This update provides information to help primary care providers tackle current challenges, including COVID-19. Submissions can be sent to covax@murrayphn.org.au

View previous editions here.

COVID vaccination provider bulletins 11 and 15 November

Pfizer Bivalent Original/Omicron vaccine
ATAGI have recommended that the Pfizer bivalent vaccine can be used as an alternative vaccine for any booster dose in people aged 18 years or older, according to the current recommendations for booster doses. No other changes have been made to booster recommendations.

The Australian Government will include Pfizer bivalent in the COVID-19 Vaccination Program from 12 December.

Co-administration of Pfizer bivalent vaccine with other non-COVID vaccines is acceptable, as per current ATAGI clinical guidance. It is NOT recommended as a primary course of vaccination or as a booster for people under 18 years.

All general practices currently participating in the COVID-19 Vaccine Program will be onboarded for Pfizer bivalent. Murray PHN will contact each practice in the coming days with details.

Pfizer vaccine for 6 months to 4 years
ATAGI have recommended the use of Pfizer 6 months to 4 years for children with severe immunocompromise, complex or multiple health conditions, or disability with significant or complex health needs.

The recommendation is for three primary doses, administered at eight-week intervals. There is no preference for either the Moderna 6 months to under 5 years or Pfizer 6 months to 4 years in high-risk children; however, completion of a primary schedule with the same brand of vaccine is recommended.

The Australian Government will include Pfizer 6 months to 4 years in the COVID-19 Vaccination Program from 16 January 2023.

All general practices currently participating in the COVID-19 Vaccine Program will be onboarded for Pfizer 6 months to 4 years. Murray PHN will contact each practice in the coming days with details.

Moderna bivalent allocation
Sites administering Moderna bivalent will have their allocation increased to 200 doses/fortnight from 19 November.

CVAS updates
Sites are reminded of the following CVAS report requirements:

• Delivery acceptance reports are due on the day of receiving your vaccine delivery, no later than 9pm local time on the day of delivery
• Stock management reports are due every week no later than 9pm local time Friday
• Wastage reports are due within two hours of any wastage incident involving 10 or more vials of a vaccine product.

• GPs, ACCHOs and GPRCs willing to manage COVID positive patients face-to-face, until 31 December 2022
• ACCHOs and rural and remote GPs willing to manage COVID-positive patients virtually and respiratory patients face-to-face, where workforce capacity is limited and the GP is serving the community for most or all health needs, until 31 December 2022
• All GPs and GPRCs willing to manage COVID positive people virtually, and respiratory patients face-to-face, until 31 December 2022
• Community pharmacists who are administering COVID-19 vaccinations and booster doses, until 31 December 2022 are eligible to order enhanced PPE bundles.

Flood recovery
Here are some quick links to help you navigate recovery. If you require additional support, email gpsupport@murrayphn.org.au or visit our website for helpful advice and information for community and health services.

• Focus on Emergency Response has been collated by Murray PHN to provide a quick-reference, printable document for use by health services staff dealing with emergency situations.
• HealthPathways: General Practice Management During a Disaster and Rural Community Support During Adversity 
• Victorian general practices: Emergency Response Planning Tool (ERPT)
• The Pharmacy Guild of Australia: Information for pharmacies affected by disaster.
• Department of Health and Aged Care: Flood and storm information and support
• Victorian Government: Flood Recovery Hotline (1800 560 760) 
• Emergency Relief Centres: here.

• Contaminated floodwater can increase the risk of infections, see advice from Loddon Mallee PHU, NSW Health, Healthdirect and WorkSafe QLD.
• A growth in mosquitos may increase the risk of mosquito-borne diseases. Share 'Beat the Bite' messaging.
• Look out for signs that you or those around you might be struggling with trauma. Head to Health services can be accessed by calling 1800 595 212 between 8.30am and 5pm, Monday to Friday except on public holidays.

Japanese Encephalitis Virus (JEV)
It is strongly recommended that JEV vaccination be reported to the Australian Immunisation Register (AIR) using your medical practice software. Reporting these vaccinations to the AIR means that the register contains a complete and reliable dataset and can monitor immunisation coverage and administration. It also means that individuals have a complete record of their vaccinations. More information for Victorian immunisation providers can be found here.

The Victorian and NSW governments have expanded eligibility criteria for free JEV vaccination. Vaccination can also be administered after arrival in flood affected areas to those from other regions deployed for prolonged recovery efforts. Further information is provided in this factsheet. Contact immunisation@health.vic.gov.au for more information and assistance with vaccine ordering.

The vaccine is free for eligible people and general practices are encouraged to bulk bill for the service whenever possible.

Providers of the vaccine in the Murray PHN region can be found here and local public health units are also providing JEV vaccines. Please call ahead to ensure stock is on hand and note some sites will be closed due to floods. 

JEV serosurvey
The Victorian Department of Health is currently leading a study investigating JEV seroprevalence in northern Victoria. The Department is urgently seeking participants, particularly from the Mildura and Shepparton regions, to be part of this study which concludes at the end of November.

Individuals can be part of the study by attending an Austin Pathology site (listed below), completing a questionnaire, and giving a blood sample.

Mildura:

• Austin Pathology, 216 Ontario Avenue, Mildura (Monday-Friday: 8am-5pm, Saturday: 8am-12pm) 

Shepparton:

• Austin Pathology, GV Health, Graham St, Shepparton (Monday-Friday: 8am-5pm)
• Austin Pathology, Shepparton Medical Centre, 45 Graham St, Shepparton (Monday-Friday: 8am-3pm)
• Austin Pathology, Corio Street Community Health, 135 Corio St, Shepparton (Monday-Friday: 7:30am-4:30pm, Saturday: 8:30am-11:30am)

• GV Health COVID-19 vaccination buses - including Pfizer, Moderna bivalent boosters and JEV vaccines.
• Loddon Mallee Public Health Unit outreach vaccination clinics – COVID, Influenza and JEV.
• Ovens Murray PHU vaccination clinics – COVID-19, influenza and JEV vaccines.

New HealthPathway
The COVID-19 Referrals and Escalation of Care pathway includes information about the face-to-face home assessment and monitoring service for COVID-19 positive patients as well as the Hospital-Led Virtual Home-Based Monitoring Program.

Infection Prevention and Control
Victorian general practices, community pharmacists and Aboriginal Community Controlled Health Organisations can call the Infection Prevention Helpline on 1800 312 968 or 03 9956 1046 9am-5pm Monday to Friday for free infection prevention and control advice.

Supporting the disability sector

Murray PHN is helping disability providers and liaison officers to engage primary care providers for in-reach vaccinations. If your practice can assist, email: covax@murrayphn.org.au

Practices can also access support and resources from disability liaison officers in: 

• Albury/Wodonga
• Bendigo/Loddon Mallee
• Shepparton/Goulburn Valley
• Wangaratta/North east

Education and training

Upcoming events

• Victorian PHNs: Statewide PHN Immunisation Forum (Japanese Encephalitis Virus, Monkeypox, Shingles, Meningococcal) | 17 November, 6.30 – 8.30pm
• Avant: An information session on managing COVID risks in the workplace after the revocation of public health directions | Thurs 24 Nov, 1-2pm

Online learning

• Phoenix Australia: Trauma-informed care during COVID-19 (self-paced approx. 5 hours). Use code PHNMCOVTIC20 to access the course free of charge.
• Phoenix Australia: Being Trauma Aware for Trauma-informed Care (self-paced 90-minutes). Use code PHNMCOVTIC20 to access the course free of charge. This course is included as part of the full Trauma-informed care course above.
• Victorian Department of Health Immunisation eLearning – JEV and Influenza
• Victorian Department of Health and VICNISS: Infection prevention and control free online learning package
• NSW Health: Fit testing and fit checking videos 

• Health Issues Centre: Covid antivirals – How do they work, who should use them and how do we increase uptake (7 September)

New and updated resources

• Vic DoH - JEV vaccine eligibility checklist for the public
• Vic DoH – JEV vaccination consent form
• Agriculture Victoria – flood response
• Better Health Victoria – JEV information in your language
• Health Translations (Victorian DoH) – JEV in Victoria
• NCCET– drug treatment flowcharts for adults, children and adolescents, and pregnant and breastfeeding women with COVID-19