Safety of COVID-19 vaccines

URGENT UPDATE: AstraZeneca Vaccine 

The Australian Technical Advisory Group on Immunisation has released a joint statement (external site) with the Thrombosis and Haemostasis society of Australia and New Zealand on Thrombosis with Thrombocytopenia Syndrome (TTS) and the use of COVID-19 Vaccine AstraZeneca. The WA Department of Health has accordingly advised the following:

  • the Pfizer COVID-19 vaccine is preferred for adults aged under 60 years and adults over 60 years with specific underlying medical conditions (Requests for alternative COVID-19 vaccine can be made online for people with qualifying medical conditions)
  • the COVID-19 Vaccine AstraZeneca is preferred for adults aged 60 years and over
  • COVID-19 Vaccine AstraZeneca can be used in adults aged under 60 years ­– where the benefits are likely to outweigh the risks for that individual and the person has made an informed decision based on an understanding of the risks and benefits
  • people who have had the first dose of AstraZeneca without any serious adverse effects can be given the second dose, including adults under 60 years.  

In Australia COVID-19 vaccines registered for use are required to undergo the Therapeutic Goods Administration’s (TGA’s) rigorous assessment and approval process to ensure compliance with our country’s strict standards on safety and effectiveness. For information on this process, you can visit the TGA website (external site).

Clinical guidance on COVID-19 vaccine in Australia

See the Australian Technical Advisory Group (ATAGI) clinical guidance for COVID-19 immunisation providers and program staff COVID-19 vaccination – ATAGI clinical guidance on COVID-19 vaccine in Australia in 2021 (external site).

See the Australasian Society of Clinical Immunology and Allergy (ASCIA) guide for health professionals on allergy and COVID-19 vaccination – Guide: Allergy and COVID-19 vaccination (external site).

Reporting adverse events following immunisation (AEFI)

Report adverse events following immunisation in WA.

Likely side effects from COVID-19 vaccines

Most side effects are mild and transient. Reactions at the injection site such as redness, swelling, pain and systemic symptoms, like headaches, fever, muscle aches and fatigue, are very common within the first 48 hours. Serious adverse events attributable to vaccination are very rare. The potential for rare or unanticipated side effects to emerge over time is low, but is being closely monitored, as for any vaccine.

Management of side effects

Most side effects start within 24 hours of vaccination and will resolve in 1–2 days on their own. To reduce discomfort, paracetamol or ibuprofen can be taken. Some of the expected vaccine side effects may be similar to the symptoms of COVID-19; however, a key differentiating factor is that respiratory symptoms (e.g. cough, runny nose etc) are not caused by the vaccine.

People with typical vaccine side effects (injection site pain, mild fever, lethargy) within the first 48 hours after vaccination with a complete absence of any respiratory symptoms may not need to get a COVID-19 test or isolate. People with respiratory symptoms should be tested for COVID-19.

Rare side effects after COVID-19 Vaccine AstraZeneca

There has been a link between the AstraZeneca COVID-19 vaccine and a very rare condition called thrombosis with thrombocytopenia syndrome (TTS), which involves blood clotting (thrombosis) and low platelet levels (thrombocytopenia).

  • TTS is a very rare condition and affects approximately 4 – 6 out of a million people who receive COVID-19 Vaccine AstraZeneca.
  • The blood clots can occur at different parts of the body, including the brain (this is called cerebral venous sinus thrombosis) and the abdomen. The low level of blood platelets can cause bleeding.
  • The symptoms of this condition occur around 4 to 28 days after vaccination.
  • People with this condition are very unwell and need to go to hospital. This condition can lead to long-term disability, and even death.

To access advice for immunisation providers on TTS and AstraZeneca COVID-19 vaccine visit Information for Immunisation Providers on Thrombosis with Thrombocytopenia Syndrome (TTS) following COVID-19 vaccination (external site).

To access information for patients visit Patient information sheet on AstraZeneca COVID-19 vaccine and thrombosis with thrombocytopenia syndrome (TTS) (external site).

Clinical guidance and specialist immunisation clinics in WA

Doctors and nurses who report a significant AEFI will receive advice by phone, email or letter from Western Australian Vaccine Safety Surveillance (WAVSS) staff to help clinically manage the future care and immunisation needs of these patients. If required, the patient will be contacted by WAVSS staff to arrange an appointment for the Specialist Immunisation Clinic (external site). A separate referral is not required.

If you require assistance in submitting an AEFI report following first or second dose of COVID-19 vaccination via the online portal, or further information relating to the progress of an AEFI report, contact WAVSS staff by:

  • phone on (08) 6456 0208 (Monday to Friday, 08:00 to 16:30, except public holidays)
  • email

If your patients have medical queries/conditions that require consideration prior to vaccination, or you require assistance in advice regarding investigation and management of suspected AEFIs, you can:

  • seek advice from public health staff on current guidelines and referral pathways by:
  • request referral to a specialist clinic via Central Referral Services (CRS)(non-WA Health providers) or via e-referral (WA health providers) to:
    • SCGH Immunology Specialist Immunisation Clinic for adults or
    • PCH Infectious Diseases Specialist Immunisation Clinic for children.

After hours support should be reserved for advice on the immediate investigation and management of serious AEFI. Clinicians may contact the on-call adult immunologist through the Sir Charles Gairdner Hospital switchboard on 08 6457 3333 for urgent after-hours clinical support.

Last reviewed: 06-08-2021