The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Ensure you’re covered at work by joining the NSWNMA.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

If members are concerned their employer is not following these guidelines, the NSWNMA can provide assistance to ensure appropriate measures are in place. Contact us.

Australian Technical Advisory Group on Immunisation (ATAGI) advice on the AstraZeneca

‘Thrombosis with thrombocytopenia syndrome’ (TTS) is a newly described serious condition, with unusual blood clots in the brain (cerebral venous sinus thrombosis) or in other parts of the body, associated with low platelet levels and can cause serious long term disability or death.

The evidence that connects TTS to receipt of the AstraZeneca vaccine has been reviewed by ATAGI and the Therapeutic Goods Administration (TGA) and subsequently, ATAGI has recommended new changes to the Australian COVID-19 Vaccine Program, including a preference for the use of the Comirnaty (Pfizer) vaccine in adults aged under 50 years.

The ATAGI statement (found here) provides further information on the key considerations.  Amongst these were the following:

• TTS remains an extremely rare event among vaccine recipients. Experience in Europe has shown approximately  4 – 6 people in every one million people develop TTS in the 4-20 days after the first dose of vaccine. However higher rates have been reported in some countries, and among younger people. One person in Australia developed the syndrome after receiving the AstraZeneca vaccine.
• While Australia currently has very low or no community transmission of COVID-19, this could change. The risk of serious disease and death in Australia remains, even as border controls and other measures continue.
• The individual benefit-to-risk balance of vaccination with COVID-19 vaccine AstraZeneca in Australia varies with age. The risk of ongoing health issues and death from COVID-19 is highest in older age groups, particularly rising from 50 years of age. By comparison, the rate, and so possibility of disability and death from TTS may be higher in younger people.

ATAGI has further recommended that:

• The AstraZeneca vaccine should only be used in adults aged under 50 where the benefits clearly outweigh the risk 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 COVID-19 Vaccine AstraZeneca without any serious adverse effects can be given the second dose, including adults under 50 years.

FAQs

Is the AstraZeneca vaccine safe?

Yes. The individual benefit-to-risk balance of vaccination with the AstraZeneca COVID-19 vaccine varies with age. This balance is based on factors including the increased risk of complications from COVID-19 with increasing age and the potential lower risk of this very rare, but serious, adverse event with increasing age. ATAGI has recommended the AstraZeneca vaccine remains safe to be given to people aged 50 years and over.

I have had my first dose of the AstraZeneca vaccine, what do I do now?

If you have had your first vaccine dose without this side effect or other serious adverse effects, you should receive your second dose as planned.

What if I am worried about side effects?

If you have recently had your first vaccine dose and are experiencing any side effects that you are worried about, see your doctor.

I’m booked in for my first dose of the AstraZeneca COVID-19 vaccine, what do I do?

If you are an adult aged under 50 years, you should only receive a first dose of AstraZeneca COVID-19 vaccine where the benefit of receiving the vaccine clearly outweighs the risk in your individual circumstance. You may wish to discuss your individual benefit-to-risk balance with your doctor.

Generally, if you have not already received a first dose of the AstraZeneca COVID-19 vaccine, then the Pfizer COVID-19 vaccine is preferred in adults aged under 50 years.

If you are 50 years of age or older, you can still receive your AstraZeneca COVID-19 vaccine.

Administration of COVID-19 vaccine

To access FAQs on administering COVID-19 vaccines, click here.

Vaccination plan

The NSW Ministry of Health recently issued advice to healthcare workers on the rollout of the national COVID-19 vaccination plan.

Vaccines are voluntary, free and offered in a phased approach (Phases 1a, 1b, 2a, 2b and 3 as set out by the Australian Government).

There are five major vaccination hubs and 99 regional satellite sites.

​​​​Each hub will be responsible for vaccinating staff in a number of Local Health Districts. The hubs will not be open to members of the public during Phase 1a.

Staff identified to receive the COVID-19 vaccination in Phase 1a will be contacted directly about how, when and where they will be able to get vaccinated.

​As stated by the Ministry of Health, healthcare workers considered for prioritisation in Phase 1a of the vaccination program include:

• Ambulance and patient transport staff
• Emergency department staff
• Critical care ward staff (ICUs and HDUs, ECMO and medical retrieval teams)
• COVID clinic and COVID testing staff (public and private)
• COVID ward staff
• COVID immunisation clinic staff
• COVID pathology lab staff (public and private)
• Workers at the Special Health Accommodation facility

More hubs are expected to follow as more doses of vaccine become available.

Position statements and supportive evidence

As professional leaders in this area, nurses and midwives can find the NMBA’s position statement on vaccination here.

Ahpra’s position statement on Registered health practitioners and students and COVID-19 vaccination is available to view here.

The National Boards and Ahpra have published a joint statement to help registered health practitioners and students understand what’s expected of them in giving, receiving and advising on and sharing information about COVID-19 vaccines. It can be viewed here.

The ANMF’s policy on vaccination is here.

ANMF Evidence on the COVID vaccine is here.

Government guarantee to private hospital sector

Thanks to ongoing pressure from unions and employers, on 31 March 2020, the Australian Government announced a partnership with the private health sector to secure 30,000 hospital beds and 105,000 nurses and staff.

The federal government agreed to contribute 50% towards activity funding, provided private providers retain their workforce. For further detail on the guarantee, refer to this document.

The Commonwealth offered agreements to all 657 private and not-for-profit hospitals to ensure their viability, in return for maintenance and capacity during the COVID-19 response.

Leave (COVID-19)

In the first instance, enquire with your employer whether it has published a policy in relation to COVID-19 and self-isolation. You may also be able to access such a policy on your employer’s intranet if it has one.

If you’re directed not to attend work because you have COVID-19, are sick and/or exhibiting flu-like symptoms, then generally you will be required to take personal leave or sick leave. If you’ve run out of personal leave or sick leave then you should be able to access your other paid leave entitlements.

Leave entitlements during self-isolation

If you’ve been directed not to attend work due to self-isolation requirements then your employee entitlements will depend on your employer’s policy and the provisions of your award or enterprise agreement (see links to Industrial Instruments below).

Most private hospital nurses and midwives are covered by an enterprise agreement. Check it for relevant leave provisions, including personal/carer’s leave, and whether there are any stand down provisions that apply. If you require assistance identifying or interpreting your enterprise agreement then we’re here to help. You can contact us using this web form.

If you’re employed under the Nurses Award 2010 (only those without an enterprise agreement) and are required to self-isolate then it is reasonable for your employer to direct you onto personal/carer’s leave because you’re not able to work. If you’ve run out of personal/carer’s leave then you should be able to access other forms of paid leave that you have accrued.

Casual employees

Casual employees generally do not have the leave entitlements available to them that permanent employees have. If you’re a casual employee and required to self-isolate then your employer should consider standing you down on pay for any rostered shifts, although you are unlikely to have a legal right to the payment of wages for this time. Particular regard should be given by your employer to the length of your employment and whether you work on a regular and systematic basis.

Support

If your employer has directed you not to attend work for reasons related to COVID-19 and you have not been in contact with a confirmed case of COVID-19 or returned from overseas travel, then please contact NSWNMA for assistance.

Unfortunately employees in the private sector are not automatically entitled to the 20 days special leave made available by the NSW Government to its employees.

The above is intended as general information only and the advice in relation to each case will depend on its particular circumstances.

The NSWNMA will continue to provide further updates for members as we receive them. Contact us here.