This Primary Care Update expands on the previous COVAX updates to include a broader range of information to support current challenges faced by primary care providers. If you have items to share across the network, please send them to covax@murrayphn.org.au

Please forward this update to any colleagues who may be interested and view previous editions here and note there will be no Primary Care Update next week due to the short week, but any updates will be included in eNews on Wednesday - subscribe here.

COVID vaccination provider bulletin 13 Sept

Moderna bivalent Original/Omicron vaccine
ATAGI have recommended that the Moderna 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 Moderna bivalent in the COVID-19 Vaccination Program from 10 October.

Co-administration of Moderna 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.

Provider information

• All sites currently participating in the COVID-19 Vaccine Program will be onboarded for Moderna bivalent in tranches. Murray PHN will advise you of your tranche as soon as we have that information. 
• All sites will receive an ongoing allocation of 100 doses. 
• If an order is not placed within eight weeks, the site will be deactivated for Moderna bivalent
• CVAS will list the vaccine as ‘Moderna bivalent 18+ blue/green’

Cold Chain Breach (CCB) process
If your vaccines have been involved in a CCB, these are the steps to follow:

1. Place affected vaccines in quarantine within the appropriate cold chain storage requirements
2. Mark stock as ‘Do not use. Do not discard.’
3. Report potential CCB to the VOC on 1800 318 208*
4. Wait for the outcome of assessment and advice on whether the vaccines are safe to use.

*Outside of VOC operating hours, email the required information to covid19vaccineoperationscentre@health.gov.au for assessment during business hours. 


Shelf-life extensions
The TGA have approved shelf-life (manufacturer expiry) extensions for the vaccines listed below, provided that approved storage conditions have been maintained. Please be aware that the packaging associated with the listed batches has not been amended to reflect the extended expiry dates. Please update the expiry date on any vials you have on site.

• Victorian Department of Health webpage
• Murray PHN webpage
• Better Health Channel – for enquiries from members of the public
• Commonwealth patient information leaflet

Japanese Encephalitis Virus (JEV)

• GV Health COVID-19 vaccination buses also providing Influenza and JEV vaccines to those who meet eligibility criteria.
• Bendigo Health Covid Clinic is open 10am-5.30pm, Tuesday to Saturday. 
• AWH Outreach Vaccination Services

COVID-19 antivirals
The Victorian Virtual Emergency Department (VVED) can prescribe COVID-19 antivirals to Victorians who return a positive result and can’t get a GP appointment or access a GP respiratory clinic. The VVED can assess patients, determine their eligibility for COVID-19 medications, and prescribe these medications.

Practices and pharmacies are encouraged to proactively identify at-risk patients and put plans in place to support their access to timely care, including antiviral and other early therapies if they contract COVID-19, influenza or other respiratory viruses.

For resources including a list of local dispensing pharmacies (updated 29 August), visit Murray PHN's antiviral webpage.

Supporting the disability sector

Disability providers and liaison officers have been advised to contact Murray PHN for assistance with engaging local primary care providers to offer in-reach vaccinations or to request Commonwealth in-reach. If your practice is able to assist with in-reach or homebound vaccinations, e: covax@murrayphn.org.au

Primary care vaccine providers can access support and resources from Disability Liaison Officers to enable people with disability to access COVID-19 vaccination at their site in: 

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

Mildura helpline for former Tristar patients
Former Tristar Mildura patients can call the Mildura Helpline for care advice and information on 1800 191 663 daily, between 8am and 10pm. Once a nurse has assessed symptoms, people may be eligible to receive a call back from a GP. For more information and links to local and other supports, click here.

Education and training

• Murray PHN: Infection Prevention and Control in general practice update (including for Monkeypox) | 15 September, 12.30-1.30pm

Online learning

• Phoenix Australia: Trauma-informed Care training for general practice staff – use Coupon Code: MPHN38 to complete the training free of charge
• Victorian Department of Health Immunisation eLearning – JEV and Influenza courses
• Victorian Department of Health and VICNISS: Infection prevention and control free online learning package
• NSW Health: Fit testing and fit checking videos

• Kirby Institute: Monkeypox: what we know and what we need to learn (22 August)
• EMPHN: Victorian Virtual ED – your questions answered (16 August)
• Western Vic PHN: What is next for COVID-19 care in General Practice (1 August)
• Safer Care Victoria: COVID+ Pathways: Supporting community access for COVID therapies (27 July)
• Murray PHN: COVID+ home visits: Infection, prevention and control (15 Dec 2021)

Communication and engagement

• Murray PHN's 'It Starts With You' Campaign' supports health services, organisations and community groups to raise awareness of the importance of getting vaccinated against COVID-19. Click here to download the campaign materials.

New and updated resources

• Victorian DoH – Evusheld prescribing resources
• Victorian DoH – forms to request access to medications for patients with COVID-19
• DoHAC – updated poster - COVID-19 vaccines in Australia (2 September)
• DoHAC – Children’s remember to check poster for Moderna 6 months – 5 years
• Victorian DoH – COVID medicines eligibility tracker
• DoHAC – Getting help for Long COVID (24 August)
• Moderna information and consent form for parents and guardians of children aged 6 months to 5 years (22 August)
• NCCET – Care at home for children and adolescents with mild COVID-19
• Victorian DoH – clinical decision-making tool for COVID-19 medication selection for at risk people who do not require oxygen (10 August)
• Department of Veterans Affairs (DVA) – COVID-19 Antiviral Veteran Factsheet
• DVA - COVID-19 Antiviral Medicines GP Factsheet
• NCIRS guide - Co-administration of vaccines for adults: a guide for immunisation providers (August 2022)
• ATAGI poster – Fourth Dose Eligibility (18 July)
• Fact sheet - Paxlovid® (nirmatrelvir and ritonavir) PBS listing (July 2022)
• Fact sheet - Lagevrio® (molnupiravir) PBS listing (July 2022)
• Updated onboarding pack - COVID-19 vaccines
• Monkeypox (MPX) – latest government advice
• Japanese encephalitis virus (JEV) – latest government advice
• COVID-19 resources for First Nations communities
• NCIRS COVID Vaccine FAQs
• AusVaxSafety COVID-19 vaccine safety data (including children 5-11 yrs)
• ATAGI clinical guidance for COVID-19 vaccine providers in Australia

Further assistance

• Non-urgent COVID-19 vaccination PHN enquiries e: covax@murrayphn.org.au
• Other primary care issues e: gpsupport@murrayphn.org.au
• Murray HealthPathways is updated daily when necessary and should be referred to for the latest information
• COVID-19 Vaccination Advice for Providers website is regularly updated
• Issues and queries relating to the ordering of vaccines, stock management, vaccine delivery dates and the online portal should be directed to the VOC on 1800 318 208.