Who cannot be vaccinated against COVID and how to obtain a medical exemption?


As Australia strives to get 80% of those over 16 and over fully vaccinated against COVID, there is more pressure to make vaccination mandatory in various sectors.

Some sectors in some states and territories have already implemented a COVID vaccine mandate, such as healthcare and senior care workers. Last week, Victoria made COVID vaccination mandatory for all authorized workers in the state, which was a difficult but necessary decision. Governments and businesses are also considering mandates for many other groups.

Vaccine passports are also on the way, which means you will need to prove that you are fully vaccinated to do things like travel abroad and to visit hospitality, entertainment, retail and other venues in some. States and Territories.

But some people cannot get the COVID vaccine for medical reasons, although these are very rare. So what are these conditions, and if you have one, how can you prove it?

Permanent exemptions

It is recommended that all Australians over the age of 12 receive two doses of a COVID vaccine. We now have solid data on these vaccines, so we know they are safe and effective. Serious adverse events are very rare.

There are few situations where a person cannot receive a COVID vaccine for medical reasons. The criteria for receiving a permanent medical dispensation are very narrow and rarely needed.

The only criteria are:

For live vaccines, such as measles, mumps and rubella (MMR) and chickenpox vaccines, severely immunocompromised people may obtain a permanent medical exemption. But this is irrelevant for COVID vaccines because they are not live vaccines.

There are certain conditions people generally believe that a vaccine exemption may be necessary, but the following are not Reasons for being exempt from COVID vaccination:

  • egg allergy, even severe

  • a chronic underlying medical condition – these people are often at higher risk of getting a more serious illness from COVID, such as immunocompromised people who may still receive COVID vaccines because they are not live vaccines

  • family history of any adverse events following vaccination.

Temporary exemptions

In some situations, a COVID vaccine may need to be temporarily postponed. For example, if someone has an acute illness with a fever of 38.5 ℃ or more. However, this would usually only be for a short time and would not require them to obtain a written temporary medical exemption.

But there are also “serious acute medical illnesses” where people can get temporary treatment. vaccination medical exemption form. This should be evaluated and given by a medical provider, and only temporarily exempt you from a COVID vaccine.

Last week ATAGI, Australia’s Immunization Technical Advisory Group, which provides medical advice to the federal government on the use of vaccines, including COVID vaccines, released expanded guidance on which of these conditions can justify a temporary medical exemption.

Read more: Soon you’ll need to get the shot to enjoy the shops, cafes, and events, but what about the staff?

These exemptions include people with acute major medical conditions such as major surgery or hospitalization for serious illness.

Temporary exemptions are only recommended for a maximum of six months. Ideally, they are examined within six months to see if the person has recovered and can now be safely vaccinated. They are also only given if another COVID vaccine is not suitable or available.

Temporary exemptions can also be specific to a certain vaccine, such as:

  • if a person has a history of heart inflammation (myocarditis or pericarditis) attributed to a previous dose, or has had another disease causing heart inflammation in the past six months, or acute decompensated heart failure. This is only for mRNA vaccines, including those from Pfizer and Moderna

  • if a person has a history of very rare bleeding and coagulation disorders, 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, people who cannot receive any of the above vaccines for any of these reasons should be given an alternative COVID vaccine.

Temporary exemptions may also be granted to people who:

  • had COVID, until they were fully recovered. ATAGI recommends that vaccination can be postponed for up to six months because a previous infection reduces the risk of re-infection for at least that time. However, they do not need to delay vaccination if they have recovered from COVID and their job requires them to be vaccinated, or if they are at higher risk of COVID due to exposure or a personal risk. Having chronic symptoms from COVID, known as “long COVID”, is not a medical reason for not getting a COVID vaccine. If people who have recently had COVID are unsure whether to get the vaccine, they should talk to their doctor about the best time to get the vaccination.

  • have had a serious adverse event related to a previous dose of COVID vaccine that cannot be attributed to another cause. An adverse event is considered serious if the person is hospitalized or results in persistent or significant disability. These events should be reported to the adverse event monitoring system in the individual’s state or territory and / or the Australian medical regulatory authority, the Therapeutic Goods Administration (TGA). They are carefully evaluated on a case-by-case basis by an experienced specialist to determine the likelihood of recurrence of the serious adverse event if another dose of COVID vaccine is given.

  • are assessed as a risk to themselves or to others during the vaccination process. For example, it could be due to a serious neurodevelopmental disorder such as autism spectrum disorder. Specialized services may be available to facilitate the safe vaccination of these individuals, for example with the help of distraction or awake sedation.

Pregnancy is not a valid reason for exemption, in the absence of one of the criteria listed above.

How can I get an exemption, if I am eligible?

Medical waivers for the COVID vaccine can be obtained from general practitioners, pediatricians, clinical immunologists, infectious diseases, general practitioners or public health physicians, gynecologists or obstetricians.

If someone thinks they are entitled to an exemption based on the above, it is often best to see a general practitioner first to discuss it.

Federal government to introduce certificate system for people to prove they have a medical exemption later this month. These would be available through the Services Australia app.

With the mandates looming, GPs and other providers will feel pressure to grant exemptions to people who do not want to be vaccinated. Employers will be looking at who can get one. This can often cause distress and conflict if the exemption request is denied, for both the provider and the patient.

Moreover, if the mandates are not applied equally and fairly, there is a risk of aggravating the disadvantage.

These mandates are set at the jurisdictional level, so there may also be differences in the groups involved depending on the state or territory.

The stakes are high for those who are not vaccinated, so it is vital that employers, individuals and healthcare providers are aware of the new ATAGI clinical guide regarding the medical exemption criteria and that the jurisdictions provide further details on the process.

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