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<\/span><\/div>12 April 2021<\/strong><\/p>\n Dear colleagues,\u00a0<\/span><\/p>\n Over the weekend\u00a0a number of\u00a0updates have been provided\u00a0regarding\u00a0the\u00a0AstraZeneca COVID-19 vaccine.\u00a0As\u00a0you know by now, ATAGI has recommended that the Pfizer vaccine is preferred over the AstraZeneca vaccine for\u00a0adults aged under 50 years.\u00a0This recommendation is based on the increasing risk of severe outcomes from COVID-19 in older adults (and hence a higher benefit from vaccination) and\u00a0the small risk of serious harm\u00a0of thrombosis with thrombocytopenia following AstraZeneca vaccine in those under 50 years.<\/p>\n Vaccinations for adults under 50 years\u00a0– AstraZeneca<\/strong><\/p>\n People who have had their first dose of AstraZeneca without serious adverse effects can safely receive the second dose of the vaccine, including adults under 50 years.<\/p>\n The AstraZeneca vaccine can be used in\u00a0adults aged under 50 years where the benefits\u00a0outweigh the risk for that individual and the person has made an informed decision based on an understanding of the risks and benefits.\u00a0To be clear, any person aged under 50 years wishing to receive the AstraZeneca vaccine, can choose to do so, however should be fully informed about thrombosis in combination with thrombocytopenia as a rare but serious side effect before vaccination.<\/p>\n To assist individuals in making an informed decision,\u00a0Queensland Health has\u00a0updated the COVID-19 vaccination information. The following information should be provided to individuals who present requesting vaccination:<\/p>\n Should a person aged under 50 years wish to proceed to vaccination with AstraZeneca,\u00a0then a note should be made by the Health Worker on the\u00a0COVID-19 Pre-Vaccination Additional and temporary Screening Questions form<\/em>, with words to the effect \u201cinformed about the risk of thrombosis with\u00a0thrombocyopenia. Aware of the recommendation by ATAGI for Pfizer over AstraZeneca. Choses to receive\u00a0AstraZenica\u00a0today.\u201d<\/p>\n To assist clinicians in answering questions from individuals regarding vaccination, Queensland Health has updated the\u00a0COVID-19 vaccination screening questions \u2013 decision support guide<\/a>.<\/p>\n There continues to be work being done in relation to sub-prioritisation\u00a0of\u00a0vaccination priority group\u00a01b\u00a0to the available Pfizer supply. I will provide more information as soon as it becomes available.<\/p>\n Information for clinicians\u00a0\u2013 identification and treatment of thrombosis in combination with thrombocytopenia<\/strong><\/p>\n Patients presenting with symptoms of thrombosis (such as severe headaches unresponsive to simple analgesia, abdominal pain or respiratory symptoms) 4-20 days after vaccination should be reviewed carefully for signs of thrombosis or bleeding. Other neurological symptoms of cerebral vein thrombosis can include those of raised intracranial pressure such as visual changes, severe headache, seizures, focal neurological deficits, and general symptoms of encephalopathy including confusion.<\/p>\n New clinician resources have been developed to assist clinicians in managing patients who present with symptoms suggestive of clotting following vaccination.\u00a0For more\u00a0information\u00a0please\u00a0see the\u00a0information for clinicians factsheet<\/a>.<\/p>\n Key initial investigations\u00a0include:<\/p>\n Early consultation with your local\u00a0haematologist\u00a0is advised.<\/p>\n\n
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