COVID vaccine FAQs: What GPs need to know

Magdalena Simonis

28/01/2021 4:48:28 PM

UPDATED: Prominent RACGP Fellow Dr Magdalena Simonis provides GPs with ready-made answers to help ease patients’ coronavirus concerns.

Patient asking GP question
Patients will likely have many questions in the lead up to and during the COVID vaccine rollout.

This article will be updated periodically to include additional information as it comes to hand.

These are difficult times for many people in the community and already, the issue of vaccine hesitancy is a concern that threatens to disrupt the Federal Government’s plan to deliver its national vaccine strategy for the benefit of the whole nation.  
It is time for us to open the conversation and engage patients, so that vaccine readiness is in the forefront of the public’s mind. 
During the early phase of the COVID-19 pandemic – a time when reliable coronavirus information was still limited – I contributed to an article to assist GPs when addressing questions coming in from the public.
As I have since been very active in informing the RACGP and Australian Medical Association (AMA) strategy, it makes sense to put some of that information in to a simple, easily accessible document.
Here are some frequently asked questions:
Question 1:
Now that the Pfizer/BioNTech vaccine has been given the green light, why are some people getting one vaccine and others getting a different one?
The simple reason for this is that we have all been waiting on science to prove the safety and effectiveness of the vaccines.
The key players in the scientific world have shared information on their vaccine strategy and trials, which is a world-first for this type of collaboration.
It’s like the international scientific community said: ‘You take this route, we’ll take this one and let’s see what we each arrive at. Then each one of us can take it to our national leaders to decide which vaccine to purchase and/or manufacture in bulk.’
The first vaccine to meet the highest Australian testing standards is the Pfizer/BioNTech vaccine.
However, it’s being produced in Belgium and the US, and as the governments of the world have monitored the developments, many like Australia had already placed their request for supply. As this is a global emergency, all nations have to share this resource, which means there will be a staggered supply of the Pfizer/BioNTech vaccine around the world. 
Other vaccines are on their way to being approved here also; however, they will be distributed in phase 1b, 2 and 3 to the rest of the population.
Question 2:
How safe are these vaccines? It feels as if there has been a rush to bring these to market.
You should feel assured that our drugs and vaccination safety watchdog, also known as the Therapeutic Goods Administration (TGA) of Australia, has some of the highest standards in the world for screening new treatments.
This means that we don’t just accept the information from other nations unless they uphold similar high standards. Even then, we put them through our own screening process as well, which has added to the delay in being approved for use here.
Question 3:
What about the other vaccines? Should I wait for those rather than have the one I am being offered?
Other vaccines are on their way to being approved here also and it might seem confusing or scary to think that this process has come so far so rapidly.
Of the 200 vaccine trials, only a handful have made it to the final phases of testing, and the technology that exists now is very different to the technology that existed 5–10 years ago.
If you think about your mobile phone today and compare it to what you were using five or 10 years ago that should give you an idea of the rate of technological progress made.
You can be assured that the vaccines Australia will approve will work and will have the highest possible safety profile.
We are fortunate that we can produce the next most likely vaccine – the AstraZeneca candidate – out of Australia and we should take the opportunity to protect ourselves and our loved ones from the crisis we are seeing unfold in the UK, USA, Brazil, India and other countries.  
Question 4:
Will having the vaccine mean that we can stop the social distancing, mask wearing and hand washing?
The simple answer is, ‘not yet’.
Every Australian should feel proud that we have such low cases of COVID-19 and COVID-19-related deaths, because it has been very difficult to adhere to physical distancing and to change our lives around, yet we have all contributed by making these sacrifices.
But in order to keep things this way and to prevent a surge in hospitalisations and deaths due to some quarantine accident, as was experienced in Victoria in July 2020, we need to vaccinate the majority of Australians. 
The vaccination program will take time, as it will occur in phases while the supplies of vaccine become available. Teams of doctors, an array of GP practices, and nurses are already preparing to receive these supplies in their clinics.
We are all in this for the long haul and need to stick to the national plan, which is to protect all Australians.
Question 5:
What side effects can I expect after having the vaccine?
So far, the side effects from the Pfizer/BioNTech vaccine can vary from local redness and a sore arm, to mild flu-like symptoms. 
They should go away in a few days and reports from both the US and UK seem to list symptoms that are quite mild.
This has given us a great deal of confidence to proceed with the national vaccination strategy, which includes the most vulnerable members of our population in the first phase.
The best place to find the latest information is the US Centers for Disease Control (CDC) website, and the UK’s public health page, as these countries have already administered millions of coronavirus vaccine doses.
There is also an Australian site that is updated regularly and is being informed by experiences overseas.
Question 6:
Will the COVID vaccine give me a COVID-19 infection?
No, it will not.
Question 7:
How will I report a suspected side effect?
There are several ways of doing this. You can tell your GP directly or report this to the centre where you received the vaccination.
Sometimes they are local reactions but not side effects that raise alarms bells.
If you are not sure about the reaction you are having, you can also report this directly through the TGA website.
Question 8:
Do I have to have the vaccine if I don’t want to?
No, you do not. The vaccine will be free and voluntary for all Australians. 
It’s important to ask yourself what it is you are concerned about and to make a list of your questions. It can be very confusing to make a decision on your own, so make the time to speak with your GP and start the conversation, so that you’re able to make an informed decision.  
We’re well aware that there will be some degree of vaccine hesitancy and this is partly because this is all so new, and also because people with extreme views express these on social media platforms, arousing strong emotions against population-based health strategies. 
The GPs in Australia are among the most highly regarded in the world for the standard of training and education we receive and will be at the heart of the vaccine delivery strategy. We’re all ears and ready to answer your questions as honestly as we can.

Dr Magdalena Simonis has been helping to inform the RACGP and AMA COVID strategy.

Question 9:
The Pfizer/BioNTech vaccine (also known as COMIRNATY), has been shown to prevent severe COVID-19 infection and death. Does the Oxford University/AstraZeneca vaccine do the same?
Yes, they are both very good at providing protection from severe disease and even death from COVID-19, which is why they are high on the list of vaccine candidates for Australians.
We believe that neither of the vaccines will prevent the spread of COVID-19 between people who are carrying the virus silently, but not sick with it. That’s why social distancing, hand washing and wearing masks in close spaces will remain in place for a while longer until we get the spread of disease under control.  
Question 10:
The vaccine needs to be given in two doses. What happens if I delay or miss my second dose?
Both the Pfizer/BioNTech and Oxford University/AstraZeneca vaccines need to be delivered in two doses: Pfizer 21 days (three weeks) apart and AstraZeneca 12 weeks apart. A delay can affect their efficacy and make them less protective. 
If you are travelling, it’s important that you arrange for the second dose to be given elsewhere. This will be recorded on the Australian Immunisation Register.
You should get the second dose even if you have side effects after the first shot, unless the vaccination provider or your doctor tells you not to get the second injection.
If you miss your second dose, this means you are not protected against the effects of COVID-19 if you become exposed.
The UK has delayed the delivery of the second dose due to supply shortages. Australia is undertaking a mammoth exercise to ensure we do not experience similar delays with the second dose.
Question 11:
Who will get the vaccine first?
Australia’s national COVID vaccine strategy has been outlined to take place in three phases, with each having a stage (a) and (b) around 2–3 weeks apart.
Phase 1a: quarantine and border workers, frontline at-risk health workers, residential aged care and disability staff, residential and disability care residents.
Phase 1b: adults over 70, all other health workers including GPs, Aboriginal and Torres Strait Islander people, younger adults with a medical condition, critical and high risk workers such as police, fire and emergency services, and meat processing workers.
Phase 2a: adults over 50 years, continuing on phase 1b with other high risk critical workers.
Phase 2b: balance of adult population and catch up of any unvaccinated Australians from previous phases.
Phase 3: people under 18, if recommended.
Question 12:
Is the vaccine safe for pregnant women?
Neither of the vaccines Australia is slated to receive initially have been tested on pregnant women in clinical trials, so there’s insufficient information about their effects on pregnant women and fetuses.
Administration should be considered only if the risk of contracting COVID-19 is high and cannot be avoided, or in case of underlying conditions that may result in serious complications of COVID-19.
The UK has provided this link for women wanting to know more about the safety of the vaccine.
Question 13:
When will I be able to see my GP for this?
Some general practice clinics will be administering the vaccine from late February 2021 and some will not. 
All GPs have been invited to participate in running COVID vaccination clinics from their practices; however, not all practices have the staff and the space to handle large numbers of people lining up to have the vaccine.
It’s not like the regular flu vaccine clinics that you are used to. This will be a slower process as you will need to be asked a few questions, fill in a consent form and then wait for up to 15 minutes nearby or in a separate area with appropriate physical distancing.
You can ask your GP now if their practice will be enrolling to deliver the vaccine in their clinic during the phase 1b and 2 rollout. By the end of February, all GPs will have a list of nearby facilities that will be administering the vaccine.

The aim is to get GPs to register for the rollout; this list will not be exhaustive, but instead will be added to as more practices come on board over time. 
Question 14:
If I don’t have a GP, where can I go to get this if I want to?
There will be designated COVID vaccination centres, much like the COVID testing clinics that you have grown accustomed to, and respiratory clinics for those being checked for symptoms.
You can also voluntarily enrol at one of the general practice clinics that is involved in the vaccination strategy and start up a relationship with a GP at the practice for your other regular health checks. This is a good opportunity to think long-term about your health.
We believe it is not likely that the vaccines will prevent spread of COVID between people who are carrying the virus silently, but are not sick with it. That’s why social distancing, hand washing and wearing masks in spaces where social distancing is not possible, will remain in place for a while longer until we get the disease spread under control.  
Question 15:
Which vaccine will I have?
Most people in the community will not receive the Pfizer/BioNTech vaccine, which is being delivered in phase 1a. You will most likely be offered the Oxford University/AstraZeneca vaccine, as it seems to give good protection and appears that it will most likely be the next vaccine to be rolled out to the wider community.
It is entirely different, easier to handle, based off existing technology, and can be produced in Australia.
Question 16:
If I have multiple allergic reactions to drugs and have previously reacted to vaccines should I have this?
If you have an immune condition or a history of a severe allergic reaction to other vaccines, it’s important to discuss these issues first with your GP. 
The US CDC has created a table that outlines how to determine whether a person with previous allergic reactions should be vaccinated.
Question 17:
Can I have the flu vaccine too?
Yes you can, but it is advised that you space them at least two weeks apart – either before you commence the COVID-19 vaccination or two weeks after the second dose – so as to ensure a maximal immune response to both vaccines.
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A.Prof Vicki Kotsirilos, AM   29/01/2021 8:06:03 AM

Excellent clear advice for patients Dr Simonis, thank you!

Dr Jack Naung San M   29/01/2021 8:32:07 AM

Very informative, thanks!

Dr Alan Graham MacKenzie   29/01/2021 11:43:08 AM

It irritates me when “expert” advice says “ask your GP”
We are reliant on drug company data and “expert” advice .
We have no personal knowledge of what is safe or not .
Can an expert please answer
1 can a person who has had a Renal Transplant have the vaccine
2 can a person on treatment for Myeloma have the vaccine
3 Can a person with severe neutropenia have the vaccine
4 Do we tell all pregnant women they should not have the vaccine
These are all questions I will be asked.
My uninformed answer will be NO.Am I correct ?
Secondly if 10-40 of every hundred Astra Zeneca vaccinations is unsuccessful is it necessary to test antibody responses to verify immunity before we issue a certificate which allows patients to go to Nursing Homes,cinemas,hairdressers ,night clubs,pubs,etc ?

Dr Annabel Kain   29/01/2021 2:14:06 PM

Good summary and some great links but:
1. GPs will not have vaccines by the end of February
2. "There will be designated COVID vaccination centres, much like the COVID testing clinics that you have grown accustomed to" - this is not the case as C'wealth not providing funding for these kind of centres beyond GPRCs and Aboriginal health. The hospital hubs are for frontline workers, quarantine, etc. You might be referring to the GP vaccination centres discussed elsewhere in the article.
3. "younger adults with a medical condition" is not clearly defined anywhere - many patients will have this question
4. I think the second dose for AZ is 4 weeks later, but suggestion it might even be extended.

Dr Magdalena Simonis   29/01/2021 4:20:33 PM

Thank you all for your comments. I understand how you feel Dr MacKenzie and hope that my attempt to answer your questions is helpful.
Transplant patients can have the mRNA vaccines because they are not live. If on immunosuppressive treatment they might not respond. Same with other lymphoid malignancies- they won’t have a good immunoglobulin response. Good sites include the Irish and
Same goes for severe neutropenia.
As for pregnancy RANZCOG
A lot is in development and the international community is openly sharing from its experiences. If in doubt, you can contact me and I will endeavour to find the information with you. It’s quite a journey we’re all on.

Dr Magdalena Simonis   29/01/2021 6:36:44 PM

Hello Dr Kain, thank you for your comments. Yes, AZ is in 2 doses 28 days apart - might be delayed but for now, it stands at 4 weeks - Pfizer at 3 weeks apart.
As for vaccination sites:
Coronavirus Victoria: Mass COVID-19 vaccination sites to be set up in Melbourne.
Things are changing no doubt as the implementation of the community delivery is being designed as I write this, but in the absence of adequate GP centres, larger sites will be used for this also. As for GPs having access to AZ vaccine, that depends on TGA approval and the hopefully will be by end Feb.we should also have a good idea of which GPs have registered for this. Online training for vaccination delivery is being provided to interested GPs already in the ensuing 2 weeks. exiting times and and ever changing space, which is why it is important we get key easy messages out now.

Dr Alan Graham MacKenzie   29/01/2021 11:19:38 PM

Thanks Magdalena
That was very helpful

Dr Hilton Leslie Shapiro   6/02/2021 12:21:20 PM

Question 13:
When will I be able to see my GP for this?
You state that “ all GPs have been invited to participate in running COVID vaccination clinics from their practices “however, not all practices have the staff and the space to handle large numbers of people lining up to have the vaccine. This is not factually correct. ONLY ACCREDITED practices were invited. ...I am a solo GP and originally was accredited for the first four cycles. However the cost benefit ratio and the hassle of maintaining accreditation meant that it was not worth my while to continue with RACGP accreditation. That is not to say that I don’t invest a lot of time and effort in immunisation and all the important issues that go around safe practice and diligent cold chain management. I have also included a clever logger system which logs my vaccine fridge temperatures to my mobile phone every two minutes and sends alerts if for any reason the vaccine fridge is out of temperature range!!

Dr Alison Anne Morris   18/02/2021 9:20:38 AM

It appears that GPs are not considered front line health workers?!? I beg to differ. I'm over 60 with co morbidities. Is it possible that that those like me, and I'm sure I'm not alone, can get the Pfizer vaccine - especially when I live near a vaccine hub.

Dr Alison Anne Morris   18/02/2021 7:11:04 PM

It appears that GPs are not considered front line health workers?!? I beg to differ. I'm over 60 with co morbidities. Is it possible that that those like me, and I'm sure I'm not alone, can get the Pfizer vaccine - especially when I live near a vaccine hub.

Satit   22/05/2021 8:01:00 AM

I have been trying to book an appointment for months, after 5 attempts they realised that they don't have any of our doctors (4 of us) email address on their system. I decided not to wait for an invitation e-mail from Queenslands health which just received 2 days ago to confirm that I am eligible for 1B. I managed to get AZ just before the new guideline regarding adult younger than 50 came out. I had a quite significant reaction but I won't say severe reaction (Sore arm, fever, chills, persistent headache not responded to panadol, vertigo, N/V, and bleeding spot not bruises). Took me a week before fully recovered. I am not that mentally and physically prepared to experience that again. I rang Hospital and they refused to give me pfizer which is fair enough. I am not even sure how am I going to react to Pfizer either. 6 weeks to go. Hope we will have more information.