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PDL issues guidance on administering the AstraZeneca COVID-19 vaccine to patients below 60 years

Pharmaceutical Defence Limited (PDL) says its professional officers have received several calls relating to the administration of the AstraZeneca (AZ) vaccine in patients below 60 years of age.

While the ATAGI advice regarding age ranges for AZ vaccine has not changed, recent Commonwealth government announcements have reiterated that healthcare practitioners – including pharmacists – can, with informed consent, administer the AstraZeneca vaccine to patients under the age of 60 years in certain circumstances.

PDL has previously confirmed to all members that the PDL Master Policy provides cover for COVID-19 vaccination when you take reasonable steps to understand and comply with the obligations that are placed on you by government approved protocols.

This includes, but is not limited to, government training, standards, directives, clinical guidelines and recommendations for the administration of vaccine which are applicable at the time of providing the vaccine.

Following the latest announcements, when handling requests for AZ vaccines in patients under 60 years of age, PDL said pharmacists should satisfy themselves of the following:

  • The Pfizer (Comirnaty) vaccine is not available to the patient;
  • The benefits to the patient are likely to outweigh the risks;
  • The patient gives informed consent to the vaccination knowing the risks;
  • State legislation permits pharmacist vaccination in this age range – for example, the NSW Vaccination Standard does not allow for pharmacist administration of COVID-19 vaccines in patients less than 60 years.

ATAGI guidance also indicates that pharmacists can administer the second dose of the AZ vaccine if the patient had no reactions to the first dose.

As long as government approved protocols continue to be complied with, then cover under the PDL Master Policy will respond as originally advised.

As the information on this issue is often changing, PDL reminds vaccinators to use the most up to date guidance documents for consumers, primary care and hospitals when discussing any aspect of COVID-19 vaccination. Pharmacists are responsible for ensuring their understanding of the guidelines is current.

PDL shared the example of a recently updated guidance document as a reference to benefit versus risk. The government document looks at weighing up the potential benefits against risk of harm from the AZ vaccine.

Another resource is the ATAGI statement on recent safety concerns. ATAGI has recommended that the COVID-19 vaccine by Pfizer (Comirnaty) is preferred over the AZ vaccine in adults aged under 50 years.

This recommendation is based on the increasing risk of severe outcomes from COVID-19 in older adults, and hence a higher benefit from vaccination, in addition to a potentially increased risk of thrombosis with thrombocytopenia following the AZ vaccine in those under 50 years.

“COVID-19 Vaccine AstraZeneca can be used in adults aged under 50 years where the benefits are likely to outweigh the risks for that individual and the person has made an informed decision based on an understanding of the risks and benefits,” said ATAGI.

“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.”

PDL recently provided guidance for pharmacists about the government’s new indemnity scheme for COVID-19 vaccines – read the article here.

*Please note that this advice is based on the information current as of 7th July 2021. Please ensure that this information is personally validated at the time of reading.

For immediate advice and incident support, call PDL on 1300 854 838 to speak with one of our Professional Officers. We are here to support our pharmacist members 24/7, Australia-wide.

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