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Immigrant Health Service

COVID-19 Immigrant health

  • Covid-19 and Covid vaccine information - main sources

    As of 3 Feb 2023

    • Covid cases - World - 671.3M  ~2.1M/week (reducing) and Australia - 11.3M (active cases now difficult to find (one source = 33,445), average daily reported cases 2656 (reducing), 7-d average hospitalised 1838, ICU 53 (@31/1/23 - both reducing)
    • Deaths - World - 6.84M ~33.8K/week (increasing) and Australia - 18,615 (1266 deaths in the last 3 weeks)
      • The overall case fatality rate was ~2% for the initial strains of covid. Deaths increase with age (>50y and more so >70y) pre-existing medical conditions, and are higher in Black, Asian and minority Ethnic (BAME) in US and other data. The risk for for serious outcomes exists across the age spectrum, and outbreaks in other countries have caused thousands of deaths in young adults. See risk calculator. 
    • Vaccination numbers
      • World - 13.26B doses (5.54B at least one dose, 5.09B people fully vaccinated)  
      • Australia - 64.68M doses >95% of age 16y+ 2 doses, 72.4% of those eligible boosted. Children @2/2/23 - 12-15y - 79.1% one dose, 73.9% fully, 5-11y 49.1% one dose, 39.2% fully (0-4y still not reported - minimal)

    • Vaccine safety and development process - Australia has followed normal process for vaccine registration and monitoring through the TGA.
    • Types of vaccine (WHO and also see UoM updates)
      • mRNA vaccines - use RNA to generate a protein that itself safely prompts an immune response 
        • Pfizer - approved for age 5y+ & booster age 12y+,  patient information (includes translated) - dose 10mcg age 5-11y, and 30mcg 12y+
        • Moderna - approved for age 6m+ & booster age 18y+, patient information (includes translated) - dose 25mcg age 6m-5y, 50mcg age 6-11y, 100mcg 12y+
          • Moderna - bivalent vaccines - (original/Omicron BA.1) - approved for use as any booster dose in age 18y+ - dose 50 mcg (i.e. lower than primary dose)
      • Viral vector vaccine - uses a safe virus that cannot cause disease, but serves as a platform to produce coronavirus proteins to generate an immune response 
        • Astra Zeneca - available adults 60y+, can be used 18-59y if patient preference, patient information (includes translated), can be used as booster if mRNA vaccines are contraindicated or declined
      • Protein conjugate vaccine - uses part of the spike protein from covid with an adjuvant to boost immune response
        • Novovax - approved for age 12y+ can be used as a booster dose if not other covid vaccine considered suitable, patient information  - dose 5mcg 12y+

    • Vaccine efficacy  note: many studies prior to omicron and difficult to compare between vaccines, vaccine efficacy wanes with time. In general, for both Delta and Omicron, hybrid immunity (infection + vaccination) provides the greatest protection (highest level and longest duration), and while protection wanes quickly for re-infection, it remains high against hospitalisation/death.
      • Pfizer - 55-95% any infection, 18-97% symptomatic infection, 74-99% severe disease/hospitalisation, 90-100% death 
        • Omicron - any 55%, symptomatic infection - varies, 3rd dose post-infection 76%, 2nd dose post-infection 55%, hospitalisation/death - varies, ~70-90%, reduces with time, 4th dose more effective than 3 doses.
          • Recent evidence in children 5-11y - fully vaccinated 41-83% protection against hospitalisation
      • Moderna - 37-92% any infection, 45-95% symptomatic infection, 77-98% severe disease/hospitalisation, 98% death
        • Omicron - any 20-64%, symptomatic infection ~40-60%, hospitalisation/death - varies, ~65-95%, reduces with time, higher for boosters, 4th dose more effective than 3 doses
      • AstraZeneca (AZ) - 45-73% any infection, 39-78% symptomatic infection, 83-100% severe disease/hospitalisation, 90-100% death
        • Omicron - any - booster <3m 30-51%, Sx - 0-50%, hospitalisation/death - varies, 25-83%
      • Novovax - limited data, around 90% symptomatic infection, 100% moderate-severe. Trials underway in children.
    • Covid vaccines do not necessarily prevent transmission, even less so with omicron (and a vaccinated person can still get the infection and pass it on to others)

    • Australian Rollout strategy  Covid vaccination recommended and Cth Covid vaccine schedule, Cth Covid vaccines for children - also summary below - delay any vaccination dose for 3-months after covid infection *commenced 29/4/22
      • Children 6m-4y with severe immunocompromise, disability or complex/multiple conditions increasing the risk of severe covid-19 - see ATAGI statement
        • Moderna paediatric 6m-<5y, primary course = 2 doses, interval 8-weeks, min 4-weeks. Where possible, separate administration from other vaccines by 7-14d
      • Primary course - anyone 5 years and older, including women at all stages of pregnancy and breastfeeding. *New intervals from 29/4/22
        • Pfizer age 5y+, primary course = 2 doses, interval 8-weeks (all ages), min 3-weeks
          • Children aged 5 years can have either Moderna paediatric dose (25 mcg) OR Pfizer 10 mcg dose
        • Moderna age 6y+, primary course = 2 doses, interval 8-weeks (all ages), min 4-weeks
        • AZ available adults 60y+ and 18-59y if they choose, not preferred in pregnancy, primary course = 2 doses, interval 12-weeks, min 4-weeks
        • Novovax available for age 12y+, primary course = 2 doses, interval 8-weeks, min 3-weeks
        • Preferred to use same vaccine type for 2 primary doses, absolute minimum interval 14d to be considered valid on AIR
        • Children aged 5-11y - Pfizer dose is one third of the adult dose (orange-top vial - registered for use 5-11y), Moderna is half the adult dose (registered for use 6-11y). If children turn 12y after their first dose they can receive the adolescent dose as their 2nd dose
      • Severely immunocompromised age 6m+ are eligible for a 3rd primary dose (considered part of the primary course, interval 2-months after 2nd dose, mRNA vaccine recommended)
      • Booster doses
        • Initial booster - all 16y+ - strongly recommended for age 16y+ regardless of vaccine type for primary course, mRNA vaccines preferred (all types), Pfizer 16y+, Moderna/Moderna bivalent 18y+, Novovax 12y+, AZ can be used if contraindication to mRNA/mRNA declined; interval 3-months after primary course. 
        • Initial booster 12-15y - eligible if severe immunocompromise, disability or complex health needs, complex/multiple conditions increasing risk of severe covid-19; Pfizer formulation, interval 3-months after primary course, Novovax may be used if no other brand suitable 
        • Winter booster - all 50y+, available 30y+ and criteria based 16y+  (announced Mar 2022, extended Jul 2022) - recommended for age 50y+, available to anyone age 30y+, and also recommended for age 16y+ residents aged care/disability, immunocompromised, complex/chronic/severe medical conditions/disability increasing risk of severe illness. See ATAGI table conditions. mRNA vaccines preferred, AZ can be used if contraindication to mRNA/mRNA declined, Novovax can be used if no other vaccine suitable. Interval 3-months after initial booster (changed Jul 2022)
        • 2023 booster - ATAGI guidelines Feb 2023 (regardless of prior doses, if 6-months after last covid vaccine or confirmed covid infection and aim for vaccine before June 2023). Bivalent mRNA vaccines preferred (although all formulations acceptable) - Pfizer original/omicron BA.4/5 (12y+) or original/omicron BA.1(18y+), or Moderna original/omicron BA.1 (18y+).
          • Recommended - all adults 65 years and older and adults 18-64 years with medical comorbidities or disability - bivalent mRNA preferred
          • Consider - all adults 18-64 years - bivalent mRNA preferred 
          • Consider - children 5-17 years with medical co-morbidities or disability - 12-17 years Pfizer original/omicron BA.4/5 preferred, 5-11y - Pfizer original.
      • The vaccine is free for everyone in Australia, even if they don't have Medicare, the vaccine is not mandatory 

    • How do I get vaccinated? - Sites include GPs, pharmacists, State run clinics, Cth vaccine clinic finder, Covidnearme and Covidqueue
    • Consent process - ATAGI guideline on consent

    • Side effects and what to do if you get them
      • It's important to remember that the main side effect of covid vaccine is to avoid serious illness and hospitalisation with Covid-19
      • All vaccines can cause side effects, usually these are mild and last 1-2 days. Common side effects include a sore arm, fatigue, headache, fever and muscle aches - take panadol or ibuprofen if needed. Respiratory symptoms (coryza/cough) are not associated.
      • Serious side effects are rare:
        • Anaphylaxis - AZ ~ 1/1,000,000; Pfizer ~ 1/200,000 (ATAGI and ASCIA) - typically within 15 minutes, mostly in people with a past history of drug allergy, and with good recovery with treatment (CDC)
        • Deaths - (TGA 17/11/22) in 64 million doses of vaccine, there have been 14 deaths likely related to vaccination, 13 with AZ vaccine, 8 from TTS (see below) and 5 other, all age 34-81y. One death occurred after a booster dose of Moderna vaccine.
        • Myocarditis and pericarditis monitoring - 1-2/100,000 Pfizer, 2/100,000 Moderna. More common after 2nd dose in 12-17y males (13/100,000 & 24/100,000 respectively) and males < 30y (9/100,000 and 23/100,000 respectively). Less common after booster doses <1/100,000. 
          • TGA (11/12/22) - 706 reports of likely myocarditis from 44.4M doses Pfizer, 113 likely myocarditis from 5.4M Moderna. See ATAGI/CSANZ advice.
          • TGA (17/11/22) - children 5-11y - 2.3M Pfizer or Moderna doses, 4 likely myocarditis, 1 probable and 6 possible cases of pericarditis. 
        • TTS after AZ vaccine - 2/100,000 - almost all after 1st dose, usually ~2 weeks after vaccination. There has not been a higher rate of more common blood clots (including DVT/PE)
          • ATAGI,  TGA- no new cases in 2022. (166 cases in total 13.5M vaccine doses in 2021), 8 deaths (4.8% total cases TTS) - earlier detection and higher survival in Australia. 

    • Monitoring - AusVaxSafety - (as of 23/1/23) 6.61M people have provided information 3 days after their vaccination - overall 44.1% reported any side effects, and 0.9% needed to visit a doctor or emergency department.
    • ATAGI risk benefit document (June 2021) and AskShareKnow decision aids (includes picture based information).
    • Record keeping - vaccines are recorded on the Australian Immunisation register (AIR)- you do not need Medicare to have an AIR record. People can also apply for an Individual Health Identifier (IHI, with certified proof of identity) - you do not need an IHI for AIR records either. Covid vaccination does not affect Centrelink payments. AIR records are individualised from age 14-years.
    • Questions on vaccinations - Commonwealth - is it true?, NCIRS, MVEC, allergies, MVEC vaccine confidence, and Victorian DH translated
    • And still test if you have symptoms

    Key data sources

    Timeline related to migration

    • 31 Dec 2019 – Pneumonia cases in Wuhan, China reported to WHO regional office
    • 25 Jan 2020 – Australian restrictions on travel to and arrivals from China
    • 30 Jan 2020 – WHO declares public health emergency of international concern
    • 01 Mar 2020 – Australian restrictions on travel to and arrivals from Iran
    • 11 Mar 2020 – WHO declares pandemic
    • 13 Mar 2020 – Expanded MBS telehealth item numbers
    • 16 Mar 2020 – Victoria declares State of Emergency
    • 16 Mar 2020 – IOM and UNHCR suspend travel for refugees. People with a 202 visa may still travel to Australia pending flight availability, quarantine applies to international arrivals
    • 18 Mar 2020 – DFAT issues standing advice to not travel overseas, with subsequent closure of many transit hubs
    • 18 Mar 2020 - Guard at Kangaroo Point APOD in Qld tests positive for coronavirus - see media reporting
    • 21 Mar 2020 – Victorian Government announces $1.7B economic survival package, including a $500M Working for Victoria fund
    • 23 Mar 2020 – Stage 1 restrictions Victoria
    • 24 Mar 2020 – Prime Minister announces a ban on all overseas travel (with limited exceptions), and advice to avoid all non-essential domestic travel
    • 24 Mar 2020 – Detention visitor program suspended
    • 25 Mar 2020 – Stage 2 restrictions Victoria – non-essential businesses close
    • 28 Mar 2020 – Enforced 14 day quarantine for all international arrivals in Victoria
    • 29 Mar 2020 – New  Coronavirus supplement announced – $550/fortnight in addition to existing payments through JobSeeker, Youth Allowance, Special Benefit, Parenting Allowance and others - see fact sheet
    • 30 Mar 2020 – Stage 3 restrictions Victoria – to apply for 4 weeks, no more than 2 people in a gathering, only 4 reasons to be out (essential supplies, healthcare, exercise, work/study if required), playgrounds closed), restrictions now enforceable
    • 30 Mar 2020 – Federal Government announces $130B JobKeeper payments – providing affected businesses with $1500/fortnight per employee (70% median wage) – for citizens, permanent residents, and special category visa (SCV) holders – see fact sheet
    • 31 Mar 2020 – OHCHR, IOM, UNHCR and WHO joint press release - The rights and health of refugees, migrants and stateless must be protected in COVID-19 response
    • 31 Mar 2020 – CDNA guidelines for COVID in correctional and detention facilities - later revised Jun 2020, and Aug 2020
    • 2 Apr 2020 – Federal government announces free childcare - see media release, and  media reporting - free childcare was not limited by residency status but ended mid-July 2020. 
    • 4 Apr 2020 – National COVID-19 Clinical evidence taskforce announced
    • 7 Apr 2020 – Victorian government announces school students to learn from home in term 2
    • 12 Apr 2020 – Additional Victorian Government funding ($59.4M) for mental health during COVID – see media release
    • 17 Apr 2020 – Additional Victorian Government funding ($40.2M) for crisis accomodation and specialist services for family violence
    • 23 Apr 2020 - Additional Victorian Government funding (S77.5M) for vulnerable children and families - including additional payments for foster carers
    • May 2020 - Additional Victorian Government funding ($17M) for people with disability
    • 6 May 2020 - NRAAG - COVID-19 consultation report
    • 6 May 2020 - RCOA Summary of April 2020 Working Group on Resettlement Briefing on Covid-19.
    • 3 Jun 2020 - UNHCR Policy Brief - Covid-19 and People on the Move - also see commentary by Gillian Triggs, Assistant High Commissioner for Protection.
    • 18 Jun 2020 - UNHCR and IOM announce resumption of resettlement travel for refugees
    • 20 Jun 2020 - Victorian worker support payment ($1500) 
    • 30 Jun 2020 - Victorian government announces further lockdowns by postcode - see Premier's media release. 
    • 3 Jul 2020 - Lockdown of public housing high rise towers in Flemington - see DHHS information and media reporting
    • 7 Jul 2020 - Victoria announces return to Stage 3 restrictions from midnight Wed 8 Jul 2020
    • 10 Jul 2020 - Victoria asks all people to wear masks in public where social distancing not possible - see DHHS information and media reporting
    • 12 Jul 2020 - Victoria announces return to remote learning for students in prep-year 10
    • 13 Jul 2020 - Guard at the Mantra Preston APOD tests positive for coronavirus - see media reporting
    • 13 Jul 2020 - Extreme hardship program - for people unable to access other Victorian or Commonwealth support, including temporary and provisional visa holders and undocumented migrants (payment of $400 for a single adult, more for families, with a possible 2nd payment after 2 months) - phone - 1800 855 240 (available to support eligible people submit an application).
    • 19 Jul 2020 - Face masks mandated in Victoria from 22 Jul 2020 - for all people aged 12 years and older
    • 21 Jul 2020 - Job Keeper program extended to 28 Mar 2021, with new changes announced including tiered payments (full time workers $1200/fortnight, part-time workers <20 hours/week $750/fortnight), increased checks of eligibility (business turnover), and new conditions for childcare commencing immediately. Changes to payments commence 28 Sep 2020, with further reductions from 4 Jan 2021.
    • 2 Aug 2020 - State of Disaster and Stage 4 restrictions announced in Victoria (note criteria for onsite supervision in Education section of this document and childcare permits).
    • Aug 2020 - Victorian coronavirus test isolation payment ($300)
    • 10 Aug 2020 - home based testing for vulnerable communities - 'Call to test' (GP referral required)
    • 13 Aug 2020 - Victorian government announces 'Working together for multicultural communities' - $14.3M additional funding. 
    • 14 Sep 2020 - Further 2 weeks of stage 4, although curfew 9 pm, exercise - 2 hours exercise/outdoor time daily - 2 people or a household; visitors - those living alone, or single parent - one nominated visitor; distance - 5 km zone, education: remote learning unless exemption
    • 24 Sep 2020 - Job Seeker/Coronavirus supplement payments  reduce to $250/fortnight (until 31 Dec 2020, then to $150/fortnight until 31 Mar 2021), also with mutual obligations reinstated, and increased threshold for additional income prior to reduction of payments (to $300).
    • 28 Sep 2020 - Victoria moves to '2nd step' out of lockdown, face masks, curfew stops, exercise as above; up to 5 people from 2 households outdoors, visitors as above, distance - 5 km zone, education - Childcare restarts
    • 28 Sep 2020 - information on DHA transitioning people in community detention to final departure BVE - initially Qld, NSW, SA, subsequent stay for Victoria
    • 1 Oct 2020 - Announcement Extreme hardship payments doubled - see Premier's media release
    • Oct 2020 - very small numbers of offshore arrivals recommence
    • 5 Oct 2020 - education - Kinder restarts and year 12 GAT testing the same week
    • 12 Oct 2020 - education - prep-2 and years 11-12, and specialist education restarts, otherwise remote learning unless exemption
    • 22 Nov 2020 - 'third step' - curfew - stops;  distance - no restrictions; outdoors - up to 50 people, visitors - household visitors - up to 15 visitors, education - staged return to school for years 3-10
    • 24 Nov 2020 - Victorian State Budget - includes $3.9 million for asylum seekers in 2020-21, and free 3-year old kindergarten (15 hrs weekly) for all refugee and asylum seeker children from 2021 across Victoria.
    • 7 Dec 2020 - face masks public transport/taxis and shared vehicles/supermarkets and department stores, outdoors - up to 100 people, visitors - household visitors - up to 30 daily (can be across different visits); international arrivals to Victoria restart
    • 18 Dec 2020 - new cases of Covid in NSW (Northern Beaches) and face masks also applied to airport terminals in Victoria
    • 18 Dec 2020 - Refugee Council of Australia (RCOA) report - Homelessness and hunger among people seeking asylum during Covid-19
    • 21 Dec 2020 - Hotel quarantine inquiry final report.
    • Jan 2021 - Medevac refugees released from APODs in Victoria - see ASRC summary numbers
    • 12 Feb 2021 - snap 5 day lockdown in Victoria, and tightening of restrictions - 5 km rules, essential reasons to leave home, 2 hours exercise, masks inside and outside 
    • 17 Feb 2021 - Victorian restrictions change - masks inside and outside if social distancing not possible, max 5 visitors, max 20 people outside
    • 22 Feb 2021 - Vaccine rollout commences - stage 1a - border/quarantine, frontline health, aged care/disability staff/residents
    • 26 Feb 2021 - Victorian restrictions eased again - masks on public transport, supermarkets, department stores
    • 14 Mar 2021 - Telehealth extended to 30 June 2021 - see PM media release and MBS guidelines (note different for GPs)
    • 17 Mar 2021 - Minister Hunt announces booking system for GPs - concerns then raised by GPs around lack of notice - see media
    • 22 Mar 2021 - Vaccine rollout stage 1b - adults 70y+, other HCW, Aboriginal people 55y+, younger adults with medical conditions/disability, essential workers (EW)
    • 26 Mar 2021 - Victorian restrictions eased - masks on public transport/ride-share, hospitals, airports/flights, symptoms; max 100 visitors, max 200 people outside, workplaces 100%, most venues 75%; 1 person/2m2
    • 28 Mar 2021 - Jobkeeper supplements and tenancy protections end
    • 31 Mar 2021 - Jobseeker coronavirus supplement payments end, and temporary waiver for newly arrived residents waiting period ends
    • 7 Apr 2021 - UNHCR statement on access to covid vaccination for refugees
    • 8 Apr 2021 - ATAGI recommends Pfizer preferred vaccine for adults <50y, with PM press conference.
    • May 2021 - Support for Asylum Seekers initiative – $3.9 million announced in the Victorian State Budget - extending case coordination, basic needs, utilities and homelessness assistance; mental health support and primary care support.
    • 3 May 2021 - Vaccine rollout stage 2a - AZ vaccine for people >50y at Cth and State services, then 17 May 2021 - same in general practice
    • 24 May 2021 - new community acquired cases in Victoria, with a rapidly increasing number of exposure sites
    • 27 May 2021 - Victoria opens Pfizer vaccination to people aged 40-49y
    • 28 May 2021 - 7 lockdown for Victoria, masks inside and outside, 5 km, 5 reasons to leave home only, schools move to online - see guidelines
    • 2 Jun 2021 - further 7 days lockdown announced for Victoria, 10 km radius
    • 3 Jun 2021 - Federal government announces 'temporary covid disaster payments' for people in greater Melbourne area with <$10,000 in 'liquid assets', $500 if work >20h, and $325 <20h.
    • 10 Jun 2021 - lockdown lifted in Victoria
    • 16 Jun 2021 - first case of delta variant in NSW --> becomes a more widespread outbreak
    • 17 Jun 2021 - ATAGI recommends Pfizer as preferred vaccine for age 16y - 59y
    • 25 Jun 2021 - NSW commences lockdown, followed rapidly by lockdowns in Queensland, NT and WA
    • 28 Jun 2021 - PM announces AZ vaccine available to anyone aged 18y+ by choice, and announces new no-fault indemnity scheme for GPs - it is not clear whether this scheme includes nurses/specialists, and details are currently unclear - see media reporting
    • July 2021 - $355,000 short term COVID-19 Asylum Seeker emergency rental brokerage fund - emergency assistance to maintain secure housing and assist with rental arrears. The funding was administered through the NASAVic HEF mechanism via Launch Housing, via ASRC, Red Cross, Uniting, Baptcare and the Brigidines.
    • 15 Jul 2021 -  5 day lockdown commences at midnight after new cases of covid delta variant in Victoria, later extended for a further 2 days, ending 28 July 2021
    • 23 Jul 2021 - TGA approved Pfizer vaccine for 12-15 year olds
    • 2 Aug 2021 - ATAGI statement on use of Pfizer vaccine in children 12-15 years (specified medical conditions, Aboriginal and Torres Strait Islander children, children in remote communities)
    • Aug 2021 - new cases of delta variant, and higher proportion in children and young adults
    • Aug 2021 - release of JRS report on homelessness in people seeking asylum during Covid (Mar 2020 - Mar 2021) - A place to call home
    • 6 Aug 2021 - Lockdown in Victoria - 7 days, cases in Al Taqwa, Warringah specialist school, high rise towers Flemington. 
    • 9 Aug 2021 - TGA provisional approval of Moderna vaccine, with 10M doses arriving from Sep 2021
    • 16 Aug 2021 - Victorian lockdown extended for another 14 days (until 2 Sep 2021), playgrounds closed and curfew imposed - see media release
    • 15 Aug 2021 - Taliban forces take control of Kabul, with subsequent evacuation of more than 100,000 people
    • 21 Aug 2021 - Regional Victoria enters lockdown, and new restrictions on childcare and kindergartens - see media release - regional lockdown lifted 8 Sep 2021
    • 25 Aug 2021 - Vaccinations open for those age 16y+
    • 31 Aug 2021 - reporting on covid vaccine coverage in Immigration detention - 35% partially and 16% fully vaccinated (comparable national figures at the time = 59%, 35%)
    • 13 Sep 2021 - Vaccinations open for adolescents aged 12-15 years
    • 17 Sep 2021 - slight easing of restrictions for metro Melbourne - exercise with one other person, 5 fully vaccinated adults, from 2 households (+dependents) can meet outdoors
    • 19 Sep 2021 - Roadmap out of lockdown released - including Burnet Institute modelling - hospitality and community sport from 70% double vaccination (16yrs+ - expected 26 Oct 2021), schools reopen from 5 Oct 2021 (year 12s start back 6 Oct 2021), 80% double vaccination (16y+ - expected 5 Nov 2021) - easing restrictions on household visitors. Peak covid cases expected mid October at the time.
    • 7 Oct 2021 - Victorian rules around secondary close contacts (i.e. people in the same house as a PCC) change - no longer required to isolate (but need to get tested if they have Sx)
    • 22 Oct 2021 - Melbourne lockdown ends - no curfew, no limits on leaving home, hospitality re-opens, 10 visitors to home, 25km limit continues
    • 29 Oct 2021 - Travel to regional Victoria permitted
    • 18 Nov 2021 - further easing of restrictions in Victoria - no restrictions home visits, masks in health facilities, public transport, retail, schools. Cases isolate 10 days, no contact tracing, household contacts isolate 7d if fully vaccinated, 14d if not vaccinated, non household contacts isolate until test negative, cases to notify their work, uni, school or childcare. Infectious period = 2 days prior to onset symptoms or test + (whichever comes first).
    • 24 Nov 2021 - Omicron variant reported to WHO - subsequently identified as variant of concern
    • 3 Dec 2021 - ATAGI statement on Omicron and booster doses
    • 5 Dec 2021 - TGA provisionally approves Pfizer vaccination for children aged 5-11 years
    • 8 Dec 2021 - ATAGI recommendations on vaccination of children 5-11y, and TGA approves use of Moderna for booster doses
    • 23 Dec 2021 - Covid cases rise in NSW to more than 5000 cases daily, interval for booster doses shortened (to 4m) for people 18y + (not yet recommended age 12-17y)
    • 24 Dec 2021 - Masks become mandatory again for all people aged 8y and older in Victoria.
    • 4 Jan 2022 - Booster dose interval shortened to 4 months
    • Jan 2022 - Rapid escalation in covid cases in Australia - from 430K cases as of 2/1/22 to 2.16M cases by 31/1/22
    • 10 Jan 2022 - Vaccinations open for children aged 5-11 years
    • 20 Jan 2022 - Novovax approved for use (age 18y+) in Australia
    • 24 Jan 2022 - Free RAT tests for concession card holders (10 per 3 months, max 5 per month, until 30 Apr 2022)
    • 28 Jan 2022 - TGA provisionally approves booster dose for 16-17 year olds
    • 31 Jan 2022 - Booster dose interval reduced further to 3 months
    • 10 Feb 2022 - ATAGI change in terminology to 'up to date' for vaccination
    • 24 Feb 2022 - Moderna approved for use in children age 6-11 years (note different age range to Pfizer)
    • 25 Feb 2022 - Victorian covid settings ease - masks no longer required indoors, still recommended and required for hospitals, public transport, schools (8y+), work from home recommendation stops
    • Early March 2022 - guidelines on recovered cases change - do not need to be tested within 8 weeks after release from isolation
    • 22 Mar 2022 -  guidelines on recovered cases change - do not need to be tested within 12 weeks after release from isolation - also close contacts who have recovered from Covid-19 do not need to quarantine if they are asymptomatic, not immunocompromised, and re-exposure is <12 weeks since release from isolation. 
    • 25 Mar 2022 - ATAGI recommends winter booster doses for: age 65y+, residents aged care/disability, severely immunocompromised, Aboriginal or Torres Strait Islander age 50y+ (4m after 3rd dose).
    • 8 Apr 2022 - TGA approves Pfizer booster doses for age 12-15y (ATAGI approval pending).
    • 22 Apr 2022 - Changes to (easing) Victorias covid restrictions - close contacts - no longer need 7d isolation (instead complete 5 RAT tests, masks indoors, and avoid sensitive settings), cases still isolate 7d, but do not require repeat testing/quarantine for 12 weeks, masks stop for schools, early childhood, hospitality, retail (only required for public transport, airports/planes, sensitive settings); no hospital visitor restrictions, travellers - no quarantine required for unvaccinated, and no post-arrival testing. Vaccine mandates remain in place for key industries (health, education, justice, aged care, disability, emergency services, food distribution, meat/seafood processing).
    • 27 Apr 2022 - Changes to ATAGI advice on vaccine intervals, and vaccination post-infection
    • 1 Jul 2022 - PCR availability scales back in Victoria - with RAT testing the preferred test option for most people
    • 7 Jul 2022 - ATAGI updates recommendations for 4th dose vaccine - available for everyone aged 30y+ and recommended age 50y+, interval drops to 3m (from 4m) - see media announcement.
    • 12 Jul 2022 - Victoria's pandemic declaration due to expire - extended for a further 3 months (to 12 Oct 2022) - see Premier's media release
    • 12 July 2022 - guidelines on recovered cases change back - do not need to be tested/isolate for 4 weeks after release from isolation (from 12 weeks)
    • 19 Jul 2022 - TGA provisional approval of paediatric Moderna vaccine for children 6m-5y
    • 24 Jul 2022 - Free RAT test availability extended for people with disability (until end Sep 2022) 
    • 28 Jul 2022 - TGA provisionally approves Novovax for age 12-17y
    • 3 Aug 2022 - ATAGI recommends covid vaccine for children 6m-<5y with severe immunocompromise, disability or complex/multiple health conditions increasing the risk of severe covid-19. 
    • 25 Aug 2022 - ATAGI supports use of Novovax for adolescents 12-17 years to commence 5 Sep 2022
    • 29 Aug 2022 - TGA provisionally approves Moderna bivalent vaccines as booster dose for age 18y+
    • 1 Sep 2022 - Covid isolation period reduced to 5 days if no symptoms and not in high risk settings, commencing 9 Sep 2022 (and also masks no longer required on planes) - see media. Pandemic Leave Disaster payments will also reduce (from $750-$540)
    • 1 Sep 2022 - Victorian work from home requirements end - see media
    • 12 Sep 2022 - ATAGI statement on use of Moderna bivalent vaccines for booster dose (age 18y+)
    • 20 Sep 2022 - TGA provisional approval Pfizer vaccine as booster for age 5-11y
    • 23 Sep 2022 - TGA provisional approval of Pfizer vaccine for children 6m - <5y (dose = 3mcg)
    • 30 Sep 2022 - TGA provisional approval Moderna bivalent original/omicron BA.4/5 as booster
    • 12 Oct 2022 - Pandemic declaration ends and isolation requirements end in Victoria - see Premier's media release, other media and Post pandemic orders (PH advice - 12 Oct 2022). Targeted financial support for eligible healthcare workers only, mandated vaccination healthcare only.
    • 14 Oct 2022 - Cth isolation payments end.
    • 19 Oct 2022 - TGA provisional approval Moderna covid vaccine for booster age 12y+
    • 27 Oct 2022 - TGA provisionally approves Pfizer bivalent (Original/Omicron BA.1) vaccine for use as a booster in age 18y+ 
    • 15 Nov 2022 - ATAGI updates recommendations to include use of Pfizer bivalent (Original/Omicron BA.1) vaccine for any booster in age 18y and TGA and provisional determination for Pfizer bivalent original/omicron BA.4/5)
    • 12 Dec 2022 -  Commonwealth announces National plan to transition Australia's Covid-19 response over the next 12 months.
    • 31 Dec 2022 - Victoria's Covid response changes again, with reduction in most State run services, and transition to primary care and LPHU led models. State run hubs close, GP respiratory infection clinics and primary care; testing - RAT testing 1st line, PCR via primary care or GP-RIC, isolation 5 days or until symptoms free.
    • 20 Jan 2023 - TGA grants provisional approval for Pfizer bivalent original/omicron BA.4/5
    • 30 Jan 2023 - TGA commences evaluation of Moderna covid vaccine for transition to full registration (primary immunisation 6y+ and booster 12y+)
    • Feb 2023 - free RATs in Victoria through LGAs (no Medicare required)
    • 8 Feb 2023 - ATAGI recommendations 2023 Covid boosters, and Pfizer bivalent (original/omicron BA.4/5) (age 12y+)

    Telehealth

    Immigrant health transitioned to telehealth for many consults from 2020 - a high proportion of our patients rely on public transport, and there were/are challenges with social distancing in a family based clinic model working with interpreters. Direct attendances were limited to targeted visits where examination, tests, or immunisations were essential over 2020-21. In 2022 - we offer 1st visits as telehealth where families prefer or when they are isolating - which allows us to take the initial history, ascertain transport and technology options, and then plan an efficient direct visit. 

    Quick tips

    • Data usage: HealthDirect telehealth uses ~230 MB on a mobile device and 450 MB on a PC for a 20 minute call – similar to Skype or FaceTime, and less than half the data of an HD YouTube video. Data use is more on three party consults, and less on lower speed internet connections. There is no data use while waiting for the consult to start.Phone companies
    • Functions: HealthDirect allows clinicians to open a chat function, share a screen and use a whiteboard function and send messages (in language!) via email or SMS
    • Three party consultations: work well for interpreting or for JMS supervision, however data use increases, which may affect call quality. 
    • Billing: 
      • Consults should record consent for telehealth and bulk-billing – verbal consent is adequate if the consult is not recorded. See ACRRM consent form for an outline of benefits and risks.
      • Previous TH items for rural/regional patients (112) replaced by TH item numbers introduced during the pandemic as of Jan 2022
      • New changes - from July 2022 for paediatricians - out of hospital attendances (non-admitted patients) - temporary item number that are now permanent

    Telehealth resources

    Translated resources

    Supports

    Covid + pathways - fact sheet (Dec 2021)

    Emergency relief and food

    Childcare and schools

    Employment related and income support

    Mental health 

    Other

    People seeking asylum 

    • Are not eligible for supports directed to permanent residents/citizens, see Asylum seekers webpage for additional resources.
    • Refugee Council of Australia - service guide (search by area)
    • SRSS – evidence for new applications is unchanged, clients should contact their case management agency.
    • Covid testing and vaccination remains free for everyone, regardless of visa or Medicare status

    Immigrant health clinic resources. Author Georgie Paxton, Sophie Oldfield, Linny Phuong, 2 April 2020, updated 9 Feb 2023. Contact: georgia.paxton@rch.org.au