Background

The VicSIS network provides specialist vaccination services for people who have experienced an adverse event following immunisation (AEFI) with a COVID-19 vaccine, or for those who are identified as at-risk of experiencing an AEFI. VicSIS clinicians provide comprehensive consultations and individualised advice, both pre- and post-vaccination either face-to-face or via telehealth appointments. Vaccination under supervision can be facilitated where deemed necessary.

Please note: VicSIS is experiencing a high volume of referrals at this time and there may be significant delays in triaging referrals. Inappropriate referrals that do not meet the criteria outlined (eg. requests for a Pfizer vaccine) or have insufficient information will be rejected. Referrers are requested to pass this information on to their patients.

  • Who should be referred to VicSIS?

    Anyone who has experienced a significant adverse event following a previous dose of a COVID-19 vaccine must first have their adverse event reported to SAEFVIC. Examples of previous significant AEFI includes:

    It is also recommended that individuals at higher risk of developing AEFI following a COVID-19 vaccination should be referred to VicSIS prior to vaccination. This includes individuals with a history of:

    • Cerebral venous sinus thrombosis (CVST), heparin-induced thrombocytopenia (HIT), idiopathic splanchnic (mesenteric, portal and splenic) venous thrombosis or anti-phospholipid syndrome with thrombosis
    • Anaphylaxis or generalised allergic reaction (without anaphylaxis) to any component of the COVID-19 vaccine to be administered
    • A history of PEG or polysorbate 80 related allergic reactions
    • A systemic mast cell activation condition with a raised tryptase who have been unable to tolerate previous intramuscular injections due to recurrent anaphylaxis.
      (NB: People with a systemic mast cell activation condition, with a raised tryptase that have tolerated previous intramuscular injections without any adverse reactions, do not require a VicSIS referral)

    For further information please refer to the Clinicians Referral Guide to VicSIS for patient eligibility criteria.

  • Who should not be referred to VicSIS?

    Minor, common or expected side effects to a COVID-19 vaccine do not need to be reported to SAEFVIC or referred to VicSIS. A list of the expected side effects of COVID-19 vaccines can be found at COVID-19 vaccination: After your AstraZeneca vaccination or COVID-19 vaccination – After your Pfizer (COMIRNATY) vaccine.

    Patients with other types of allergies (eg. food, latex or venom) do not require a VicSIS referral and COVID-19 vaccines can safely be administered in routine vaccination centres. More information on allergy can be found via our COVID-19 vaccine FAQs.

  • Can I refer patients aged 60 years and over who are requesting the Pfizer vaccine?

    The priority groups for COVID-19 vaccines are decided by the Commonwealth government. Referrals requesting preference of COVID-19 vaccine brand (who do not meet referral criteria) will be rejected.

    Please refer to the COVID-19 vaccine brand guidance for clinicians for referral criteria.

  • What allergic conditions require a VicSIS referral?

    A referral to VicSIS allergy clinic is recommended if an individual has:

    • Experienced immediate (within 2 hours) and generalised symptoms of an allergic reaction following receipt of a COVID-19 vaccine
    • A history of anaphylaxis or generalised allergic reaction to any component of a COVID-19 vaccine (eg. PEG or polysorbate 80)
    • A systemic mast cell activation disorder with a raised tryptase who have been unable to tolerate previous intramuscular injections due to recurrent anaphylaxis.

    Please refer to Guidance for differentiating anaphylaxis and acute stress response for vaccine providers for more information.

    Please note: People with a systemic mast cell activation condition, with a raised tryptase that have tolerated previous intramuscular injections (ie. influenza vaccine) without any adverse reactions, do not require a VicSIS referral – vaccination can be administered safely at a routine vaccination centre with a 30 minute observation period. Other types of allergy (eg. food, latex or venom allergies) do not require a VicSIS referral – vaccination can be administered safely at a routine vaccination centre with a routine 15 minute observation period.

    Acute generalised urticaria (hives) can occur one to two weeks after vaccination and generally does not need VicSIS review. The patient can go on to have future vaccines in the community with the routine 15 minute observation period.  Persistent delayed urticaria post vaccination not responding to routine treatment can be referred to any vaccine specialist/allergist for further follow up. Please refer to MVEC: COVID-19 vaccines and allergy for more information.

    VicSIS allergy clinics are located at Monash Health and Austin health (For details please see How can patients be referred to VicSIS below).

  • Who can refer to VicSIS?

    All referrals must be made by a medical practitioner (ie. no self-referrals) and should only be sent to a single clinic. Referrals must be sent from a hospital or practice email address. Referrals from private or no-reply email addresses or with incomplete referrer details will not be accepted. Referrals must not be forwarded on by a patient email address.

    Referrals with incomplete information or not made by a medical practitioner will not be accepted.

    Treating clinicians are encouraged to inform their patients as soon as possible if their referral is rejected. Inappropriate referrals can lead to unnecessary delays in vaccination, leaving patients vulnerable to infection.

    Please note: VicSIS is experiencing a high volume of referrals at this time and there may be significant delays in triaging referrals. Inappropriate referrals that do not meet the criteria outlined (eg. requests for a Pfizer vaccine) or have insufficient information will be rejected. Referrers are requested to pass this information on to their patients.

  • How can patients be referred to VicSIS?

    Only a medical practitioner can refer to VicSIS (ie. no self-referrals).

    Referrals can be made by emailing a completed VicSIS Referral Form through to the patient’s closest VicSIS site or where they receive regular care. A patient can only be referred to a single VicSIS site.

    Please note: VicSIS is experiencing a high volume of referrals at this time and there may be significant delays in triaging referrals. Inappropriate referrals that do not meet the criteria outlined (eg. requests for a Pfizer vaccine) or have insufficient information will be rejected. Referrers are requested to pass this information on to their patients.

    There are currently eight VicSIS clinic sites in Victoria, each with their own specialist clinicians.

    VicSIS ClinicReferral email
    Alfred Hospitalspecialistimmunisationservice@alfred.org.au
    Austin Hospital (includes specialist allergy clinic)COVIDvaccineallergy@austin.org.au
    Barwon HealthVicSIS@barwonhealth.org.au
    Monash Health (includes specialist allergy clinic)vicsis@monashhealth.org
    Northern HospitalSpecialImmunisationService@nh.org.au
    Peter MacCallum Cancer CentreSpecialistImmunisationService@petermac.org
    Royal Children’s Hospital*clinics.saefvic@saefvic.org.au
    Royal Melbourne Hospitalspecialistimmunisationservice@mh.org.au
    Sunshine HospitalCOVIDvaccinationSIS@wh.org.au

    *The Royal Children’s Hospital is not a funded VicSIS site, however it is recognised as an established vaccine safety clinic for paediatric patients. Referrals can be made to the Royal Children’s Hospital by sending a referral to clinics.saefvic@saefvic.org.au

Authors: Nigel Crawford (Director SAEFVIC, Murdoch Children’s Research Institute), Francesca Machingaifa (MVEC Education Nurse Coordinator), Rachael McGuire (MVEC Education Nurse Coordinator), Sally Gordon (VicSIS Lead, Department of Health), Ngaree Blow (VicSIS Lead, Department of Health), Elise Virah Sawmy (Senior Project Officer, VicSIS, Department of Health) and Eleanor Duckworth (Project Officer, VicSIS, Department of Health)

Reviewed by: Francesca Machingaifa (MVEC Education Nurse Coordinator) and Rachael McGuire (MVEC Education Nurse Coordinator)

Date: June 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.