Winter Dose of COVID-19 vaccine

The Australian Technical Advisory Group on Immunisation (ATAGI) recommends an additional dose of COVID-19 vaccine for winter for selected population groups (see summary and poster) who are at greatest risk of severe illness from COVID-19 and who have received their primary vaccination and first booster dose.

• ATAGI advice on the administration of seasonal influenza vaccines in 2022
• ATAGI clinical advice on COVID-19 vaccination

The best time for Influenza vaccinations is mid-April through May. The vaccine provides optimal coverage for approximately five months, which should get most of your patients through ‘Flu season.

However, there is nothing to stop you from beginning vaccinations, for your patients who qualify under NIP, as soon as you receive the first allocation of vaccine (check and confirm your practice's pre-allocation order here). You can also start ordering commercial supplies for those of your patients who don’t qualify for free immunisations under the NIP scheme.

Below are some practical tools to help you get ready.

• COORDINARE Immunisation Tools and Resources
• NSW Health Flu Provider Toolkit
• RACGP Pandemic Flu Kit and Implementation Guide

We know there are people in the community who are particularly vulnerable to influenza and COVID-19. Page 10 of the NSW Health Influenza Vaccination Provider Toolkit provides detail on patients to target for funded vaccines. If you need help identifying these at risk populations at your practice you can always refer to COORDINARE’s Winter Strategy clinical data auditing activities using CAT4.

Other vulnerable groups may also be considered ‘at-risk’ for developing influenza and can be identified by using the CAT4 tool. Below are some aides for these patients.

Refugee and migrant populations

• llawarra Shoalhaven HealthPathways Refugee Health
• ACT & SNSW HealthPathways Refugee Health
• Translating and Interpreting Service
• Multicultural communities
• Model of care for refugees

Family and domestic violence

• Illawarra Shoalhaven HealthPathways Domestic Family Violence
• ACT & SNSW HealthPathways Assault or Abuse
• Domestic violence help

At risk or socially disengaged adolescents

• Illawarra Shoalhaven HealthPathways Child or Young Person at Risk
• ACT & SNSW HealthPathways Child or Young Person at Risk

Patients with dementia

• Illawarra Shoalhaven HealthPathways Older Persons' Health
• ACT & SNSW HealthPathways Older Adults' Health

Pregnant patients

Refer to instructions from Best Practice or Medical Director to identify these patients.

This toolkit aims to help practices identify and implement processes to support those vulnerable groups most at risk of becoming unstable, very unwell or admitted to hospital during the flu season.

• Quality improvement toolkit: Preparing for winter and Quality Improvement Plan Template

This toolkit aims to help practices review their systems to ensure infection control and safe work environments are maintained during the pandemic.

• Quality improvement toolkit: Infection Control

This clinical data auditing excerpt is part of the SPDS program and can be used to identify vulnerable patient cohorts for follow-up by clinicians.

• Winter Strategy - clinical data auditing activities using CAT4

This model of care incorporates different elements of the 2019 Winter Strategy projects that can be adapted to fit your practice patient population and interests.

• Winter Strategy Model of Care

These quality improvement recipes provide simple ideas that practices can implement.

• Aboriginal and Torres Strait Islander QI Recipe
• patients with cardiac conditions QI Recipe
• patients with diabetes QI Recipe
• patients with multiple chronic conditions QI Recipe
• patients on multiple medications QI Recipe
• patients with asthma QI Recipe
• patients with COPD QI Recipe

These case studies, model of care documents and video resources from the Patient Centred Medical Home (PCMH) initiatives can be adapted to develop your own workflows in practice.

• PCMH resources

Other resources

• RACGP: An introduction to Aboriginal and Torres Strait Islander cultural protocols and perspectives
• COORDINARE Population Health Profile

As all practices have had to adapt rapidly to the increase in demand from patients for support with COVID-19, it’s great when we can share experiences between local practices that may assist others. A number of practices have agreed to share some of their current workflows to support others also experiencing similar challenges:

• Bulli Medical Practice
• Terralong Street Surgery
• Woonona Medical Practice

 

Practices can stay updated with the latest influenza Immunisation and COVID-19 information and processes by accessing their local HealthPathways site:

ACT & Southern NSW
Influenza Immunisation
COVID-19
Username: together
Password: forhealth

Illawarra Shoalhaven
Influenza Immunisation
COVID-19
Username: connected
Password: 2pathways

When was the last time your practice reviewed its triage protocols? With another COVID-19 spike in Omicron, and influenza season well on the way, now may be the time!

The RACGP Standards for General Practice has useful information to guide you whilst undertaking a review, or creating of a set of triage protocols if your practice doesn’t already have one.

Coming up to flu season there will be another set of immunisations being stored in your practice vaccine fridge. Maintenance of the cold chain, to successfully preserve those vaccines, is vital.

Education in cold chain management for any staff who may not have received their training yet (or those staff members who would like a refresher) can be found here, and don’t forget to keep a register of who completed the training and when for accreditation and QI purposes!