Medical exemption to mandatory COVID-19 vaccination

The Directions for mandatory COVID-19 vaccinations for most occupations and workforces in WA are being introduced in a phased approach. People must meet criteria for exemption against all COVID-19 vaccines to qualify for an exemption from WA mandatory COVID-19 vaccination.

There are various exemption criteria (medical and non-medical) for relevant Direction listed in the Direction-specific Exemption Guidelines (external site).

WA medical practitioners are required to assist with the following medical exemptions:

  1. medical exemptions (temporary or permanent) recognised by Australian Immunisation Register (AIR) via the AIR medical exemption form (IM011)
  2. Temporary exemptions provided by the WA Chief Health Officer (CHO) related to a medical condition.

An online decision-making tool (external site) has been developed for WA medical practitioners to:

  • assess whether a person might be eligible for a medical exemption (temporary or permanent; recognised by AIR or provided by WA CHO) from WA COVID-19 mandatory vaccination.
  • provides information on other non-medical exemptions, provided by the WA CHO

The decision-making tool is specific to WA and helps guide eligible health professionals when patients request medical exemption to mandatory COVID-19 vaccination.

Medical exemptions (permanent or temporary) recognised by AIR

GPs should proceed with the Decision-Making Tool (external site to determine what type of exemption criteria are applicable to the patient.

Permanent medical exemption

The AIR – immunisation medical exemption form (IM011) (external site) allows permanent exemption recording for:

  • anaphylaxis following a previous dose of the relevant COVID-19 vaccine
  • anaphylaxis to any component of the relevant COVID-19 vaccine

In order to be permanently medically exempt from WA mandatory COVID-19 vaccination, a patient must meet this requirement for all the COVID-19 vaccines available for use in Australia

If a patient has a medical contraindication to one brand of COVID-19 vaccine, they are usually able to receive an alternate brand. When they cannot receive an alternative brand they may be eligible for a permanent or temporary exemption.

Temporary medical exemption

A temporary medical exemption may be issued to defer vaccination temporarily and should not be provided for longer than 6 months in the first instance. If the cause of the medical contraindication persists at 6 months, a new medical exemption form will need to be completed.

Conditions warranting temporary medical exemption (external site) via AIR are:

  • Acute major medical illness eg: major surgery or hospital admission for serious illness
  • Vaccine recipient who is a risk to themselves or others during the vaccination process (e.g. due to severe neurodevelopmental condition) may warrant a temporary vaccine exemption.
  • People with acute illness from SARS-CoV-2 infection (this may be up to six months after onset of the SARS-CoV-2 infection). Chronic symptoms following COVID-19 ("Long COVID”) is not a contraindication to COVID-19 vaccination but does warrant a clinical discussion. Note-COVID-19 vaccines should be delayed for at least 90 days after receiving an anti-SARS-CoV-2 monoclonal antibody or convalescent plasma.
  • For an mRNA vaccine: acute decompensated heart failure; or inflammatory cardiac illness such as myocarditis, pericarditis, acute rheumatic fever, or acute rheumatic heart disease (i.e. with active myocardial inflammation) within the last 3 months. Further information is outlined by ATAGI Guidance on Myocarditis and Pericarditis after mRNA COVID-19 vaccines. (external site)
  • Individuals who have experienced a serious adverse event* following COVID-19 vaccination. An adverse event following immunisation (AEFI) is considered serious if it:
    • requires in-patient hospitalisation or prolongation of existing hospitalisation or results in persistent or significant disability/incapacity; AND
    • has been determined following review by, an experienced immunisation provider/medical specialist to be associated with a risk of recurrence if another dose is given; AND
    • has been reported to Western Australian Vaccine Safety Surveillance (WAVSS) system (external site)

Examples of serious adverse events include Thrombosis with Thrombocytopenia (TTS), Immune Thrombocytopenic Purpura (ITP) or Guillain-Barre syndrome (GBS) or Anaphylaxis.

Additional situations which may warrant exemption

  • Very rarely an individual may have an ATAGI listed contraindication or precaution to COVID-19 vaccines available in Australia which does not meet the options available on the AIR IM011 form (external site).
  • For Vaxzevria (AstraZeneca) vaccine this includes history of capillary leak syndrome, cerebral venous sinus thrombosis (CVST), idiopathic splanchnic (mesenteric, portal or splenic vein) thrombosis, antiphospholipid syndrome (with thrombosis and/or miscarriage) or young age.
  • In this situation, where there are contraindications or precautions to all vaccines, referral to the vaccine safety clinic is recommended. Your patient may submit a request to the Chief Health Officer for temporary exemption while awaiting appointment. This must be accompanied by medical evidence and confirmation of referral.
Temporary exemption by the WA CHO (related to a medical condition)

GPs should proceed with the Decision-Making Tool (external site) and provide relevant supporting evidence to patient so that they can apply to the Chief Health Officer (CHO) for a temporary exemption related to a medical condition. 

General practitioners do not need to submit further forms for these exemptions. The individual worker or owner/operator of the facility must complete and submit an application, using the Direction specific exemption application form (external site), include supporting documentation and submit the documents to COVIDVaccinationExemption@health.wa.gov.au.

There are very limited reasons where people may be able to apply directly to the CHO for temporary medical exemption.

Situations when an individual can request temporary medical exemption from CHO are:

  • Medical exemption in process - if the individual has applied for a medical exemption and is awaiting outcome advice, e.g. waiting for AIR immunisation history statement to be updated.
    Provide patient with a copy of the completed AIR immunisation medical exemption (IM011) form (external site), if not using PRODA (external site).
  • Awaiting specialist appointment - if the individual is awaiting clinical assessment with a specialist provider such as the Sir Charles Gairdner Hospital (SCGH) Vaccine Safety clinic.
    Provide patient with a copy of the specialist referral letter.
  • Exemption for 7 days or less - if exemption is being requested for 7 days or less due to acute, severe medical condition that will only cause a short delay to vaccination.
    Provide patient with relevant evidence e.g., medical certificate.
  • International vaccination - if the individual has been vaccinated against COVID-19 outside Australia with a vaccine that is not approved or recognised by the Therapeutic Goods Administration (TGA) (external site).
Conditions that do not count as medical exemptions

The following list outlines examples of what does not count as grounds for a medical exemption from a COVID-19 vaccine:

Download the list of Conditions not eligible for a medical exemption from a COVID-19 vaccine (PDF 100KB).

Last reviewed: 08-12-2021