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  • COVID-19 Primary Care Update 117

    Latest update from @Carl De Wet
    Adverse events after COVID-19 immunization

     

    Astra-Zeneca COVID-19 vaccine training module

    • We have received many queries about the vaccine ingredients, so I thought I would share this for interest. None of the vaccine ingredients are of human or animal origin and there are no food, latex or gelatin in the COVID-19 vaccines that are currently available. If individuals have had an allergic reaction to other vaccines in the past, it does not mean that they will also be allergic to the COVID-19 vaccines (Australasian Society of Clinical Immunology and Allergy [ASCIA], 2021). 
    • Non-active ingredients of the vaccine (no preservatives are used):
    • L-Histidine (an amino acid). 
    • L-Histidine hydrochloride monohydrate (an amino acid). 
    • Magnesium chloride hexahydrate (supports many activities inside cells). 
    • Polysorbate 80 (a stabiliser).
    • Sodium chloride. 
    • Disodium edetate dihydrate (EDTA, a binding agent) 
    • Water for injection. 

    Practical tips: COVID-19 vaccine consent, including in RACFs

    • The ATAGI immunisation provider guide to obtaining informed consent for COVID-19 vaccine addresses frequently asked questions your patients may have regarding the vaccinations, along with suggested discussion points.
    • The DoH has released a consent form for COVID-19 vaccination. It is not mandatory to use this consent form, or to obtain written consent, but practices will need a way to ensure patients have the relevant information prior to receiving the vaccine, and to document informed consent.
    • The DoH has released a resource pack containing information for residential aged care providers, workers, residents, carers and families. It is comprehensive and excellent and worth saving for future refence. Two of the resources are particularly relevant:
    • A RACF consent process flowchart (attached and online). The flowchart does not routinely include GPs in the consent process. The role of GPs relate to the following: ‘RACFs unsure of clinical suitability [will] seek clinical advice to determine suitability to participate’.
    • The Clinical Governance requirements for COVID-19 vaccination clinics at RACF document further clarifies: ‘where there are concerns in relation to resident suitability for the vaccine, RACFs should consult with GPs. GPs may provide a phone assessment or may review the resident personally’ and ‘RACF is responsible for facilitating, seeking and recording informed consent for all residents…’ (page 2)

    High incidence of respiratory disease in Queensland

    • The latest Sullivan Nicolaides report confirms what many primary care clinicians suspect: a recent, sharp increase in the incidence of RSV and rhinovirus (thanks Mike).
    • It remains important to continue to test for COVID-19

    Webinars

    • The Queensland Clinical Senate and Clinical Networks held a second COVID-19 vaccine information sessions for clinicians yesterday. The webinar is now available to view. It addressed, among other things:
    • phase 1a vaccinations – how will I know if I’m included?
    • the role of the recently established Vaccination Coordination Centre (VCC)
    • advice for phase 1a clinicians who might be pregnant, planning a pregnancy or breastfeeding
    • timing your COVID-19 vaccinations around other potential vaccinations.
    • The Gold Coast PHN will be delivering a free, online COVID-19 update on 25 February at 19:00. Registrations are now open.

    Online resources

    Public Health Directions

    From midday 22 February 2021, updates to the Quarantine for International Arrivals Direction (No. 5) and Border Restrictions Direction (No. 23) came into effect. The updates implement improvements to the Queensland end-to-end quarantine system and include:

    Quarantine for International Arrivals Direction (No. 5)

    • You can only open the door of your quarantine room for a permitted purpose, such as to collect food, laundry or medical supplies, and if everyone inside is wearing a surgical face mask.
    • You can only leave government arranged quarantine for medical care at a hospital, in an emergency situation or to depart on a connecting international flight.
    • Travel when allowed to leave and return to quarantine must be in an ambulance, emergency services vehicle or transport arranged by a government authority and you must wear a surgical face mask.
    • International arrivals must complete a Queensland International Arrivals Registration, unless they have travelled to Queensland on a quarantine-free flight. You should complete a registration 3 days before you depart for Queensland.
    • International transit passengers can arrive in Queensland and leave on another international flight if they follow the Australian Government Department of Health advice.

    Border Restrictions Direction (No. 23)

    • You can only open the door of your quarantine hotel room for a permitted purpose, such as to collect food, laundry or medical supplies, and if everyone inside is wearing a surgical face mask.
    • Travel when allowed to leave and return to a quarantine hotel must be in an ambulance, emergency services vehicle or transport arranged by a government authority and you must wear a surgical face mask.
    • Travel when allowed to leave and return to home quarantine must be by private vehicle and you must wear a surgical face mask. You cannot travel in a taxi, rideshare or by public transport.
    • Air crew when allowed to leave and return to home quarantine or crew accommodation must travel by private vehicle or transport provided by the airline. They cannot travel in a taxi, rideshare or by public transport.
    • If you need to enter Queensland from a COVID-19 hotspot for court or tribunal obligations, you must have written confirmation or an order of the court or tribunal that confirms you are required to attend in-person and that alternative arrangements, such as video link, are not appropriate.
    • You cannot leave quarantine for medical supplies unless you have an exemption from the Chief Health Officer.