Requests for alternative COVID-19 vaccine

There are medical circumstances which require an alternative vaccine and the application process is outlined below.

In some rare cases, there are individuals aged 60 years or over with certain medical conditions, imminent medical treatment or recognised allergen precautions to AstraZeneca, where it is recommended they receive the Comirnaty (Pfizer) COVID-19 vaccine.

Qualifying medical conditions

Conditions where Pfizer (Comirnaty) is recommended for people 16 years and over

In accordance with guidance (external site) from the Australian Technical Advisory Group on Immunisation (ATAGI) and the Thrombosis and Haemostasis Society of Australia and New Zealand (THANZ), Pfizer (Comirnaty) is recommended for people 16 years and above with:

  • A past history of cerebral venous sinus thrombosis (CVST)
  • A past history of heparin-induced thrombocytopenia (HIT)
  • A past history of idiopathic splanchnic (mesenteric, portal and splenic) venous thrombosis
  • Anti-phospholipid syndrome with thrombosis
  • People with serious potentially life-threatening adverse events attributed to the first dose of AstraZeneca such as anaphylaxis or TTS.

Persons aged 60 years and older are required to provide a letter from their General Practitioner or Specialist doctor stating that they have a history of any of the above conditions.

Imminent medical treatment likely to induce immune compromise

Additionally, persons aged 60 years and older who are scheduled to receive imminent medical treatment (within 3 months) likely to induce clinically significant immune compromise, for example, chemotherapy/radiotherapy/organ transplantation, or immune compromising treatment, are able to apply for the Pfizer (Comirnaty) vaccine to allow completion of their 2-dose immunisation schedule prior to treatment.

Persons aged 60 years and older are required to provide a letter from their relevant specialist/s or General Practitioner confirming imminent medical treatment, likely to induce immune compromise, is scheduled within three months.

People with a recognised allergen ‘precaution’ to AstraZeneca

A person advised by an allergist/immunologist that they should not be given AstraZeneca vaccine due to having one of the Australasian Society of Clinical Immunology and Allergy (ASCIA) recognised contraindications (external site) to COVID-19 Vaccine AstraZeneca can apply for Pfizer (Comirnaty) vaccination.

Persons aged 60 years and older that have been advised not to receive COVID-19 Vaccine AstraZeneca are required to provide a letter from their allergist/immunologist.

Application process

Individuals who meet the qualifying medical conditions will need a letter from their GP or treating specialist outlining which of the criteria applies to them. The letter needs to be in electronic format so it can be attached to the online application.

Once this letter has been obtained, the Request for alternative COVID-19 vaccination form for persons aged 60 years and over needs to be completed online.

If the link above does not work, please copy and paste the URL below into your web browser:

A phone number and email address are also required to complete the application.

The application can be completed by the applicant or by someone else on their behalf.

In people 60 years and over, ATAGI continue to advise that AstraZeneca can be provided to persons with the following conditions:

  • People with a past history of venous thromboembolism in typical sites, such as deep vein thrombosis or pulmonary embolism
  • People with a predisposition to form blood clots, such as those with Factor V Leiden, or other non-immune thrombophilic disorders
  • People with a family history of clots or clotting conditions
  • People currently receiving anticoagulant medications
  • People with a history of ischaemic heart disease or cerebrovascular accident
  • People with a current or past history of thrombocytopenia.

After reviewing the evidence on TTS, the Australian Technical Advisory Group on Immunisation (ATAGI) and the Thrombosis and Haemostasis society of Australia and New Zealand advised that TTS is different from other blood clotting conditions and is triggered by the immune system’s response to the COVID-19 Vaccine AstraZeneca.

Further information and advice on the COVID-19 AstraZeneca vaccine can be found on the Australian Department of Health Website (external site).

Last reviewed: 17-06-2021