Covid-19 and Covid vaccine information - main sources

• Cth - resources. Previously excellent translated information, now not easily found. 
• Immunisation handbook - Covid
  
• WHO, NCIRS, MVEC, University of Melbourne vaccine updates, Doherty Institute modelling
  
• Vaccine appointment finders - Cth vaccine clinic finder, Covidnearme, EVA - Easy vaccine access
• Free RAT tests available in local councils- all people in Victoria, Medicare not required 
  
• ATAGI clinical guidance covid vaccines and updated booster advice (Sep 2023)
• 
  
• CDC - SARS-CoV-2 variant classifications

As of 14 Jul 2024

• Covid cases - World - 775.7 M and Australia 11.97M, (1200 7-d average), 1026 hospitalised (also see DH) and ICU 9.
• Covid deaths - World - 7.05M and Australia - 25,397 (983 since 10 Apr 2024)
  • The overall case fatality rate was ~2% for the initial strains of covid. Deaths increased with age (>50y and more so >70y) pre-existing medical conditions, and have been higher in Black, Asian and minority Ethnic (BAME) in US and other data. In Australia, higher mortality was seen in Middle East born populations.  See risk calculator. 
• Vaccination numbers
  • World - 13.58B doses (5.63B at least one dose, 5.18B people fully vaccinated)  
  • Australia - 12 Jul 2024 - 71.8M doses >95% of age 16y+ 2 doses, boosters in last 6 months: 35.6% age 75y+, 23.6% 65-74y and 4.1% age 18-64y
    • Children not reported since Mar 2023@15/3/23 - 12-15y - 78.4% one dose, 73.0% fully, 5-11y 48.2% one dose, 38.5% fully (0-4y minimal)
      
      
• Vaccine safety and development process - Australia followed normal process for vaccine registration and monitoring through the TGA.
• Types of vaccine (Handbook, WHO). Also see older UoM updates *most recent is Dec 2022
  • mRNA vaccines - use RNA to generate a protein that itself safely prompts an immune response 
    • Pfizer - different formulations for age 6m and older, dose 3mcg 6m-4y, 10mcg 5-11y, and 30mcg 12y+
      • Original formulation used 6m-4y (3mcg dose, maroon cap), monovalent omicron-based vaccines preferred for primary course and booster doses age 5y+ (Nov 2023)
        
      • bivalent (original/Omicron BA.4/5) age 12y+ (30mcg dose, grey cap)
      • monovalent Omicron XBB.1.5 age 5-11y (10mcg dose, light blue cap) and 12y+ (30mcg dose, dark grey cap)
    • Moderna
      • monovalent Omicron XBB.1.5 - age 12y+ (50mcg dose)
  • Viral vector vaccine - uses a safe virus that cannot cause disease as a platform to generate an immune response. Previous Astra Zeneca vaccine.
    
  • Protein conjugate vaccine - uses part of the spike protein from covid with an adjuvant to boost immune response. Previous Nuvaxovid (Novovax) for age 12y+, not manufactured after early 2022, and last doses expired Jan 2024.
    
    
• Vaccine efficacy  many studies prior to omicron variant and omicron vaccine, difficult to compare vaccines, and efficacy wanes with time. In general, for both Delta and Omicron, hybrid immunity (infection + vaccination) provides the greatest protection (highest level and longest duration), and while protection wanes for re-infection, it remains high against hospitalisation/death.
  • Pfizer - 55-95% any infection, 18-97% symptomatic infection, 74-99% severe disease/hospitalisation, 90-100% death 
    • Omicron - (studies on ancestral vaccines) any 55%, Sx infection - varies, 3rd dose post-infection 76%, 2nd dose post-infection 55%, hospitalisation/death - varies, ~70-90%, reduces with time, 4th dose more effective than 3 doses. See ATAGI advice on XBB.1.5 vaccines Nov 2023.
      
      • Children 5-11y - fully vaccinated 41-83% protection against hospitalisation
  • Moderna - 37-92% any infection, 45-95% Sx infection, 77-98% severe disease/hospitalisation, 98% death
    • Omicron - (studies on ancestral vaccines) any 20-64%, Sx infection ~40-60%, hospitalisation/death - varies, ~65-95%, reduces with time, higher for boosters, 4th dose more effective than 3 doses. See ATAGI advice on XBB.1.5 vaccines Nov 2023.
  • Novovax - limited data, around 90% symptomatic infection, 100% moderate-severe (adults).
• Covid vaccines do not prevent transmission of infection.
  
  
• Vaccine recommendations: see Handbook, C^th summary - also summary below:

  • *6 months - 4 years with severe immunocompromise* or complex medical conditions - 2 doses, consider 3rd dose based on risk-benefit assessment. From June 2023, only Comirnaty vaccine for this age group (3mcg dose). Separate from other vaccines (7-14 days). Omicron XBB.1.5 expected to be available 2024. No booster doses.

  • 5-17 years Omicron XBB.1.5 vaccines  
    • Severe immunocompromise *2 doses, consider 3rd dose based on individual risk-benefit assessment. Boosters: consider every 12 months based on risk-benefit assessment.
    • Complex medical conditions *1 dose. No booster doses.
    • All others - not recommended.
      
      
  • 18 years and older - *now 1 dose primary course, Omicron XBB.1.5 vaccines. *Severely immunocompromised 2 primary doses, consider 3rd dose (doses 8 weeks apart). Vaccine can be given during pregnancy or breastfeeding; unvaccinated pregnant women are recommended to have a primary course of covid vaccination. Boosters: regardless of prior doses, if 6-months after last covid vaccine (Omicron XBB.1.5-based vaccines preferred):
    
    • 75 years and older - recommended every 6 months
    • 65-74 years - recommended every 12 months, consider every 6 months
    • 18-74 years with severe immunocompromise - recommended every 12 months, consider every 6 months
    • 18-64 years consider every 12 months based on risk-benefit assessment.
      
      
• Omicron XBB.1.5 vaccines: 5-11 years Comirnaty (10mcg light blue cap), 12 years and older either Comirnaty (30mcg dark grey cap) or Moderna Spikevax (50mcg).
  
• The vaccine is free for everyone in Australia, even if they don't have Medicare, the vaccine is not mandatory. 
  
  
• How do I get vaccinated? - Sites include GPs, pharmacists, Cth vaccine clinic finder, Covidnearme 
  • Continue normal medicines, seek medical advice if on immunosuppression, immunotherapy, chemotherapy or anticoagulants (heparin), 
  • Covid vaccine can be given with other vaccines in age 5y+, for children 6m-4y it is preferable to separate Covid vaccine from other vaccines by 7–14 days.
• Consent process - ATAGI guideline on consent.
  
  
• Side effects - the main side effect of covid vaccine is to avoid serious illness and hospitalisation with Covid-19
  • All vaccines can cause side effects, usually these are mild and last 1-2 days. Common side effects include a sore arm, fatigue, headache, fever and muscle aches - take panadol or ibuprofen if needed. Respiratory symptoms (coryza/cough) are not associated.
  • Serious side effects are rare:
    • Anaphylaxis ~10 per million doses (also see CDC)
    • Deaths - (TGA Oct 2023) -14 deaths likely related to vaccination (none in 2023), 13 with AZ vaccine, 8 from TTS, 5 other, 1 a/w Moderna booster, all age 21-81y
    • Myocarditis and pericarditis monitoring - 1-2/100,000 Pfizer, 2/100,000 Moderna. More common after 2nd dose in 12-17y males (13/100,000 & 24/100,000 respectively) and males < 30y (9/100,000 and 23/100,000 respectively). Less common after booster doses <1/100,000. 
• Monitoring - AusVaxSafety - (as of 15/4/24) 6.81M people provided information 3 days after vaccination, 43.7% reported any side effects, 0.9% needed to visit a doctor or emergency department.
• AskShareKnow decision aids (includes picture based information).
• Records - vaccines are recorded on Australian Immunisation Register (AIR). People without Medicare can also get an AIR records. Covid vaccination does not affect Centrelink payments. AIR records are individualised from age 14 years.
  
• Questions on vaccinations - Commonwealth - is it true?, NCIRS, MVEC, allergies, MVEC vaccine confidence, and Victorian DH translated
• If you have symptoms - still complete a RAT.

Key data sources

• Immunisation Handbook - Covid-19
• RCH COVID Clinical Practice Guideline
• Victorian DH, community resources
  
  • MCRI Report Covid-19 and child and adolescent health (Sep 2021)
• Federal – Department of Health, vaccine rollout data, Australian living guidelines (funding discontinued 30 June 2023) and booster advice 2024.
  
• Covid-19 kids research updates (to Dec 2020) and vaccine updates (to Dec 2022), and Research database 
• National Refugee-led Advisory and Advocacy group - COVID-19 consultation report 
• Mobility in the time of Covid-19 - Zolberg Institute on Migration and Mobility - including 14 principles of protection.

Timeline related to migration

• 31 Dec 2019 – Pneumonia cases in Wuhan, China reported to WHO regional office
• 25 Jan 2020 – Australian restrictions on travel to and arrivals from China
• 30 Jan 2020 – WHO declares public health emergency of international concern
• 01 Mar 2020 – Australian restrictions on travel to and arrivals from Iran
• 11 Mar 2020 – WHO declares pandemic
• 13 Mar 2020 – Expanded MBS telehealth item numbers
• 16 Mar 2020 – Victoria declares State of Emergency
• 16 Mar 2020 – IOM and UNHCR suspend travel for refugees. People with a 202 visa may still travel to Australia pending flight availability, quarantine applies to international arrivals
• 18 Mar 2020 – DFAT issues standing advice to not travel overseas, with subsequent closure of many transit hubs
• 18 Mar 2020 - Guard at Kangaroo Point APOD in Qld tests positive for coronavirus - see media reporting
  
• 21 Mar 2020 – Victorian Government announces $1.7B economic survival package, including a $500M Working for Victoria fund
• 23 Mar 2020 – Stage 1 restrictions Victoria
• 24 Mar 2020 – Prime Minister announces a ban on all overseas travel (with limited exceptions), and advice to avoid all non-essential domestic travel
• 24 Mar 2020 – Detention visitor program suspended
• 25 Mar 2020 – Stage 2 restrictions Victoria – non-essential businesses close
• 28 Mar 2020 – Enforced 14 day quarantine for all international arrivals in Victoria
• 29 Mar 2020 – New  Coronavirus supplement announced – $550/fortnight in addition to existing payments through JobSeeker, Youth Allowance, Special Benefit, Parenting Allowance and others - see fact sheet
• 30 Mar 2020 – Stage 3 restrictions Victoria – to apply for 4 weeks, no more than 2 people in a gathering, only 4 reasons to be out (essential supplies, healthcare, exercise, work/study if required), playgrounds closed), restrictions now enforceable
• 30 Mar 2020 – Federal Government announces $130B JobKeeper payments – providing affected businesses with $1500/fortnight per employee (70% median wage) – for citizens, permanent residents, and special category visa (SCV) holders – see fact sheet
• 31 Mar 2020 – OHCHR, IOM, UNHCR and WHO joint press release - The rights and health of refugees, migrants and stateless must be protected in COVID-19 response
• 31 Mar 2020 – CDNA guidelines for COVID in correctional and detention facilities - later revised Jun 2020, and Aug 2020
• 2 Apr 2020 – Federal government announces free childcare - see media release, and  media reporting - free childcare was not limited by residency status but ended mid-July 2020. 
• 4 Apr 2020 – National COVID-19 Clinical evidence taskforce announced
• 7 Apr 2020 – Victorian government announces school students to learn from home in term 2
• 12 Apr 2020 – Additional Victorian Government funding ($59.4M) for mental health during COVID – see media release
• 17 Apr 2020 – Additional Victorian Government funding ($40.2M) for crisis accomodation and specialist services for family violence
• 23 Apr 2020 - Additional Victorian Government funding (S77.5M) for vulnerable children and families - including additional payments for foster carers
• May 2020 - Additional Victorian Government funding ($17M) for people with disability
• 6 May 2020 - NRAAG - COVID-19 consultation report
• 6 May 2020 - RCOA Summary of April 2020 Working Group on Resettlement Briefing on Covid-19.
  
• 3 Jun 2020 - UNHCR Policy Brief - Covid-19 and People on the Move - also see commentary by Gillian Triggs, Assistant High Commissioner for Protection.
  
• 18 Jun 2020 - UNHCR and IOM announce resumption of resettlement travel for refugees
• 20 Jun 2020 - Victorian worker support payment ($1500) 
• 30 Jun 2020 - Victorian government announces further lockdowns by postcode - see Premier's media release. 
• 3 Jul 2020 - Lockdown of public housing high rise towers in Flemington - see DHHS information and media reporting
• 7 Jul 2020 - Victoria announces return to Stage 3 restrictions from midnight Wed 8 Jul 2020
• 10 Jul 2020 - Victoria asks all people to wear masks in public where social distancing not possible - see DHHS information and media reporting
• 12 Jul 2020 - Victoria announces return to remote learning for students in prep-year 10
• 13 Jul 2020 - Guard at the Mantra Preston APOD tests positive for coronavirus - see media reporting
• 13 Jul 2020 - Extreme hardship program - for people unable to access other Victorian or Commonwealth support, including temporary and provisional visa holders and undocumented migrants (payment of $400 for a single adult, more for families, with a possible 2nd payment after 2 months) - phone - 1800 855 240 (available to support eligible people submit an application).
• 19 Jul 2020 - Face masks mandated in Victoria from 22 Jul 2020 - for all people aged 12 years and older
• 21 Jul 2020 - Job Keeper program extended to 28 Mar 2021, with new changes announced including tiered payments (full time workers $1200/fortnight, part-time workers <20 hours/week $750/fortnight), increased checks of eligibility (business turnover), and new conditions for childcare commencing immediately. Changes to payments commence 28 Sep 2020, with further reductions from 4 Jan 2021.
  
• 2 Aug 2020 - State of Disaster and Stage 4 restrictions announced in Victoria (note criteria for onsite supervision in Education section of this document and childcare permits).
• Aug 2020 - Victorian coronavirus test isolation payment ($300)
• 10 Aug 2020 - home based testing for vulnerable communities - 'Call to test' (GP referral required)
• 13 Aug 2020 - Victorian government announces 'Working together for multicultural communities' - $14.3M additional funding. 
• 14 Sep 2020 - Further 2 weeks of stage 4, although curfew 9 pm, exercise - 2 hours exercise/outdoor time daily - 2 people or a household; visitors - those living alone, or single parent - one nominated visitor; distance - 5 km zone, education: remote learning unless exemption
• 24 Sep 2020 - Job Seeker/Coronavirus supplement payments  reduce to $250/fortnight (until 31 Dec 2020, then to $150/fortnight until 31 Mar 2021), also with mutual obligations reinstated, and increased threshold for additional income prior to reduction of payments (to $300).
• 28 Sep 2020 - Victoria moves to '2nd step' out of lockdown, face masks, curfew stops, exercise as above; up to 5 people from 2 households outdoors, visitors as above, distance - 5 km zone, education - Childcare restarts
• 28 Sep 2020 - information on DHA transitioning people in community detention to final departure BVE - initially Qld, NSW, SA, subsequent stay for Victoria
• 1 Oct 2020 - Announcement Extreme hardship payments doubled - see Premier's media release
• Oct 2020 - very small numbers of offshore arrivals recommence
• 5 Oct 2020 - education - Kinder restarts and year 12 GAT testing the same week
• 12 Oct 2020 - education - prep-2 and years 11-12, and specialist education restarts, otherwise remote learning unless exemption
• 22 Nov 2020 - 'third step' - curfew - stops;  distance - no restrictions; outdoors - up to 50 people, visitors - household visitors - up to 15 visitors, education - staged return to school for years 3-10
• 24 Nov 2020 - Victorian State Budget - includes $3.9 million for asylum seekers in 2020-21, and free 3-year old kindergarten (15 hrs weekly) for all refugee and asylum seeker children from 2021 across Victoria.
• 7 Dec 2020 - face masks public transport/taxis and shared vehicles/supermarkets and department stores, outdoors - up to 100 people, visitors - household visitors - up to 30 daily (can be across different visits); international arrivals to Victoria restart
• 18 Dec 2020 - new cases of Covid in NSW (Northern Beaches) and face masks also applied to airport terminals in Victoria
• 18 Dec 2020 - Refugee Council of Australia (RCOA) report - Homelessness and hunger among people seeking asylum during Covid-19
• 21 Dec 2020 - Hotel quarantine inquiry final report.
• Jan 2021 - Medevac refugees released from APODs in Victoria - see ASRC summary numbers
• 12 Feb 2021 - snap 5 day lockdown in Victoria, and tightening of restrictions - 5 km rules, essential reasons to leave home, 2 hours exercise, masks inside and outside 
• 17 Feb 2021 - Victorian restrictions change - masks inside and outside if social distancing not possible, max 5 visitors, max 20 people outside
• 22 Feb 2021 - Vaccine rollout commences - stage 1a - border/quarantine, frontline health, aged care/disability staff/residents
• 26 Feb 2021 - Victorian restrictions eased again - masks on public transport, supermarkets, department stores
• 14 Mar 2021 - Telehealth extended to 30 June 2021 - see PM media release and MBS guidelines (note different for GPs)
• 17 Mar 2021 - Minister Hunt announces booking system for GPs - concerns then raised by GPs around lack of notice - see media
• 22 Mar 2021 - Vaccine rollout stage 1b - adults 70y+, other HCW, Aboriginal people 55y+, younger adults with medical conditions/disability, essential workers (EW)
• 26 Mar 2021 - Victorian restrictions eased - masks on public transport/ride-share, hospitals, airports/flights, symptoms; max 100 visitors, max 200 people outside, workplaces 100%, most venues 75%; 1 person/2m²
• 28 Mar 2021 - Jobkeeper supplements and tenancy protections end
• 31 Mar 2021 - Jobseeker coronavirus supplement payments end, and temporary waiver for newly arrived residents waiting period ends
• 7 Apr 2021 - UNHCR statement on access to covid vaccination for refugees
• 8 Apr 2021 - ATAGI recommends Pfizer preferred vaccine for adults <50y, with PM press conference.
• May 2021 - Support for Asylum Seekers initiative – $3.9 million announced in the Victorian State Budget - extending case coordination, basic needs, utilities and homelessness assistance; mental health support and primary care support.
• 3 May 2021 - Vaccine rollout stage 2a - AZ vaccine for people >50y at Cth and State services, then 17 May 2021 - same in general practice
• 24 May 2021 - new community acquired cases in Victoria, with a rapidly increasing number of exposure sites
• 27 May 2021 - Victoria opens Pfizer vaccination to people aged 40-49y
• 28 May 2021 - 7 lockdown for Victoria, masks inside and outside, 5 km, 5 reasons to leave home only, schools move to online - see guidelines
• 2 Jun 2021 - further 7 days lockdown announced for Victoria, 10 km radius
• 3 Jun 2021 - Federal government announces 'temporary covid disaster payments' for people in greater Melbourne area with <$10,000 in 'liquid assets', $500 if work >20h, and $325 <20h.
• 10 Jun 2021 - lockdown lifted in Victoria
• 16 Jun 2021 - first case of delta variant in NSW --> becomes a more widespread outbreak
• 17 Jun 2021 - ATAGI recommends Pfizer as preferred vaccine for age 16y - 59y
• 25 Jun 2021 - NSW commences lockdown, followed rapidly by lockdowns in Queensland, NT and WA
• 28 Jun 2021 - PM announces AZ vaccine available to anyone aged 18y+ by choice, and announces new no-fault indemnity scheme for GPs - it is not clear whether this scheme includes nurses/specialists, and details are currently unclear - see media reporting
• July 2021 - $355,000 short term COVID-19 Asylum Seeker emergency rental brokerage fund - emergency assistance to maintain secure housing and assist with rental arrears. The funding was administered through the NASAVic HEF mechanism via Launch Housing, via ASRC, Red Cross, Uniting, Baptcare and the Brigidines.
• 15 Jul 2021 -  5 day lockdown commences at midnight after new cases of covid delta variant in Victoria, later extended for a further 2 days, ending 28 July 2021
• 23 Jul 2021 - TGA approved Pfizer vaccine for 12-15 year olds
• 2 Aug 2021 - ATAGI statement on use of Pfizer vaccine in children 12-15 years (specified medical conditions, Aboriginal and Torres Strait Islander children, children in remote communities)
• Aug 2021 - new cases of delta variant, and higher proportion in children and young adults
• Aug 2021 - release of JRS report on homelessness in people seeking asylum during Covid (Mar 2020 - Mar 2021) - A place to call home
• 6 Aug 2021 - Lockdown in Victoria - 7 days, cases in Al Taqwa, Warringah specialist school, high rise towers Flemington. 
• 9 Aug 2021 - TGA provisional approval of Moderna vaccine, with 10M doses arriving from Sep 2021
• 16 Aug 2021 - Victorian lockdown extended for another 14 days (until 2 Sep 2021), playgrounds closed and curfew imposed - see media release
• 15 Aug 2021 - Taliban forces take control of Kabul, with subsequent evacuation of more than 100,000 people
• 21 Aug 2021 - Regional Victoria enters lockdown, and new restrictions on childcare and kindergartens - see media release - regional lockdown lifted 8 Sep 2021
• 25 Aug 2021 - Vaccinations open for those age 16y+
• 31 Aug 2021 - reporting on covid vaccine coverage in Immigration detention - 35% partially and 16% fully vaccinated (comparable national figures at the time = 59%, 35%)
• 13 Sep 2021 - Vaccinations open for adolescents aged 12-15 years
• 17 Sep 2021 - slight easing of restrictions for metro Melbourne - exercise with one other person, 5 fully vaccinated adults, from 2 households (+dependents) can meet outdoors
  
• 19 Sep 2021 - Roadmap out of lockdown released - including Burnet Institute modelling - hospitality and community sport from 70% double vaccination (16yrs+ - expected 26 Oct 2021), schools reopen from 5 Oct 2021 (year 12s start back 6 Oct 2021), 80% double vaccination (16y+ - expected 5 Nov 2021) - easing restrictions on household visitors. Peak covid cases expected mid October at the time.
• 7 Oct 2021 - Victorian rules around secondary close contacts (i.e. people in the same house as a PCC) change - no longer required to isolate (but need to get tested if they have Sx)
• 22 Oct 2021 - Melbourne lockdown ends - no curfew, no limits on leaving home, hospitality re-opens, 10 visitors to home, 25km limit continues
• 29 Oct 2021 - Travel to regional Victoria permitted
• 18 Nov 2021 - further easing of restrictions in Victoria - no restrictions home visits, masks in health facilities, public transport, retail, schools. Cases isolate 10 days, no contact tracing, household contacts isolate 7d if fully vaccinated, 14d if not vaccinated, non household contacts isolate until test negative, cases to notify their work, uni, school or childcare. Infectious period = 2 days prior to onset symptoms or test + (whichever comes first).
• 24 Nov 2021 - Omicron variant reported to WHO - subsequently identified as variant of concern
• 3 Dec 2021 - ATAGI statement on Omicron and booster doses
• 5 Dec 2021 - TGA provisionally approves Pfizer vaccination for children aged 5-11 years
• 8 Dec 2021 - ATAGI recommendations on vaccination of children 5-11y, and TGA approves use of Moderna for booster doses
• 23 Dec 2021 - Covid cases rise in NSW to more than 5000 cases daily, interval for booster doses shortened (to 4m) for people 18y + (not yet recommended age 12-17y)
• 24 Dec 2021 - Masks become mandatory again for all people aged 8y and older in Victoria.
• 4 Jan 2022 - Booster dose interval shortened to 4 months
• Jan 2022 - Rapid escalation in covid cases in Australia - from 430K cases as of 2/1/22 to 2.16M cases by 31/1/22
• 10 Jan 2022 - Vaccinations open for children aged 5-11 years
• 20 Jan 2022 - Novovax approved for use (age 18y+) in Australia
• 24 Jan 2022 - Free RAT tests for concession card holders (10 per 3 months, max 5 per month, until 30 Apr 2022)
• 28 Jan 2022 - TGA provisionally approves booster dose for 16-17 year olds
• 31 Jan 2022 - Booster dose interval reduced further to 3 months
• 10 Feb 2022 - ATAGI change in terminology to 'up to date' for vaccination
• 24 Feb 2022 - Moderna approved for use in children age 6-11 years (note different age range to Pfizer)
• 25 Feb 2022 - Victorian covid settings ease - masks no longer required indoors, recommended/required for hospitals, public transport, schools (8y+), work from home recommendation stops
• Early March 2022 - guidelines on recovered cases change - do not need to be tested within 8 weeks after release from isolation
• 22 Mar 2022 -  guidelines on recovered cases change - do not need to be tested within 12 weeks after release from isolation - also close contacts who have recovered from Covid-19 do not need to quarantine if they are asymptomatic, not immunocompromised, and re-exposure is <12 weeks since release from isolation. 
• 25 Mar 2022 - ATAGI recommends winter booster doses for: age 65y+, residents aged care/disability, severely immunocompromised, Aboriginal or Torres Strait Islander age 50y+ (4m after 3rd dose).
• 8 Apr 2022 - TGA approves Pfizer booster doses for age 12-15y (ATAGI approval pending).
• 22 Apr 2022 - Changes to (easing) Victorias covid restrictions - close contacts - no longer need 7d isolation (instead complete 5 RAT tests, masks indoors, and avoid sensitive settings), cases still isolate 7d, but do not require repeat testing/quarantine for 12 weeks, masks stop for schools, early childhood, hospitality, retail (only required for public transport, airports/planes, sensitive settings); no hospital visitor restrictions, travellers - no quarantine required for unvaccinated, and no post-arrival testing. Vaccine mandates remain in place for key industries (health, education, justice, aged care, disability, emergency services, food distribution, meat/seafood processing).
• 27 Apr 2022 - Changes to ATAGI advice on vaccine intervals, and vaccination post-infection
• 1 Jul 2022 - PCR availability scales back in Victoria - with RAT testing the preferred test option for most people
• 7 Jul 2022 - ATAGI updates recommendations for 4th dose vaccine - available for everyone aged 30y+ and recommended age 50y+, interval drops to 3m (from 4m) - see media announcement.
• 12 Jul 2022 - Victoria's pandemic declaration due to expire - extended for a further 3 months (to 12 Oct 2022) - see Premier's media release
• 12 July 2022 - guidelines on recovered cases change back - do not need to be tested/isolate for 4 weeks after release from isolation (from 12 weeks)
• 19 Jul 2022 - TGA provisional approval of paediatric Moderna vaccine for children 6m-5y
• 24 Jul 2022 - Free RAT test availability extended for people with disability (until end Sep 2022) 
• 28 Jul 2022 - TGA provisionally approves Novovax for age 12-17y
• 3 Aug 2022 - ATAGI recommends covid vaccine for children 6m-<5y with severe immunocompromise, disability or complex/multiple health conditions increasing the risk of severe covid-19. 
• 25 Aug 2022 - ATAGI supports use of Novovax for adolescents 12-17 years to commence 5 Sep 2022
• 29 Aug 2022 - TGA provisionally approves Moderna bivalent vaccines as booster dose for age 18y+
• 1 Sep 2022 - Covid isolation period reduced to 5 days if no symptoms and not in high risk settings, commencing 9 Sep 2022 (and also masks no longer required on planes) - see media. Pandemic Leave Disaster payments will also reduce (from $750-$540)
• 1 Sep 2022 - Victorian work from home requirements end - see media
• 12 Sep 2022 - ATAGI statement on use of Moderna bivalent vaccines for booster dose (age 18y+)
• 20 Sep 2022 - TGA provisional approval Pfizer vaccine as booster for age 5-11y
• 23 Sep 2022 - TGA provisional approval of Pfizer vaccine for children 6m - <5y (dose = 3mcg)
• 30 Sep 2022 - TGA provisional approval Moderna bivalent original/omicron BA.4/5 as booster
• 12 Oct 2022 - Pandemic declaration ends and isolation requirements end in Victoria - see Premier's media release, other media and Post pandemic orders (PH advice - 12 Oct 2022). Targeted financial support for eligible healthcare workers only, mandated vaccination healthcare only.
• 14 Oct 2022 - Cth isolation payments end.
• 19 Oct 2022 - TGA provisional approval Moderna covid vaccine for booster age 12y+
• 27 Oct 2022 - TGA provisionally approves Pfizer bivalent (Original/Omicron BA.1) vaccine for use as a booster in age 18y+ 
• 15 Nov 2022 - ATAGI updates recommendations to include use of Pfizer bivalent (Original/Omicron BA.1) vaccine for any booster in age 18y and TGA and provisional determination for Pfizer bivalent original/omicron BA.4/5)
• 12 Dec 2022 -  Commonwealth announces National plan to transition Australia's Covid-19 response over the next 12 months.
• 31 Dec 2022 - Victoria's Covid response changes again, with reduction in most State run services, and transition to primary care and LPHU led models. State run hubs close, GP respiratory infection clinics and primary care; testing - RAT testing 1st line, PCR via primary care or GP-RIC, isolation 5 days or until symptoms free.
• 20 Jan 2023 - TGA grants provisional approval for Pfizer bivalent original/omicron BA.4/5
• 30 Jan 2023 - TGA commences evaluation of Moderna covid vaccine for transition to full registration (primary immunisation 6y+ and booster 12y+)
• Feb 2023 - free RATs in Victoria through LGAs (no Medicare required)
• 8 Feb 2023 - ATAGI recommendation: 2023 Covid boosters, and Pfizer bivalent (original/omicron BA.4/5) (age 12y+)
• 21 Mar 2023 - AZ vaccine no longer available in Australia
• 30 May 2023 - ATAGI recommendation: bivalent COVID-19 vaccine preferred for primary vaccination age 12y+.
• Jun 2023 - The following vaccines stop being available for use in Australia - Pfizer original 12y+, Moderna bivalent Original/Omicron BA.1 formulation 18y+, Moderna original 6m-5y and 6-11y
• 9 June 2023 - CHO Brett Sutton resigns - see media, finishing 28 Jun 2023, replaced by Dr Clare Looker
• 30 Jun 2023 - Victorian Covid taskforce stood down and major restructure in DH
  
• 1 Sep 2023 - ATAGI - updated Covid booster advice, further booster (if more than 6m since last booster) - recommended all 75y+, consider all 65-74y and 18-64y with severe immunocompromise
• 5 Oct 2023 - Australian immunisation handbook includes new chapter on Covid. Covid booster recommendations now based on previous dose (and no specific timing in relation to recent infection, taking a pragmatic approach given reduced Covid testing). A greater interval between infection and vaccination is associated with greater protection from vaccination.
• 20 Nov 2023 - ATAGI - updated advice on use of monovalent Omicron XBB.1.5 vaccines
• Jan 2024 - Novovax no longer available (not manufactured since early 2022, last doses expire Jan 2024)
• 1 Mar 2024 - ATAGI 2024 booster advice - see Cth summary.

Telehealth

Immigrant health transitioned to using telehealth from 2020 - a high proportion of our patients rely on public transport, and there were/are challenges with social distancing in a family based clinic model working with interpreters and ongoing Covid infections in the community. Direct attendances in 2020-21 were limited to targeted visits where examination, tests, or immunisations were essential. From 2022 - we have offered visits as telehealth if preferred or needed. 

Quick tips

• Data usage: HealthDirect telehealth uses ~230 MB on a mobile device and 450 MB on a PC for a 20 minute call – similar to Skype or FaceTime, and <50% of an HD YouTube video. Data use is more on 3-party consults, and less on lower speed internet connections. There is no data use while waiting for the consult to start.
• Functions: HealthDirect allows clinicians to open a chat function, share a screen, use a whiteboard function and send messages (in language!) via email or SMS
• Three party consultations: work well for interpreting, however data use increases, which may affect call quality. 
• Billing: 
  • Consults should record consent for telehealth and bulk-billing – verbal consent is adequate if the consult is not recorded. See ACRRM consent form for an outline of benefits and risks.
  • Previous TH items for rural/regional patients (112) were replaced by TH item numbers introduced during the pandemic as of Jan 2022
  • Changes from July 2022 for paediatricians - out of hospital attendances (non-admitted patients) - temporary item number that became permanent
  • • Specialist telehealth – 92422¹³²   92423¹³³ 91824¹¹⁰  91825¹¹⁶  91826^{minor attendance}   92140¹³⁵   92141¹³⁷
    • Specialist telephone - 91836^{minor attendance}
      

• Health Direct - Guidelines for clinicians and patients, and translated
• RCH Telehealth site
  

Translated resources

• DH - Coronavirus translated resources 
  
• Department of Home Affairs - 63 languages, wide range of information
• SBS resources - 65 languages
  
• Health Translations 
• Department of Health – translated and vaccine information
  
• NDIS - Translated information on coronavirus and NDIS - includes access request form
• RCH - Translated
• Vaccines - Cth vaccine information and Victorian DH translated
  

^{Immigrant health clinic resources. Author Georgie Paxton, Sophie Oldfield, Linny Phuong, 2 April 2020, updated 14 Jul 2024. Contact: georgia.paxton@rch.org.au}