Important update from CMO to COVID-19 Vaccine Delivery Partners
Dear Australian COVID-19 Vaccine Delivery Partner
By now you will be aware of advice provided by the Australian Technical Advisory Group on Immunisation (ATAGI) in light of the evolving evidence of a rare but serious side effect involving thrombosis with thrombocytopenia following receipt of the AstraZeneca vaccine.
This ‘thrombosis with thrombocytopenia syndrome’ (TTS) is a newly described serious condition, with unusual blood clots in the brain (cerebral venous sinus thrombosis) or in other parts of the body, associated with low platelet levels and can cause serious long term disability or death.
The evidence that connects TTS to receipt of the AstraZeneca vaccine has been reviewed by ATAGI and the Therapeutic Goods Administration (TGA) and subsequently, ATAGI has recommended new changes to the Australian COVID-19 Vaccine Program including a preference for the use of the Comirnaty (Pfizer) vaccine in adults aged under 50 years.
The ATAGI statement (found here) provides further information on the key considerations that went into formulating this advice. Amongst these were the following:
- TTS remains an extremely rare event among vaccine recipients. Experience in Europe has shown approximately 4 – 6 people in every one million people develop TTS in the 4-20 days after the first dose of vaccine. However higher rates have been reported in some countries, and among younger people. One person in Australia developed the syndrome after receiving the AstraZeneca vaccine.
- While Australia currently has very low or no community transmission of COVID-19, this could change. The risk of serious disease and death in Australia remains, even as border controls and other measures continue.
- The individual benefit-to-risk balance of vaccination with COVID-19 vaccine AstraZeneca in Australia varies with age. The risk of ongoing health issues and death from COVID-19 is highest in older age groups, particularly rising from 50 years of age. By comparison, the rate, and so possibility of disability and death from TTS may be higher in younger people.
Please note that ATAGI has further recommended that:
- The AstraZeneca vaccine should only be used in adults aged under 50 where the benefits clearly outweigh the risk for that individual and the person has made an informed decision based on an understanding of the risks and benefits.
- People who have had the first dose of COVID-19 Vaccine AstraZeneca without any serious adverse effects can be given the second dose, including adults under 50 years.
The Australian Government places safety above all else, as it has done throughout the pandemic, and will continue to follow the medical advice in protecting Australians. On this basis, the Government has accepted ATAGI’s recommendations and will move swiftly to ensure Australia’s vaccination program and advice to patients is adjusted accordingly, as per the TGA’s and Department of Health Secretary and Chief Medical Officer statements.
In the short term, and in line with ATAGI’s recommendations, you may want to contact any patients under 50 who are currently booked to receive their first dose of the AstraZeneca COVID-19 vaccine and cancel in cases where the benefit clearly does not outweigh the risk.
As per the previous ATAGI statement on 2 April (found here), please remain alert for warning signs of TTS in those who have received the AstraZeneca COVID-19 vaccine. So far these have included as either central venous sinus thrombosis (CVST) or thrombosis in other sites, such as intra-abdominal venous systems. These presentations have occurred between 4 and 20 days following receipt of the AstraZeneca COVID-19 vaccine. CVST may present as a new onset persistent headache not settling with analgesia, features of raised intracranial pressure (including acute severe headache, vomiting, confusion), focal neurological deficits, and/or seizures. Thrombosis in the intra-abdominal venous system may present as abdominal pain.
I appreciate that this change in direction is sudden, and may cause additional stress and difficulty over the next period. It is also likely to contribute to an increase in vaccine hesitancy amongst your patients. GPs are key to managing this risk in their roles as trusted advisors, and we expect that you will be called upon to assist your patients to make an informed decision based on their individual circumstances. I suggest you reiterate to your patients:
- the risk of developing this side-effect following receipt of the AstraZeneca vaccine is extremely rare;
- the new age-based recommendations are made out of an abundance of caution and the benefits of the COVID-19 AstraZeneca vaccination outweigh the risks for the vast majority of people; and
- that if you have received your first dose of the vaccine with no major adverse reaction, you are strongly encouraged to receive the second dose as planned.
If you have questions about specific patients with prior medical conditions, you can contact the specialist immunisation service within your jurisdiction.
The Department is further developing and refining resources for informed consent that clearly convey the benefits and risks of vaccination for both providers and consumers, and we will continue to provide you with advice and patient resources in coming days and will be sent directly to you. The attached script has also been developed to assist your practice to respond to patients who may call with questions about the AstraZeneca vaccine. Please continue to check www.health.gov.au for the most up to date information.
ATAGI and the TGA will continue to review the evidence on a regular basis, and as with everything during this pandemic, it is possible that there may be further changes to this advice as new evidence emerges or the epidemiological situation changes. The Department will be working with states and territories to determine how those under the age of 50 in phase 1 can access the Pfizer (Cominarty) vaccine in a timely fashion. We will keep you updated with this process as it continues, and will come back in coming days with further resources and information.
I want to take this opportunity to again thank you for your flexibility, commitment and resilience during the pandemic.
Prof Paul Kelly MBBS, DTM+H, PhD, FAFPHM
Chief Medical Officer
Australian Government Department of Health
The script prepared for General Practices to assist in responding to patients with questions about the AstraZeneca COVID-19 vaccine can be found here.
The Department of Health acknowledges the Traditional Custodians of Australia and their continued connection to land, sea and community. We pay our respects to all Elders past and present.
Ministerial Media Release: AstraZeneca COVID-19 Vaccine
The Australian Government received advice from the vaccine expert taskforce, the Australian Technical Advisory Group on Immunisation (ATAGI). The Government accepts the advice from Australia’s medical experts and will move swiftly to ensure Australia’s vaccination program and advice to patients is adjusted accordingly.
The Australian Government places safety above all else, as it has done throughout the pandemic, and will continue to follow the medical advice in protecting Australians. The ATAGI advice is clear that the AstraZeneca COVID-19 vaccine is highly effective in preventing severe disease caused by COVID-19. The medical advice to the Government is that the risk of blood clotting side effects from the Astra Zeneca vaccine is four to six in one million people, in the first four to 20 days post the vaccine. This is a rare but serious side effect.
Read the full media release here.
SWAMS pick up rural health award
The South West Aboriginal Medical Service (SWAMS) has been recognised for its outstanding work in the public health sector at the 2021 WA Rural Health Awards. The organisation’s Kaart Darabiny ‘What are you thinking?’ Mental Health Team was successful in the Building Healthy Country Communities category at the awards, which were held last month. The program is designed to support young people at risk and using culture to promote a holistic view on wellness as well as working with clients who have experienced trauma.
Seven doctors from the South West, more than ever before, were also recognised at the ceremony for 40 years of service to rural health. Mary Collins, Ronald Jewel, Michael Peterkin, Frederik Pretorius, Phil Reid, David Robinson and Allan Walley all received recognition and were thanked for their service by Rural Health West chief executive Tim Shackleton. “We are extremely pleased to shine a light on the work undertaken by these outstanding health professionals and sincerely thank them on behalf of their patients and the rural communities they serve,” he said.
To view the full article click here.
SWAMS’ Kaart Darabiny Mental Health Team. Image source: South Western Times.
Call for radical mental health system reform
The Australian Association of Social Workers’ (AASW) submission to the House of Representatives Select Committee inquiry into Mental Health and Suicide Prevention has called for government to seize the opportunity to build a more cohesive system of mental health support that will radically reform Australia’s mental health system. AASW CEO, Cindy Smith, said the AASW’s extensive submission draws on decades of experience of its members working with some of the most vulnerable and marginalised people in our society and this submission and its recommendations for improvements to the mental health system are consistent with previous submissions. “Social workers have been talking about the failings of the mental health system for decades and here we are in 2021, still beset by long waiting lists to access publicly funded services, inadequate rebate amounts under Better Access, and a shortage of mental health professionals across the country.”
To view the AASW media release in full click here.
Artwork by Matt Davidson. Image source: The Sydney Morning Herald.
Rural and Remote health COVID-19 roundtable
Regional Health Minister, Mark Coulton MP, chaired the 12th special rural and remote health COVID-19 roundtable with members of the Rural Health Stakeholder group on 18 February 2021. A summary of the proceedings and decisions can be found here.
Image source: AJP.com.au.
Health professional kidney disease webinar
Kidney Health Australia are hosting a Health Professional Webinar discussing chronic kidney disease in Aboriginal and Torres Strait Islander Peoples. The webinar will be presented by Associate Professor Mark Thomas at 7:00 PM Tuesday 20 April 2021.
Registration is essential. You can register here or via the link in this flyer.
Add your voice to family violence consultation
The Australian Government has opened public consultation on the next National Plan to reduce family, domestic and sexual violence in Australia. All Australians can add their views and voices to the consultation via an online questionnaire, available on the Engage website. Women who have experienced violence, family safety advocates, service providers and other stakeholders will also be invited to take part in a two-day National Women’s Safety Summit to be held on 29 and 30 July 2021. The Summit was agreed as part of the establishment of the Taskforce on Women’s Safety in December last year.
To view the joint media release here.
Decolonising public health policies
Wingara Mura Leadership Program Academic Fellow Carmen Parter has written a PhD thesis with the title Decolonising public health policies: Rightfully giving effect to Aboriginal and Torres Strait Islander peoples’ knowledges and cultures of ways of being, knowing and doing in public health policies.
In her thesis Carmen argues that ‘for the knowledges held by Indigenous people to be recognised and valued, the dominant western non-Indigenous culture must accept that Indigenous people’s cultural knowledges of ways of being, knowing and doing are relevant to policy production.’ Carmen goes on to say in her concluding remarks ‘As policy makers and all levels of government embark on a new National Closing the Gap Agreement (Australian Government, 2020), a continued and trusting co-design approach that is a genuine partnership with Aboriginal and Torres Strait Islander people and communities is paramount. A systems perspective is warranted to address the ingrained and invisible colonialist, imperialist and racialized paradigms – the native assumptions – that have dominated the Indigenous affairs and Indigenous public health policy environment for the last 31 years.’
To view the thesis in full click here.
Image source: Eco-shout website.
COVID-19 an opportunity to build a better healthcare sector
The opportunities of the COVID-19 pandemic continue to represent an opportunity for Australia to do better in supporting the health of all, according to the Australian College of Nursing (ACN). Speaking on World Health Day, ACN Chief Executive Officer, Adjunct Professor Kylie Ward FACN, said that the World Health Organisation (WHO)’s annual report should be seen as an opportunity by governments to build a better health care sector as the world rolls out the COVID-19 vaccine.
“Many of the issues identified by the WHO are issues that we face not only in Australia, but in our Pacific region where we have a role to both lead and support local health systems,” Adjunct Professor Ward said. “We must use the pandemic as an opportunity to continue to support people most impacted by global inequality in health care, not just to aim to return to the previous status quo.”
Adjunct Professor Ward said the Australian Government must use World Health Day to look to support the most vulnerable members of our community, including Aboriginal and Torres Strait Islander peoples, Australians living in rural and remote areas and elderly Australians.
To view the article in full click here.
Image source: Benefits pro.
Fully-funded community data use course – BE QUICK!
After the successful launch of its Full-Time Data Analytics (the science of being able to tell an accurate story from a set of data) and Cloud Course, Goanna Education is offering a part-time course that you can fit around your work schedule.
This fully funded program has been developed in conjunction with Data Analysts working in the industry, educators and technical recruiters. This program will teach participants how to identify the right data, make sure that data is fit for analysis, analyse the data and then present it visually in order to better explain the results to other people. The course is designed specifically for Indigenous Australia and it is a requisite that students identify as Aboriginal or Torres Strait Islander to apply.
The part time Data Analytics course starts on Monday 12 April 2021.
It is made up of:
- 6–7 week self-study blocks with weekly online drop-ins, and
- 4 intensive learning weeks: 1. Excel: 24–28 May; 2. Excel: 19–24 July; 3. Databases: 13–17 Sep; and 4. Power BI: 18–22 Oct.
The course includes the opportunity to sit exams for 3 Microsoft Certifications and finishes 22 October 2021.
To register click here. 
VIC – Mooroopna/Shepparton – Rumbalara Aboriginal Co-operative – multiple positions
Health Outreach Worker x 1 PT (Fixed Term) – Mooroopna
The Outreach Worker plays a pivotal role in service coordination, advocacy and support for the Aboriginal and Torres Strait Islander community throughout the Integrated Team Care Goulburn Valley Primary Health Network Region. You will be required to provide culturally appropriate coordination of care for patients with complex needs/chronic disease including treatment, early intervention and prevention and associated services in the context of an Aboriginal Health Service.
To view the position description and to apply click here.
Applications close 4:00 PM Tuesday 13 April 2021.
Specialist Aboriginal Family Violence Team Leader (Orange Door) x 1 FT – Shepparton Office
The Aboriginal Family Violence Team Leader is a leadership position co-located in The Orange Door site and will have a significant role to work closely with other Orange Door partners as well as provide supervision to the Aboriginal Family Violence practitioners to lead high quality, culturally safe and effective responses to Aboriginal and Torres Strait Islander people seeking support and safety.
To view position description and to apply click here.
Applications close 4:00 PM Friday 16 April 2021.
Specialist Aboriginal Family Practitioner (Orange Door) x 1 FT – Shepparton Office
The Aboriginal Family Violence Practitioner will provide screening, assessment, triage and short-term response to all incoming referrals through the Orange Door Hub using an Integrated Practice Framework and ensuring the delivery of high quality, culturally safe and effective responses to Aboriginal and Torres Strait Islander people seeking support and safety.
To view position descriptions and to apply click here.
Applications close 4:00 PM Friday 16 April 2021.
Family Partnership Worker x 1 FT (identified) – Mooroopna
Culturally support delivery of The Australian Nurse-Family Partnership Program to clients, alongside the Nurse Home Visitor and Nurse Supervisor. Includes, promotional event planning and coordination, cultural connection and community networking.
To view position description and to apply click here.
Applications close 4:00 PM Tuesday 20 April 2021.
Nurse Home Visitor x 1 FT (fixed term) – Mooroopna
Deliver the Australian Nurse-Family Partnership Program to clients in a home setting, alongside the Family Partnership Worker and Nurse Supervisor. Includes, promotional event planning and coordination, maintaining stakeholder networks, improving pregnancy outcomes, improving child health and development and helping parents develop a vision for their own future.
To view position description and to apply click here.
Applications close 4:00 PM Tuesday 20 April 2021.
Kinship Case Manager x 1 FT – Mooroopna
Work with and support children and young people and carers to meet case contracted kinship targets. The role will work directly within case management and care teams ensuring a shared understanding of key issues related to theoretical frameworks including attachment theory, trauma theory, brain development, ages and stages of development, resilience theory, strength-based approach and the neurobiological development of maltreated children. The minimum qualifications required to be considered for these positions include: Tertiary qualification in Community Services, Social Work, Youth Work or related discipline.
To view position description and to apply click here.
Applications close 4:00 PM Friday 23 April 2021.
Team Leader Kinship Care, Better Futures Home Stretch x 1 FT – Mooroopna
Provide strong leadership to a team of workers, oversee and maintain the responsibility for the Better Futures, Home Stretch Programs, staff operating in this space to ensure young people are transitioning occurs from Kinship Care to Better Futures Home Stretch. Minimum qualifications required to be considered for these positions include: Tertiary qualification in Community Services, Social Work, Youth Work or related discipline.
To view position description and to apply click here.
Applications close 4:00 PM Friday 23 April 2021.
Family Preservation Worker x 1 FT – Mooroopna
To provide intensive support to Aboriginal families in a culturally respectful way and to support parents to maintain care or to resume care of their child/children who are referred to the Family Preservation Program by Child Protection. The Worker is responsible for the provision of all aspects of casework services to families referred to the Rumbalara Family Preservation Program Minimum qualifications required to be considered for these positions include: Diploma of Community Services and Welfare Studies or equivalent is preferred.
To view position description and to apply click here.
Applications close 4:00 PM Friday 23 April 2021.
Assessment Officer x 1 PT (3 days per week) – Shepperton
Undertake in home holistic assessments, for people wanting to access Aged Care and Disability related supports and then match the client or carer’s needs and goals to the most appropriate service. The position requires someone who is experienced with navigating funded supports such as the Home and Community Care Program for Younger People (HACC PYP), Commonwealth Home Support Program (CHSP), the National Disability Insurance Scheme (NDIS); has an understanding of the issues faced by Indigenous and Torres Strait Islander people; and has Tertiary qualifications in Aged Care, Community Services, Case management or equivalent.
To view position description and to apply click here.
Applications close 4:00 PM Friday 23 April 2021.
Support Worker x Casual (flexible as per demand) – Shepperaton
Assist members of the Aboriginal and Torres Strait Islander Community by providing direct support to clients and consumers in the delivery of services for Home and Community Care Program for Younger People (HACC PYP), Commonwealth Home Support Program (CHSP) and the National Disability Insurance Scheme (NDIS) offered by Rumbalara Aged Care and Disability Services. Minimum qualifications required to be considered for this position include: Qualifications in Certificate IV in Aged Care Work or equivalent, or willing to undertake such training.
To view position description and to apply click here.
Applications close 4:00 PM Friday 23 April 2021.
Image source: Baldasso Cortese Architecture website.
