From the Guidelines
Australian COVID-19 vaccination guidelines for special populations recommend tailored approaches based on individual risk factors. For people with severe allergic reactions, observation periods are extended to 30 minutes after vaccination, and those with specific allergies to vaccine components should avoid the relevant vaccines 1. Pregnant women are recommended to receive mRNA vaccines (Pfizer or Moderna) at any stage of pregnancy, as benefits outweigh risks and provide passive antibody transfer to the baby 1. Cancer patients should be vaccinated, with timing considerations around chemotherapy cycles to optimize immune response—ideally two weeks before or after treatment 1. Immunocompromised individuals should receive a standard primary course plus an additional primary dose (three doses total), followed by booster doses as recommended for the general population 1. These patients may have reduced vaccine effectiveness but vaccination remains crucial for protection. The specific vaccine brand may vary based on age and availability, with Pfizer and Moderna generally preferred for pregnant women and younger age groups. Individuals with special conditions should consult healthcare providers for personalized advice, as recommendations may be updated based on emerging evidence about vaccine effectiveness and safety in these populations.
Some key considerations for special populations include:
- For pregnant women, the benefits of mRNA vaccines outweigh the risks, and vaccination can provide passive antibody transfer to the baby 1.
- For cancer patients, vaccination timing should be considered around chemotherapy cycles to optimize immune response 1.
- For immunocompromised individuals, a standard primary course plus an additional primary dose is recommended, followed by booster doses as recommended for the general population 1.
- For individuals with severe allergic reactions, observation periods are extended to 30 minutes after vaccination, and those with specific allergies to vaccine components should avoid the relevant vaccines 1.
Overall, the Australian guidelines prioritize a tailored approach to COVID-19 vaccination for special populations, taking into account individual risk factors and medical conditions.
From the Research
Australian Guidelines for COVID-19 Vaccination in Special Populations
The Australian guidelines for COVID-19 vaccination in special populations, including those with a history of severe allergic reactions, pregnant women, cancer patients, and individuals with immunocompromised states, are not explicitly stated in the provided evidence. However, the following information can be gathered from the studies:
- Severe Allergic Reactions: Individuals with a history of severe allergic reactions, including anaphylaxis, should be cautious when receiving COVID-19 vaccines 2, 3. The US Centers for Disease Control and Prevention (CDC) advises people with a previous history of any immediate allergic reaction to remain under observation for approximately 30 minutes after COVID-19 vaccination 2.
- Pregnant Women: There is no specific information provided in the studies regarding COVID-19 vaccination in pregnant women.
- Cancer Patients: There is no specific information provided in the studies regarding COVID-19 vaccination in cancer patients.
- Immunocompromised States: Individuals with immunocompromised states may be at greater risk of allergic reactions to COVID-19 vaccines 2, 3.
Key Considerations for COVID-19 Vaccination
Some key considerations for COVID-19 vaccination include:
- Polyethylene Glycol (PEG) and Polysorbate 80: These excipients in COVID-19 vaccines can cause allergic reactions in some individuals 3, 4.
- Risk Stratification: A focused history can help establish contraindications to giving COVID-19 vaccines and guide the administration of alternate vaccines to people with high-risk allergy histories 5.
- Monitoring: Vaccines should be monitored for 30 minutes after administration to detect any potential allergic reactions 5.
Vaccination Recommendations
Based on the studies, the following vaccination recommendations can be made:
- Pfizer-BioNTech Vaccine: This vaccine can be safely administered to individuals with high-risk allergy histories, including those with PEG or polysorbate 80 allergies 4, 5.
- Janssen Vaccine: This vaccine can be safely administered to individuals with high-risk allergy histories, including those with PEG or polysorbate 80 allergies 5.
- Alternative Vaccines: Alternative vaccines may be necessary for individuals with a history of anaphylaxis or severe allergic reactions to COVID-19 vaccines 6.