risk of Tier 1 thrombosis with thrombocytopenia syndrome is higher in younger age groups, with significant associated mortality and morbidity.

    Importantly, almost all cases of myocarditis/pericarditis associated with mRNA COVID-19 vaccines have made a full recovery.

  • Will vaccination have any impact on puberty or fertility?

    There is no evidence to suggest that COVID-19 vaccines has a detrimental impact on puberty or fertility for boys or girls. This is in direct contrast to COVID-19 disease which has been shown to increase the rate of miscarriage and premature birth and decrease male sperm count.

    In particular, there have been concerns around COVID-19 mRNA vaccines and their impacts on puberty and fertility in children and young adults. Importantly, there is no evidence to suggest that hormone levels involved in puberty are affected by the vaccines.

    There is also no evidence that COVID-19 antigens from the vaccine accumulate in harmful amounts in ovaries, fallopian tubes or testes. During COVID-19 vaccine clinical trials, participants became pregnant at similar rates in both the vaccine groups and placebo groups.

    For more information please refer to:

  • What is the rationale for vaccinating children when the risk of children becoming seriously ill or needing hospitalisation is low?

    COVID-19 vaccines have been shown to prevent serious disease and hospitalisation.

    Although COVID-19 disease is most often milder in children than adults, infection still occurs at a similar rate. As variants of concern such as Delta are now widespread in our community, the expected rates of children needing hospitalisation with COVID-19 disease is also likely to increase.

    Therefore vaccinating children against COVID-19 where possible will assist in a number of ways:

    • it reduces the overall burden or “load” of COVID-19 disease in the community
    • it helps to reduce transmission or spread of COVID-19 throughout the community, including from children to adults (who are at higher risk of severe disease)
    • it helps to protect other members of the community who cannot be vaccinated (including younger children) or more those in the community that are more vulnerable to severe disease.
  • If a child has experienced serious side effects following other vaccines can they receive COVID-19 vaccines?

    Most side effects experienced following a vaccination are generally mild and short lived. However, there may be some instances where a child has experienced a significant or severe side effect (eg. anaphylaxis). In these circumstances it may be appropriate for this child to be referred to an immunisation specialist for a consultation prior to administering a COVID-19 vaccine.

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

  • My 12 yo is on the small side. Is it safe for them to receive a full dose/adult dose of the vaccine?

    Vaccine doses are not size dependent but rather they are age dependent. This principle also applies when vaccinating low birth weight babies. They receive the appropriate dose for their age, and it is not modified for prematurity or size.

    A full dose of COVID-19 vaccine is recommended for those aged 12 years and older because this is the dose that was administered in clinical trials and was found to be both effective in preventing severe disease, as well as being safe. Conversely there is no data on the safety of using lower doses > 12 yo children or how effective a lower dose would be in preventing disease for those aged > 12 yo.

    It is reassuring to note that teens are actually reporting fewer side effects following mRNA vaccines than adults are.

    For information on the safety of COVID-19 vaccines in teens in Australia please refer to AusVaxSafety.

  • Other countries either do not recommend COVID-19 vaccines for children or only recommend 1 dose. Why does Australia recommend 2 doses for children > 12 years of age?

    Information gained from clinical trials showed that a 2-dose course of vaccine had the greatest antibody responses and impact on preventing severe disease and hospitalisation. Based on careful consideration of global safety and efficacy data, Australian epidemiological considerations and indirect benefits such as wellbeing and participation in education ATAGI recommends that everyone > 12 years of age receive 2 doses of COVID-19 vaccines.

    This not only aims to provide maximum protection for the vaccinee, but also for other vulnerable groups in the population.

    This may differ from some other coutries which only recommend a single dose of vaccine for children and adolescents. The reasons for this may vary and may be based on local epidemiology and factors.

    For further information refer to the ATAGI statement on the use of COVID-19 vaccines in young adolescents in Australia.

  • Will children younger than 12 receive COVID-19 vaccines?

    On December 5 2021, the TGA granted provisional approval for the administration of Comirnaty (Pfizer) to children aged 5-11 years. Further information on eligibility criteria for this cohort is expected in the coming weeks.

    Clinical trials are currently underway for COVID-19 vaccines in the younger population (> 6 months of age).

    For further information please refer to MVEC: COVID-19 vaccination in children.

  • Can children provide their own consent for COVID-19 vaccination?

    Generally speaking, a parent or guardian can provide consent for a child. In Victoria, individuals aged 12-17 are able to provide their own consent if they are deemed to be a “mature minor”.  The individual must demonstrate an understanding the proposed procedure and the effect of the decision to be vaccinated in order to provide their own consent. The laws relating to consent can vary between states and territories and it is important to refer to the individual jurisdiction to determine what laws apply.

    If a child refuses a vaccination after valid consent has been provided, it is important to respect the child’s wishes and withhold vaccination.

    Please refer to the Victorian COVID-19 Vaccination Guidelines for more information.

  • What is the recommended interval between COVID-19 vaccines and the routine school vaccines (eg. Year 7 and Year 10)?

    COVID-19 vaccines and other vaccines (including influenza and routine NIP vaccines) can be co-administered opportunistically.

    To read more please refer to COVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021

  • Is the recommended interval between COVID-19 vaccine doses different for children and adults?

    The intervals between vaccine doses are the same for adults and children (≥ 12 years). Doses of Comirnaty (Pfizer) are recommended to be administered 3-6 weeks apart. Spikevax (Moderna) doses are recommended to be administered between 4-6 weeks apart.

    The TGA has granted provisional approval for the administration of Comirnaty (Pfizer) in children aged 5-11 years with 2 doses being administered 3 weeks apart. Further guidance on intervals and eligibility criteria will be available in the coming weeks.

  • Will Novavax COVID-19 vaccines be available to children?

    Clinical trials assessing the safety and efficacy of the Novavax COVID-19 vaccine candidate in children aged 12-17 years are currently underway.

  • Is there a blood test you can have to see if you responded to the first dose and therefore the second dose is not needed?

    COVID-19 serology is not routinely available following vaccination and is not able to inform the decision to proceed with future doses. Due to the novel nature of SARS-CoV-2, a correlate of protection has not yet been established for COVID-19 in humans.

    For more information please refer to COVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021.

  • How can children with needle phobias be supported to receive vaccines safely?

    It is recommended that children with anxiety, intellectual disabilities and needle phobias avoid attending large scale vaccination sites for immunisation. These sites are loud and busy and can increase distress. Smaller settings such as a GP clinic or pharmacy may be preferred.

    Further information and strategies to assist with needle phobia can be found at MVEC: Needle phobia.

    If all avenues for addressing severe needle phobia have been exhausted a referral to VicSIS for COVID-19 vaccination can be considered. Information on which strategies have been trialed should be included in the patient referral.

  • Is it safe for children with heart conditions to receive mRNA COVID-19 vaccines?

    COVID-19 mRNA vaccines can safely be administered to the majority of individuals with a pre-existing heart conditions. Individuals with the following conditions can safely receive COVID-19 mRNA vaccines without the need for additional monitoring or precautions:

    • coronary artery disease
    • myocardial infarction
    • stable heart failure
    • arrhythmias
    • rheumatic fever
    • rheumatic heart disease
    • kawasaki disease
    • most congenital heart disease
    • those with implanted cardiac devices
    • congenital heart disease
    • cardiac transplant
    • cardiomyopathy.

    Those with a history of the following conditions can also receive COVID-19 mRNA vaccines; however should consult their treating specialist to determine the appropriate timing for vaccination:

    • current or recent (within the past 3 months) myocarditis or pericarditis due to causes other than vaccination
    • acute rheumatic fever or acute rheumatic heart disease (with evidence of active inflammation)
    • acute decompensated heart failure.

    For more information please refer to MVEC: myocarditis and pericarditis following COVID-19 mRNA vaccines.

  • Is it safe for children with eczema, asthma or allergies to receive COVID-19 vaccines?

    COVID-19 vaccines can safely be administered to children who have previously been diagnosed with eczema and asthma. Having a history of severe asthma has been associated with an increased risk of severe COVID-19 disease and therefore vaccination is strongly recommended in this patient group.

    Children with allergies/anaphylaxis to food, drugs, venom or latex can safely receive COVID-19 vaccines without the need for additional precautions or monitoring. Those with a history of allergic reactions or anaphylaxis to a component of a COVID-19 vaccine should be referred to a VicSIS clinic for an individual assessment and plan prior to vaccination. Vaccination is contraindicated for individuals with a history of anaphylaxis to a previous dose of COVID-19 vaccine or anaphylaxis to a component of the COVID-19 vaccine that is to be given.

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

Reviewed by: Rachael McGuire (MVEC Education Nurse Coordinator), Francesca Machingaifa (MVEC Education Nurse Coordinator) and Daryl Cheng (MVEC Medical Lead)

Date: December 5, 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.