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

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 email info.mvec@mcri.edu.au for further clarification.

Administration technique

  • What do I do if there was leakage of diluent when reconstituting Comirnaty (Pfizer)?

    If you have injected most of the diluent into the vial and there has been no breach in infection control, the vaccine can still be used. If there is uncertainty as to how much diluent was lost, you may still use the vaccine provided you are able to draw up at least 4 doses.

    To read more please refer to the Australian Government Department of Health: COVID-19 vaccine- clinical considerations.

  • Can COVID-19 vaccines be given subcutaneously?

    Vaxzevria (AstraZeneca), Comirnaty (Pfizer) and Spikevax (Moderna) should be administered via intramuscular injection. There is no safety or efficacy data relating to subcutaneous administration.

  • When administering a COVID-19 vaccine the syringe disconnected from the needle and I am not sure how much of the dose my patient received, what should I do?

    If the process of administering a vaccine is interrupted and most of the dose has not been given, repeat the whole dose as soon as practicable. If you have given most of the dose, you do not need to give the dose again. Please contact your safety service if there are any concerns/questions.

    To read more please refer to the Australian Immunisation Handbook: Administration of vaccines or Australian Government Department of Health: COVID-19 vaccine- clinical considerations.

  • What is the recommended site for injection for patients who have had axillary lymph nodes removed/have a history of lymphoedema?

    There is no strong evidence to suggest that vaccine administration into the deltoid will increase the likelihood of lymphoedema in patients who have had lymph nodes removed or have a previous history of lymphoedema.

    Vaccine administration into the deltoid of the unaffected arm may be preferred, alternatively intramuscular injection into the vastus lateralis (thigh) can be considered.

    Please refer to MVEC: Administration of injected vaccines – correct technique or Breastcancernow.org: Can I have coronavirus vaccine if I’ve had breast cancer treatment? for more information.

  • Can COVID-19 vaccines be co-administered with other vaccines?

    The Australian Technical Advisory Group on Immunisation (ATAGI) recommends a minimum interval of 7 days between the administration of a COVID-19 vaccine and other vaccines.

    Shorter intervals (eg. less than 7 days or co-administration on the same day) are acceptable in some circumstances, including:

    • An increased risk of COVID-19 or another vaccine preventable disease (eg. COVID-19 outbreak, influenza outbreak, a tetanus-prone wound)
    • Logistical issues such as difficulty scheduling visits to maintain the 7 day interval

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

  • What is the recommendation for administering COVID-19 vaccines to individuals with bleeding disorders?

    COVID-19 vaccines should be administered via intramuscular injection only. People who are taking anticoagulant therapy or have a history of a bleeding disorder are at higher risk of haematoma formation following intramuscular injection. Prior to vaccine administration, patients should be advised of this risk.

    The correct needle size and length should be used and firm pressure should be applied to the site (no rubbing) for at least 2 minutes following immunisation.

    Subcutaneous administration is not recommended due to a lack of safety and efficacy data regarding this route of administration.

    For further information please refer to the Australian Immunisation Handbook.

Vaccine schedule

  • Can COVID-19 vaccines be used interchangeably (eg. using a different brand for the first and second dose)?

    Mixed schedules are not currently recommended in Australia, however, they may be warranted in select circumstances, such as:

    • a specific medical contraindication or precaution
    • the need to complete a COVID-19 vaccine course that has been commenced with a brand not available in Australia

    For further information refer to ATAGI clinical advice on use of a different COVID-19 vaccine as the second dose in special circumstances.

  • Are booster doses of COVID-19 vaccines recommended in Australia?

    All COVID-19 vaccines used within Australia require 2 doses to complete a primary course. 3rd doses or booster are not currently recommended for any group of people.

    Further data on the duration of protection from COVID-19 disease and vaccination, as well as information on emerging variants is still evolving and this recommendation may change in the future.

    Please refer to ATAGI statement about the need for additional doses of COVID-19 vaccines for further information.

  • What are the ABSOLUTE minimum and maximum intervals for each COVID-19 vaccine dose?

    Vaccination with Vaxzevria (AstraZeneca) requires a 2-dose course, administered with 4-12 weeks between doses. If more than 12 weeks has elapsed between doses, the second dose should be administered as soon as possible with no need to re-start the course again. If the second dose is inadvertently administered with an interval of less than 14 days, it is considered invalid and a repeat dose (third dose) should be given 4-12 weeks after the invalid dose.

    Vaccination with Comirnaty (Pfizer) requires a 2-dose course administered 3-6 weeks apart. Vaccination with Spikevax (Moderna) requires a 2-dose course 4-6 weeks apart. If the second dose of Comirnaty or Spikevax is administered later than the recommended timeframe, there is no need to re-start the course. If the second dose is inadvertently administered less than 14 days apart, it is considered invalid and a repeat dose (third dose) should be given 4-12 weeks after the invalid dose.

  • What happens if the second COVID-19 vaccine dose is given early, late or is missed?

    Based on ATAGI advice, the absolute minimum interval between doses one and two of any COVID-19 vaccine is 14 days. If two doses are inadvertently administered sooner than 14 days apart the second dose is considered invalid and a further dose (third dose) should be administered 4-12 weeks after the invalid second dose. The same brand of COVID-19 vaccine should be given in this circumstance unless contraindicated.

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

  • What is the recommendation for individuals who have received a brand of COVID-19 vaccine that is not available in Australia?

    Individuals who have previously received one dose of COVID-19 vaccine that is not available in Australia can receive any available COVID-19 vaccine brand to complete the course. This second dose can be administered 4-12 weeks following the first dose. A longer interval will be accepted if this is not possible.

    For further information refer to COVID-19 vaccines: clinical considerations: people who have received a first dose of COVID-19 vaccine not yet available in Australia.

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

    Evidence suggests that immunity gained from COVID-19 infection will provide protection against reinfection for up to 6 months. There is no minimum interval 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. Individuals suffering prolonged symptoms (longer than 6 months) can consider vaccination on a case-by-case basis in consultation with their GP.

    There have been no vaccine safety signals identified in people who also have a history of COVID-19 infection. Side effects following vaccination have been reported to occur at similar or decreased rates compared with recipients who have not previously been infected with COVID-19 disease.

  • What are the vaccine recommendations for people who have contracted COVID-19 disease after receiving dose 1 of the vaccine but before dose 2?

    For Comirnaty (Pfizer) it is recommended that dose 2 is delayed for 8 weeks following recovery from acute infection.

    For Vaxzevria (AstraZeneca) it is recommended that dose 2 is delayed for 12 weeks following recovery of acute infection. Earlier vaccination can be considered if the risk of exposure to disease is high (eg. quarantine worker).

  • How long will it take to develop immunity once vaccinated?

    There is some evidence that one dose of Comirnaty (Pfizer) or Spikevax (Moderna) will provide partial protection after 12 days however this is likely to be short lived. Generally the time required following vaccination for the body to develop immunity will depend on the vaccine; this usually takes a number of weeks. Completing both doses of the 2 dose course is recommended.

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

    ATAGI currently recommends a 7 day interval between the administration of COVID-19 vaccines and any other vaccine (including live-attenuated vaccines). Please refer to COVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021 for more information.

  • Can I get a blood test to check my immune response?

    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 pelase refer to COVID-19 vaccination- ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021.

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:

  • 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.

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.

  • 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

  • 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 (AstaZeneca)?

    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. This includes any of the following conditions:

    • myocarditis, pericarditis or endocarditis > 6 months prior to vaccination
    • coronary artery disease
    • myocardial infarction
    • stable heart failure
    • arrhythmias
    • prior history of rheumatic fever or rheumatic heart disease (RHD), Kawasaki Disease
    • most congenital heart disease
    • people with implantable cardiac devices.

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

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

  • What are the vaccine recommendations for people who have previously been diagnosed with myocarditis or pericarditis?

    There is a small group of people with a history of specific cardiac conditions who should consult a GP, cardiologist or immunisation specialist for further advice on the timing of vaccination prior to receiving a COVID-19 mRNA vaccine. This includes:

    • recent (eg. within the past 6 months) or current and ongoing inflammatory cardiac illness e.g., myocarditis, pericarditis or endocarditis
    • acute rheumatic fever or acute rheumatic heart disease
    • people aged 12-29 years with dilated cardiomyopathy
    • complex or severe congenital heart disease including single ventricle (Fontan) circulation
    • acute decompensated heart failure
    • cardiac transplant recipients.

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

    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.

Authors: Daniela Say (MVEC Immunisation Fellow), 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) and Francesca Machingaifa (MVEC Education Nurse Coordinator)

Date: September 17, 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.