As Australia works towards fully vaccinating more than 80%-16 against COVID-19, there is more pressure to make vaccination mandatory in many areas.
Some states and territories already have a COVID vaccine mandate in certain areas, such as health and aged-care workers. Victoria last week made COVID vaccination mandatory for all authorized state employees, in what has been a difficult but necessary decision. Governments and businesses are also considering mandates for several other groups.
Vaccine passports are also on the way, which means you’ll need to show proof of full immunization to travel internationally and visit hospitality, entertainment, retail, and elsewhere in some states and territories.
But there are some people who are not able to get the COVID vaccine due to medical reasons, although this is very rare. So what are these conditions, and if you have one of them, how can you prove it?
It is recommended that all Australians over the age of 12 receive two doses of a COVID vaccine. We now have strong data on these vaccines, so we know they are safe and effective. Serious adverse events are very rare.
There are some situations where one cannot have the COVID vaccine for medical reasons. The criteria for obtaining a permanent medical exemption are very narrow and are rarely required.
The only criteria are:
For live vaccines such as the measles, mumps, and rubella (MMR) and varicella vaccines, people who are significantly immunized may receive a permanent medical exemption. But this is not relevant for COVID vaccines as they are not live vaccines.
There are some situations that people commonly believe may require exemption from the vaccine, but the following are: No Reasons for exemption from COVID vaccination:
Egg Allergies, Even Severe
a chronic underlying medical condition – these individuals are often at higher risk of more serious illness from COVID, such as people who are immunized who can still receive COVID vaccines because they are not live vaccines
Family history of any adverse event after vaccination.
There are some situations when a COVID vaccine may need to be temporarily postponed. For example, if someone has a serious illness with a fever of 38.5℃ or more. However, this will usually only be for a short period and will not require them to obtain a written temporary medical waiver.
But there are also some “acute major medical illnesses” where people may be able to obtain a temporary vaccination medical exemption form. It needs to be evaluated and given by a medical provider, and only temporarily exempts you from a COVID vaccine.
Last week ATAGI, the Australian Technical Advisory Group on Immunization, which provides medical advice to the federal government on the use of vaccines, including COVID vaccines, issued expanded guidance on which of these situations may require a temporary medical exemption.
Read more: Soon you’ll need vaccinations to enjoy shops, cafes and events – but what about the staff there?
These exemptions include those with serious major medical conditions such as major surgery or hospital admission for serious illness.
It is recommended to provide temporary exemption only for six months. Ideally, they are reviewed within six months to see if the person has recovered and can now be safely vaccinated. They are also given only when no other COVID vaccine is suitable or available.
Temporary remission may also be specific to a certain vaccine, such as:
If a person has a history of heart inflammation (myocarditis or pericarditis) caused by a previous dose, or any other disease causing inflammation of the heart in the past six months, or acute decompensated heart failure. This is only for mRNA vaccines, including those by Pfizer and Moderna.
If a person has a history of specific very rare bleeding and clotting conditions, including: capillary leak syndrome, cerebral venous sinus thrombosis, heparin-induced thrombocytopenia, idiopathic splanchnic thrombosis, or antiphospholipid syndrome (with thrombosis and/or miscarriage) ). This is only for the AstraZeneca vaccine.
If possible and safe, individuals who cannot receive one of the above vaccines for one of these reasons should receive an alternative COVID vaccine.
Temporary exemptions may also be available for people who:
Until they make a complete recovery, they have got COVID. The ATAGI recommends that vaccination be deferred for up to six months, as previous infection reduces the chance of re-infection for at least that time. However, if they have recovered from COVID and their job requires them to be vaccinated, or they are at high risk of COVID because of exposure or personal exposure, they do not need to delay vaccination. Having chronic symptoms after COVID, known as “long COVID”, is not a medical reason for not receiving the COVID vaccine. If people who have recently had COVID are unsure whether to get vaccinated, they should talk to their doctor about the best time to get vaccinated.
The previous COVID vaccine dose has resulted in a serious adverse event that cannot be attributed to any other cause. An adverse event is considered serious if the person is hospitalized or it causes persistent or significant disability. These events need to be reported to the adverse event monitoring system in the individual’s state or territory and/or to Australia’s medical regulator, the Therapeutic Goods Administration (TGA). They are carefully evaluated on a case-by-case basis by an experienced specialist to find out how likely the serious adverse event is to recur if another dose of the COVID vaccine is given
Assessed as a risk to self or others during the vaccination process. For example, it may be due to a serious neurodevelopmental condition such as autism spectrum disorder. Specialist services may be available that can help facilitate safe vaccination for these individuals, such as with the aid of distraction or wakefulness.
In the absence of any of the criteria listed above, pregnancy is not a valid reason for exemption.
If I am eligible, how do I get the discount?
COVID vaccine therapy exemptions can be obtained from general practitioners, pediatricians, clinical immunologists, infectious disease, general or public health practitioners, gynecologists or obstetricians.
If someone feels that they qualify for a waiver based on the above, it is best to first visit a GP to discuss it.
The federal government will introduce a certification system for people to prove they have a medical exemption later this month. These services will be available through the Australia app.
With the mandate in place, GPs and other providers will feel pressure to exempt those who do not want to be vaccinated. Employers will demand clarity about who can receive. If a waiver request is denied, for both the provider and the patient, it can often lead to distress and conflict.
Also, there is a risk of compounding losses if the mandate is not enforced equitably and fairly.
These mandates are created at the level of a jurisdiction, so there may also be differences of opinion about which groups are affected depending on the state or territory.
The stakes are high for people who live without vaccinations, so it’s important employers, individuals and medical providers know about the new ATAGI clinical guidance on medical exemption criteria and the jurisdiction process. provide additional clarity.