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Transplant Australia is very concerned for the health and welfare of the Australian Transplant Community during the Coronavirus Pandemic. We are working with doctors (TSANZ) and nurses (TNA) to bring you the latest advice and information to keep you and your family as safe as possible.

Response to article in The Guardian

response from Dr. Peter Boan, Infectious Diseases Physician on behalf of the COVID-19 Taskforce as follows;

 

Monoclonal antibodies against COVID-19 are an important component of preventing COVID-19 and treating early COVID-19 in immunosuppressed individuals, who do not respond to vaccine as well as non-immunosuppressed individuals. Australian authorities have obtained access to a monoclonal antibody called Sotrovimab, which is being used in NSW and Victoria for early treatment of COVID-19 in those at risk for progression to severe disease, including immunosuppressed people who have been vaccinated. Australian authorities are trying to get access to more monoclonal antibody products however they are in short supply (see link to the Washington Post 14 Sept 2021). The TSANZ/OTA COVID-19 Taskforce will continue to advocate for access to monoclonal antibodies for various indications, including pre-exposure prophylaxis and post-exposure prophylaxis for immunosuppressed individuals.

 

https://www.washingtonpost.com/health/2021/09/14/monoclonal-antibodies-shortage/

TA Letter to Federal Health Minster

In September we wrote to the Federal Minister for Health, The Hon. Greg Hunt, supporting calls for transplant recipients and others with compromised immune systems to receive additional booster shots to protect against COVID-19.

We highlighted a number of studies which revealed an alarming low antibody response rate in some transplant recipients while also referring to other studies which have shown a third and even fourth booster shot greatly improves protection for recipients. You may have seen that the UK and USA has already announced booster shots for the transplant community.

We are supporting the good work of the Rapid Response Taskforce on COVID and Organ Donation and the Organ & Tissue Authority in recommending additional protection for recipients. The Government’s COVID scientific body, ATAGI, is currently assessing the evidence.

We asked the Minister to specifically include the needs of the immune-compromised in the National Plan to transition out of lockdown. Currently this roadmap is silent on what will happen for vulnerable members of the community when the vaccination rate hits 70 and 80 per cent of the general population.

Finally, we highlighted the great response of recipients to embrace vaccination as revealed in our survey which more than 1,500 recipients responded. The summary of that survey can be reviewed here: TA Vaccination Survey of Transplant Recipients

In the meantime time, and once again, please stay safe.

 

TSANZ Update 14th April 2021

This statement has been developed by the TSANZ, the peak representative body of transplantation professionals in Australia and New Zealand as a guide for transplant recipients following a statement from the Australian Technical Advisory Group on Immunisation (ATAGI) on the AstraZeneca COVID-19 vaccine in response to new vaccine safety concerns.
TSANZ support the following as recommended by the COVID-19 National Transplantation and Donation Rapid Response Taskforce:

To read the full statement Click here to view

Early COVID Vaccination data

Covid Vaccine in Tx JAMA2021

Response by Professor Steve Chadban :
It is the second phase of the study I spoke to on the Webinar – ie. a small study of a non-random selection (mostly health care workers with transplants) and the data is captured about 2 weeks after a FIRST dose of mRNA vaccine – so early days in terms of an immune response, particularly as second dose is given at 3 weeks. It only looks at B cell/antibody response, not T cell or innate response, and ultimately it cannot provide data on whether the vaccine reduces incidence or severity of COVID19. That said, it does support our initial concerns that vaccines may be less effective in Tx populations than general populations. As Peter Boan rightly concluded, this should not alter our advice to immunise all Tx recipients as soon as possible with whatever vaccine is offered, except where there is a clear contra-indication.

Endorsed by Peter Boon and Helen Pilmore (President of  TSANZ)

Click here to view

DonateLife has also released the following statement:

DonateLife is closely monitoring COVID-19 developments and what they mean for organ donation and transplantation.

The safety and wellbeing of all Australians is our utmost priority.

While hospitals are currently still performing lifesaving organ transplants, the rapid change in status surrounding COVID-19 means there is likely to be an impact on the system in coming days and weeks. We will continue to closely monitor developments and provide regular updates through our social media channels on COVID-19’s impact on organ donation and transplantation.

Organ transplant recipients and others with underlying health conditions are urged to rigorously adhere to health advisories issued by the Department of Health as well as local and state and territory health departments.

Transplant recipients seeking more information on the potential impact of Covid-19 on vulnerable people should call the 24/7 Coronavirus Health Information Line on 1800 020 080.

Advisory No: 4 – Information for Transplant Recipients and their families

Transplant Australia is very concerned about the coronavirus, COVID-19, and its potential impact upon the transplant population.

As you can appreciate the information is changing daily which is making it hard to give definitive advice. We have already recommended all recipients adopt the safe hygiene practices issued by the World Health Organisation.

But for more specific information relevant to your own states and own circumstances we strongly advise you check to see if your transplant unit has issued any guidelines.

In the meantime it is agreed that the Guidance on Social Distancing for protecting older people and vulnerable adults in the UK is relevant and should be reviewed by all recipients. It is reprinted below. In addition on this page we will reprint any guidelines that are issued so that you can review them and adapt them to your own needs. For example this Advice has been issued in Western Australia from the Charles Gairdner Hospital and should be reviewed by all recipients.

Generic Flyer for people at risk COVID -19 (3)

As more advice comes to hand we will share it here.

Please everyone. Stay safe, isolate as much as possible, wash your hands, observe good hygiene practices and look after your health by exercising, reducing alcohol intake and eating well.

Make sure you stay connected with family and friends. Listen to what the health authorities are saying, don’t rely too much on all the noise on social media.

We will get through this.

Kind regards

Chris Thomas
CEO

Q&A – Transplant Talk – COVID Vaccinations for Transplant Recipients and Dialysis Patients 

Adults 

  1. How will the anti-rejection drugs affect the body’s response to the antigens in the vaccine?
    We don’t know for certain , but based on experience with other vaccines we predict the immunosuppressants (anti-rejection drugs) may reduce the response to COVID-19 vaccines a little, but predict the vaccine will still have effect.
  2. Can People with immunosuppression safe to take AstraZeneta vaccine?
    Yes. The COVID-19 vaccines planned for use in Australia including the AstraZeneca vaccine are not live vaccines.
  3. Does the vaccine contain a live virus. I was told, as renal recipient, that we should not be administered ‘live” vaccines.
    The COVID-19 vaccines planned for use in Australia including the AstraZeneca vaccine are not live vaccines.
  4. Adenovirus triggered/caused my chronic rejection in 2016 & I was finally re-transplanted towards the end of last year – am I safe to get the AstraZeneca vaccine?
    Unlike adenovirus infections, the adenovirus vector in the AstraZeneca vaccine does not replicate (multiply/proliferate). We do not predict that it will cause organ rejection.
  5. What percentage of people who undertook the vaccine trials were transplant (specifically kidney transplant) patients and what was the outcome of the trials on those people?
    Transplant patients were excluded from the COVID-19 vaccine trials to date. We have preliminary data from John Hopkins Medicine suggesting vaccination does not cause different side effects compared to the regular population. COVID-19 causes severe disease in transplant patients, so we strongly suggest you get the COVID-19 vaccine offered to you.
  6. Being that transplant patients take anti-rejrction drugs etc to prevent an immunsystem. how does the vaccine work for transplant patients if they don’t have that immune system to build the cells to fight against covid-19?
    Based on experience with other vaccines we predict the immunosuppressants (anti-rejection drugs) may reduce the response to COVID-19 vaccines a little, but predict the vaccine will still have effect.
  7. Are children of Transplant recipients going to be given separate advice regarding vaccination, or will they be treated as per “ordinary” children?
    From the information available to us at this time, we think family members of transplant patients (including children who have had transplants) will have to wait for their turn to be vaccinated. Even children who are immunosuppressed have a low rate of serious COVID-19 infection compared to immunosuppressed or elderly adults.
  8. What about patients waiting for transplant? Where do they fit?
    Patients waiting for transplant will be prioritised for vaccination like transplant recipients. They are in phase 1b of the vaccine rollout.
  9. If Pfizer has not tested for immunocompromised, how could the post transplant be suitable?
    Based on experience with other vaccines we predict the immunosuppressants (anti-rejection drugs) may reduce the response to COVID-19 vaccines a little, but predict the vaccine will still have effect. We do not expect any different side effects compared to the general population nor do we expect vaccine to cause organ rejection- this is supported by preliminary results from John Hopkins Medicine.
  10. Clarification – were there any trials or patients in any testing groups transplant patients? If not how can you be sure the impact on patients and risks?
    Based on experience with other vaccines we predict the immunosuppressants (anti-rejection drugs) may reduce the response to COVID-19 vaccines a little, but predict the vaccine will still have effect. We will have more information coming through soon, but we do not expect any different side effects compared to the general population nor do we expect vaccine to cause organ rejection- this is supported by preliminary results from John Hopkins Medicine. Because COVID-19 often causes severe disease in organ transplant patients, we strongly suggest you get vaccinated when this is offered to you.
  11. How long will infection control occur after the second vaccination? Will we need a vaccine annually as we do for the flu vaccine?
    Protection in the trials has been examined for about 2 months so far, but we will get more information as individuals in the trials are followed for longer. It is likely that further doses of vaccine are required in future.
  12. The vaccine reactions are similar to the anti rejection medication such as tacrolimus is there any data on this?
    The reactions to the vaccine are not generally confused with anti-rejection drugs or other medications. The vaccine side effects occur in the day or so after the vaccine and last for a short time.
  13. What do we need to do after receiving the vaccine? What happens then?
    You can be less anxious about being infected with COVID-19, but until a lot of the population here and overseas is vaccinated and we have further information of protection by the vaccine in transplant patients, you still need to wash your hands and socially distance.
  14. Given the immunosuppressed state of transplant patients, what sort of protection can we expect from the vaccine, using Pfizer vaccine’s 95% efficacy as a guide, would we expect may be 50% efficacy? I understand we may not have that information for COVID vaccine but what about based on data from other vaccines with similar efficacy, e.g. hepatitis/ measles vaccine.
    It is difficult to estimate vaccine effectiveness in transplant patients, so we will have to wait for this data, but we do expect protection against COVID-19 particuarly severe disease, as has been seen in the trials in the general population.
  15. Which group will caregivers or close family contacts of transplantees fit in? In 1b, along with us?
    Family contacts or caregivers do not move up the vaccine queue because they have a transplant patient as a contact, so they will have to wait until their time for vaccine is due.
  16. Do I need to have this vaccine I would prefer not
    COVID-19 can cause serious disease in transplant patients, so we strongly suggest you are vaccinated when this is offered to you.
  17. Will my wife get the vaccine at the same time as me or will she have to wait being she is of good health and in her 30’s?
    She will have to wait.
  18. Would we think that the systemic reactions would be less in Tx patients given immunosuppression?
    Not sure about this at the moment but this information will come through soon. We do not expect different side effects to the general population.
  19. Are there any early results coming in from the John Hopkins study in the US on vaccines in transplant patients?
    Early results suggest the vaccine did not cause organ rejection and side effects were similar to the general population.
  20. As transplant recipients i assume we fall into phase 1(b)- so do we get astra- zeneca dose?
    Phase 1b is likely to be use of Pfizer and AstraZeneca, but it is not currently clear which vaccine transplant patients will receive. You will not get a choice of vaccine.
  21. Given that the annual flu vaccine will be distributed at a similar time to the covid vaccine for group 1b, should we be having the flu vaccine first, before covid vaccine?
    For caution it is recommended that influenza vaccine and COVID-19 vaccines are separated by 14 days but if they are given closer together we don’t expect this will cause any problems.
  22. After the first 2 doses, what is planned as to the next shot to be received, given duration of protection unknown.
    P
    rotection in the trials has been examined for about 2 months so far, but we will get more information as individuals in the trials are followed for longer. It is likely that further doses of vaccine are required in future.
  23. Please have a breakdown on the effectiveness of other vaccines for immunocompromised individuals as compared to the optimally healthy immunity. And in turn, should recipients actually receive the vaccines and if so, which one?
    It is difficult to estimate vaccine effectiveness in transplant patients, so we will have to wait for this data, but we do expect protection against COVID-19 particuarly severe disease, as has been seen in the trials in the general population. Because COVID-19 infection can be serious in organ transplants, we strongly suggest you get the vaccine which is offered to you. You won’t get to choose which vaccine you receive, and either we expect to be effective.
  24. Is there any data on how the various vaccines interact with eachother i.e. if you for example have the Pfizer vaccine initially and complete that course, and then get the Astra Zeneca or other vaccine other than Pfizer the following year (or whenever the booster is recommended) does this impact on vaccine efficacy or health of transplant patients?
    Use of different vaccines in the same person has not been tested yet, but this is the subject of planned trials.
  25.  
  26. My wife was a kidney donor, which phase does she fit in?
    Unless she has other medical illnesses, she will likely be offered vaccine based on her age.
  27. Does type of transplant make a difference regarding COVID? Eg. Is someone with a corneal graft of more or less risk than someone with a transplant requiring blood matching?
    Some organ transplants are at higher risk of serious COVID-19 disease, such as lung transplants. Broadly speaking, the more intense the immunosuppression, the higher the risk of severe disease.
  28. So given tx patients are in group 1b the timing suggests end of April therefore should they influenza shot in mid late March to ensure adequate time between shots.
    The timing of COVID-19 vaccine for groups in phase 1b is not exactly certain, so will have to negotiate the best time for influenza vaccine closer to the time.
  29. What is the efficacy difference between live vaccine and non-live” vaccine.
    Live vaccines can be dangerous for immunosuppressed patients like transplant patients, but all the COVID-19 vaccines planned for Australia are not live vaccines.
  30. what about the Israel experience and the head to head comparison between vaccines and their experience in a transplant population.
    Data have not been reported from Israel yet.
  31. Will patients on dialysis be treated similar to transplant patients and are there other factors that need to be considered when getting the vaccine.
    Patients on dialysis will be in phase 1b like transplant patients.
  32. I presume that donors are checked for covid?
    Yes donors are routinely screened for COVID-19 infection.
  33. Do the stats presented for kidney transplant recipients include SPK transplant recipients?
    The data of risk for serious COVID-19 infection in kidney transplants may include some with pancreas transplant but we do not have separate data for kidney-pancreas recipients. Their risk would be expected to be the same as kidney recipients.
  34. Any data for hearts, lungs and livers.
    Risk of serious COVID-19 infection is similar for non-kidney organ transplants to kidney transplants, however lung recipients have a higher risk of serious COVID-19 disease.
  35. Are they still giving placebos?
    They give placebo for the study, but then those individuals will be offered vaccine as it becomes available to them.
  36. Is long covid more prevalent in renal patients?
    Probably. “Long” COVID or persistent symptoms after infection are more common in those with severer disease, such as those requiring hospitalisation, which is more common in patients with kidney disease.
  37. Would be when unvaccinated and contracting Covid are we less likely to develop severe lung disease given the reduced inflammation aspect of immun suppression?
    Although short course steroid (dexamethasone) is used as a treatment for severe COVID (not mild or moderate COVID where it has no effect), the immunosuppression taken to prevent rejection does not improve outcomes when infected with COVID-19. The opposite, the outcomes (including the lung involvement) are worse, probably due to the combination of immunosuppressants (not just steroids).
  38. Are there any details on COVID vaccinations affects on Kidney TX patients who are currently being monitored for viruses such as the BK virus
    BK virus infection and disease should not impact the vaccination at all.
  39. I’ve read that the vaccines are presumed safe for pregnant women – what is the recommendation for TX patients who are of child bearing age (looking to undergo IVF procedures).
    Neither Pfizer nor AstraZeneca vaccines have shown any adverse effects to the foetus in the small number of women who have become pregnant in the vaccine studies, and animal data does not suggest any adverse effects of vaccination on the foetus. The government stance is that pregnant women can consider being vaccinated if they have factors to increase the chance of severe COVID in pregnancy (and having a transplant is one of these). At the moment, the Pfizer vaccine has a little more data in pregnant women and is likely to be preferred if you are actually pregnant, but if you are simply contemplating pregnancy either vaccine is fine.
  40. Is there a vaccine transplant study? Happy to volunteer if you are going to do a study on it.
    There are a number of planned studies. We would encourage you to speak to your transplant unit.
  41. Will parents and carers of under 16 transplant patients be eligible for the vaccine before the general public, considering that the child can’t get it until they turn 16?
    Because children (even immunosuppressed children) have low rates of serious COVID-19 infection, contacts of immunosuppressed children are not planned to move up the queue at the moment.
  42. If you donate your kidney to a living relative then should I be vaccinated.
    Donating a kidney does not make you unhealthy, so you would be considered like the general population who are all being encouraged to be vaccinated. We suggest you should be vaccinated.
  43. Will the vaccine be as effective for those who have recently had a kidney transplant -less than 6 months, higher dose of pred and other immunosuppressive meds.
    The immunosuppression is at the highest level initially after transplant when vaccine response may not be quite as good, so we will likely suggest waiting about 3 months after transplant to get vaccinated. Formal advice should be out soon.
  44. I have had a kidney transplant and am looking forward to getting the jab. However my partner wants to know, can he get a jab at the same time? If he doesn’t, won’t that keep me at risk?
    The priority is to protect you and If you get the vaccine that will help protect you, and the added protection of vaccination of your close contacts will occur later.
  45. Does vaccination increase antibodies in the event you need another transplant in the future(god forbid). this would be general to vaccine not just the covid.
    The antibodies produced from the vaccine are specific against COVID and not against organs, so we do not expect these antibodies to cause problems with organ rejection, and our experience with other vaccines suggests they are safe in this regard.
  46. Can we get multiple vaccines, will that improve the odds or is more than one too many?
    Individuals are likely to require more vaccine doses and perhaps different types of vaccines as time goes on, but we are not sure about this yet. Vaccines have not been mixed with each other in any trials, so you only get the one type for now.
  47. How will I, as transplant recipient be notified for vax?
    Our understanding is the government will alert you to make an appointment via a booking system.
  48. Since Australia has such low COVID cases, should immunosuppressed patients wait until there is more data on the vaccines before getting it?
    The future is uncertain, and one predicts travel will open up and borders become more lax with vaccination across the world, with more likelihood of circulating COVID-19 infection in Australia. The vaccines are not live so also do not expect them to cause significant adverse effects in transplant patients. So we don’t think you should delay getting vaccinated.
  49. Will my 16 yo daughter with KT be in group 1b or group 5?
    Age 16 or over is the approval for the Pfizer vaccine, so we would think phase 1b.
  50. What time line for vaccination post transplant ie/ if recently transplanted how long to wait before receiving vaccination.
    The guidance is yet to be formalised, but we are likely to suggest you wait about 3 months after transplant before being vaccinated to get a better response to the vaccine.
  51. Will immediate family members get opportunity to get vaccine at same time as transplant patient?
    No, the vaccine is distributed based on where individuals come in the phases.
  52. If you are working from home would you advise to continue to do so until you are vaccinated?
    It depends on how much COVID is circulating in the community. If COVID is not circulating in your area, it should be safe to be at work.
  53. Should family members who may become living donors have the same vaccine?
    Living donors or family members may have a different vaccine to a patient with a transplant but there is no problem with this.
  54. Why are the rates of death from Covid-19 higher in dialysis patients?
    We are not exactly sure.
  55. Is there any data if it effects fertility?
    There are no signs that the vaccines affect fertility.
  56. Will you require all potential living donors to have a vaccine before they can donate an organ?
    No
  57. Do we get the vaccine from our GPs or the transplant clinic
    The government hasn’t talked about this so we are not sure at the moment. This should become clear soon.
  58. Will the systemic reaction after the vaccine be proportionate to the antibody response (and efficacy)? any evidence so far?
    Yes there probably is an association of local or systemic reactions to vaccine response but this hasn’t been described so far
  59. Am on dialysis take claxanne 60. can i have the vaccine
    Yes you can have the vaccine on anticoagulants. You will need advice from your doctor about management of the clexane at the time of vaccination.
  60. What about those in rural and remote areas . Will it take us longer to get a vaccine
    No. Vaccine hubs are being set up in rural areas.
  61. Any concerns for HTx patients with PTLD?
    Not specifically. But you will need to speak to your doctor about this situation as you may have had rituximab which does lower vaccine responses for some months after the drug.
  62. I’ve read that there might be a fast call up available to stop wasting vaccines
    Nothing has been said by the government about this.
  63. Is recommendation for flu Vax after 1st jab or both jabs ?
    We are not sure it makes any difference, so whatever is practical when the time comes.
  64. Is there any extra risk to my live donor from Covid and dose that qualify for them to move higher into the vaccinationpriority list.
    No there is no additional risk of severe COVID in a live organ donor above the general population so we don’t expect they will be prioritised.
  65. I had my transplant 3 month ago but have another condition that flared up a month after transplant Familial Mediterranean Fever, so how vaccine will effect my case?
    The vaccine is not expected to cause exacerbations of inflammatory conditions such as Familial Mediterranean Fever. We would advise you to be vaccinated.
  66. Is it safe to get covid immunisation if patient had allergic reaction with flu?
    Yes. The only reason you can’t get a COVID vaccine is severe allergy to the COVID vaccine itself. If you had severe reaction (anaphylaxis) to another vaccine or drug, sting, food, you will be monitored for 30 mins rather than 15 mins after the vaccine as a measure of caution.
  67. I am interested to know if there is a difference in the efficiency of the vaccines with the differing immunosuppressant drugs? The research you referred to mentioned some of the most common types of immunosuppressant drugs.
    We are not sure of this at the moment, but from research with other vaccines we know that certain immunosuppressants can affect response to vaccine more than others, but the main drugs which do this are generally given only early after transplant, or sometimes as treatment for rejection.
  68. what group will pre transplant patients will be in for the vaccine
    Phase 1b because they all have organ failure.
  69. Given there is quite a discrepancy in the efficacy of vaccines will the medical transplant community have a say in which the government give us?
    Immunisation experts continue to guide the government on the best vaccine for each particular group of society based on what is available, what the evidence shows, and what is most optimal for each group of individuals.
  70. How long will new transplant recipients have to wait before they can get the vaccine?
    This has not been decided, but probably something like 3 months after transplant.
  71. Is it possible to get access to John Hopkins findings and especially for transplant cases.
    The preliminary data can be found online in search engines, and look out for when the study has been finished and published.
  72. Is there any differences for those taking cyclosporine?
    Most transplant patients take ciclosporin or the related drug tacrolimus, so there is nothing special about this drug in itself in relation to COVID or vaccination.
  73. If I don’t have the vaccine and my dead donor has had the mRNA based vax will their kidney’s biological coding mingle with mine and hence i will have the ‘vaccine’
    The vaccine effect is short lived and does not transfer in a donated organ. Vaccine in a donor will not have any effect in the recipient.
  74. Are any of the three vaccinations, genetically modified in anyway?
    The AstraZeneca adenovirus vector has been genetically modified to carry the gene to make COVID Spike protein, and also modified so that it won’t replicate in your body.
  75. How do we keep a KT recipent safe during the period when not everyone in the household are not immunized. Also same for elderly between 1st and 2nd dose
    Protection begins 2-3 weeks after the first dose. You must continue hand hygiene, social distancing.
  76. I am keen to travel again at some time in the future. Once vaccinated is there a way to understand how the effective the vaccine will be over time? Can you test for that?
    The duration of protection in the general population is uncertain and this will be answered by ongoing studies in this area which will take time. Also finding blood tests which are associated with protection after vaccination is an area of active research.
  77. Would assessment of antibody be an adequate means of assessing vaccination effectivity?
    This is uncertain and an area of active research. The common antibody tests may not be a good marker of protection after vaccination, so at least in the general population are not recommended to test after vaccination.
  78. Do we know any stats from other countries where the rates of infection have been higher amongst the transplant and dialysis community ie the UK – showing how we compare to the general public in relation to the outcome of the infection.
    Data from these countries with more burden of COVID show that dialysis and renal transplant patients are more likely to have serious disease, go to hospital, go to the ICU, and more likely to die than the general population.
  79. When are we likely to see more stats on transplant immunizations ?
    This will likely come through in the next few months.

Paediatric

  1. So at the moment no vaccination plans for transplant kids at the moment?
    Currently there is limited data of the vaccines in children so they are not currently approved for children, but this will change as further trial data comes through.
  2. You note there is insufficient data for under 16 – is there sufficient data for transplant recipients?
    Currently we have limited data on use of COVID-19 vaccines in transplant patients, but do not expect different side effects compared to the regular population, we do not expect them to precipitate organ rejection, and because COVID-19 causes severe disease in transplant patients, we strongly suggest you get the COVID-19 vaccine offered to you
  3. Since no data about kids below 16, so transplant kids are excluded?
    Currently there is limited data of the vaccines in children so they are not currently approved for children, but this will change as further trial data comes through.
  4. If family members that reside with you are under 16, what is the recommendation regarding vaccination.
    Currently there is limited data of the vaccines in children so they are not currently approved for children, but this will change as further trial data comes through.
  5. What is the efficacy difference between live vaccine and non-live” vaccine.
    Live vaccines can be dangerous for immunosuppressed patients like transplant patients, but all the COVID-19 vaccines planned for Australia are not live vaccines.
  6. Will children under 16yrs who are tx recipients be getting the vaccine.
    When enough study has been done on children and it is approved by the Therapeutic Goods Administration of Australia
  7. Will parents and carers of under 16 transpant patients be elligible for the vaccine before the general public, considering that the child can’t get it until they turn 16?
    Because children (even immunosuppressed children) have low rates of serious COVID-19 infection, contacts of immunosuppressed children are not planned to move up the queue at the moment.
  8. Will the vaccine be as effective for those who have recently had a kidney transplant -less than 6 months, higher dose of pred and other immunosuppressive meds.
    The immunosuppression is at the highest level initially after transplant when vaccine response may not be quite as good, so we will likely suggest waiting about 3 months after transplant to get vaccinated. Formal advice should be out soon.
  9. Does vaccination increase antibodies in the event you need another transplant in the future(god forbid). this would be general to vaccine not just the covid.
    The antibodies produced from the vaccine are specific against COVID and not against organs, so we do not expect these antibodies to cause problems with organ rejection, and our experience with other vaccines suggests they are safe in this regard.
  10. Will my 16 yo daughter with KT be in group 1b or group 5?
    Age 16 or over is the approval for the Pfizer vaccine, so we would think phase 1b.
  11. Should family members who may become living donors have the same vaccine?
    Living donors or family members may have a different vaccine to a patient with a transplant but there is no problem with this.
  12. What can we do to protect children while we wait for a vaccine to be approved for them?
    Continue measures to reduce exposure to COVID-19 and vaccinate family and other close contacts when this opportunity comes up.
  13. Is it important for close adult family and friends of transplanted children to get vaccinated?
    Because this provides a “ring” of protection around the child, as close contacts are the most likely to transmit the virus to the child.
  14. Will my child get a choice of vaccine when vaccines have been approved for children?
    We are not sure at this stage, though like adults we suspect not. It will depend on vaccine trial data and supplies of vaccines in Australia.
  15. Will there be any risk of rejection with the vaccine?
    We are waiting for further data but the vaccines are not expected to cause rejection and have not done so far. The benefits in preventing infection outweigh potential risks and we suggest all transplant and immunocompromised patients are vaccinated.
  16. Will the immunosuppression affect my child’s response to the vaccine?
    We are awaiting more data. Although vaccine responses with immunosuppression are often a little lower than other individuals, we still expect the COVID-19 vaccines to be effective.
  17. When the vaccine is approved for children, will my child be offered immediate access, or do we need to wait for more data in immunosuppressed children?
    We expect when COVID-19 vaccines are approved for children generally that immunosuppressed children should also be vaccinated even if there limited data specific for immunosuppressed children. The vaccines are not live. We do not expect different side effects in immunosuppressed children.

Advice for people at risk of coronavirus (COVID-19)

The following information is taken from the Australian Government Coronavirus Website.

COVID-19: Consumer evidence summary for Kidney or Kidney-Pancreas Transplant Recipients 

CARI COVID 19 Consumer Evidence Transplant Summary

CARI COVID 19 Consumer Evidence Transplant Summary – Infographic

Why this virus is so dangerous for older people and people with chronic medical conditions

The risk of serious illness from coronavirus increases if you are older or if you have a chronic medical condition.

The highest rate of fatalities is among older people, particularly those with other serious health conditions or a weakened immune system.

There is currently no cure or vaccine for coronavirus, or immunity in the community, so you need to make sure you protect yourself.

Protecting yourself

Good hygiene and taking care when interacting with other people are the best defences for you and your family against coronavirus. This includes:

  • covering your coughs and sneezes with your elbow or a tissue
  • disposing of used tissues immediately into a rubbish bin and washing your hands
  • washing your hands often with soap and water, including before and after eating and after going to the toilet, and when you have been out to shops or other places
  • using alcohol-based hand sanitisers (60% alcohol), where available
  • cleaning and disinfecting surfaces you have touched
  • stay 1.5 metres away — 2 arms’ length — from other people. This is an example of social distancing
  • stay at home and avoid contact with others
  • avoid non-essential travel
  • consider having the chemist deliver your medicines
  • consider having your groceries and essential items delivered to your home

Read our fact sheet about the support available to you if you are isolated and finding it difficult to access food and basic household items.

Symptoms

Symptoms include (but are not limited to) fever, a dry cough, tiredness, a sore throat and difficulty breathing.

If you develop mild symptoms of COVID-19:

  • isolate yourself from others at home and use a separate bathroom, if available
  • use a surgical mask when around other people. If you don’t have a mask, practise good sneeze/cough hygiene
  • practise good hand hygiene
  • call a doctor and tell them about your symptoms and whether you have had contact with someone diagnosed with COVID-19

If you have serious symptoms such as difficulty breathing:

  • call 000, ask for an ambulance and notify the officers if you have been in contact with anyone with COVID-19

Chronic conditions that increase the risk of serious illness from COVID-19

The following chronic conditions are of concern in Aboriginal and Torres Strait Islander people over 50 years and vulnerable workers over 65 years:

  • Chronic renal failure
  • Coronary heart disease or congestive cardiac failure
  • Chronic lung disease (severe asthma (for which frequent medical consultations or the use of multiple medications is required), cystic fibrosis, bronchiectasis, suppurative lung disease, chronic obstructive pulmonary disease, chronic emphysema)
  • Poorly controlled diabetes
  • Poorly controlled hypertension

People at any age with significant immunosuppression, as defined as:

  • Haematologic neoplasms: leukemias, lymphomas, myelodysplastic syndromes
  • Post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months or on treatment for GVHD)
  • Immunocompromised due to primary or acquired immunodeficiency (including HIV infection)
  • Current chemotherapy or radiotherapy
  • High-dose corticosteroids (≥20 mg of prednisone per day, or equivalent) for ≥14 days
  • All biologics and most disease-modifying anti-rheumatic drugs (DMARDs) as defined as follows:
    • Azathioprine >3.0 mg/kg/day
    • 6-Mercaptopurine >1.5 mg/kg/day
    • Methotrexate >0.4 mg/kg/week
    • Prednisone >20 mg/day. If <14 days treatment, can resume work when treatment ceased
    • Tacrolimus (any dose)
    • Cyclosporine (any dose)
    • Cyclophosphamide (any dose)
    • Mycophenolate (any dose)
    • Combination (multiple) DMARDs irrespective of dose

FAQs

Social Distancing

Keep your distance

One way to slow the spread of viruses, such as coronavirus, is social distancing (also called physical distancing).

The more space between you and others, the harder it is for the virus to spread.

 

In public

Social distancing in public means people:

  • stay at home and only go out if it is absolutely essential
  • keep 1.5 metres away from others
  • avoid physical greetings such as handshaking, hugs and kisses
  • use tap and go instead of cash
  • travel at quiet times and avoid crowds
  • avoid public gatherings and at risk groups like older people
  • practise good hygiene

See important information on restrictions on public gatherings.

Households

All Australians are required to stay home unless it is absolutely necessary to go outside.

Australians are permitted to leave home for the essentials, such as:

  • shopping for food
  • exercising — in a public space such as a park, limited to no more than 2 people
  • going out for medical appointments or to the pharmacy
  • providing care or support to another person in a place other than your home
  • going to work if you cannot work from home.

Australians should work from home where they can.

Steps for social distancing in all homes include:

  • keeping visitors to a minimum
  • regularly disinfecting surfaces that are touched a lot, such as tables, kitchen benches, hand rails and doorknobs
  • increasing ventilation in the home by opening windows or adjusting air conditioning

If someone in your household is sick, you should:

  • care for the sick person in a single room, if possible
  • keep the number of carers to a minimum
  • keep the door to the sick person’s room closed. If possible, keep a window open
  • wear a surgical mask when you are in the same room as the sick person. The sick person should also wear a mask when other people are in the same room
  • protect at-risk family members by keeping them away from the sick person. At-risk people include those aged over 65 years or people with a chronic illness. If possible, find them somewhere else to live while the family member is sick

At work

If you can, work from home. If you cannot work from home and you are sick, you must not attend your workplace. You must stay at home and away from others.

Steps for social distancing in the workplace include:

  • stop shaking hands to greet others
  • consider cancelling non-essential meetings. If needed, hold meetings via video conferencing or phone call
  • put off large meetings to a later date
  • hold essential meetings outside in the open air if possible
  • promote good hand, sneeze and cough hygiene
  • provide alcohol-based hand rub for all staff
  • eat lunch at your desk or outside rather than in the lunch room
  • regularly clean and disinfect surfaces that many people touch
  • open windows or adjust air conditioning for more ventilation
  • limit food handling and sharing of food in the workplace
  • avoid non-essential travel
  • promote strict hygiene among food preparation (canteen) staff and their close contacts

Information for employers and jobseekers is available on the Department of Education, Skills and Employment website.

In schools

If your child is sick, they must not go to school or childcare. You must keep them at home and away from others.

To reduce the spread of viruses or germs in schools:

  • wash hands with soap and water or use hand sanitiser when entering school, and at regular intervals
  • stop activities that lead to mixing between classes and years
  • avoid queuing
  • cancel school assemblies
  • have a regular handwashing schedule
  • regularly clean and disinfect surfaces that many people touch
  • conduct lessons outdoors where possible
  • consider opening windows and adjusting conditioning for more ventilation
  • promote strictest hygiene among food preparation (canteen) staff and their close contacts

For more information on school operations, visit the Department of Education, Skills and Employment website.

Keep in touch with others

You can still keep in touch with loved ones while you practise social distancing:

  • use video chats
  • make phone calls to people you would normally catch up with in person
  • use online groups to interact
  • chat with neighbours while keeping 1.5 metres apart
  • look after your mental health. Visit Head to Health for more information

Handwashing and respiratory hygiene

There are general principles you can follow to help prevent the spread of respiratory viruses, including:

  • washing your hands more often – with soap and water for at least 20 seconds or use a hand sanitiser when you get home or into work, when you blow your nose, sneeze or cough, eat or handle food
  • avoid touching your eyes, nose, and mouth with unwashed hands
  • avoid close contact with people who have symptoms
  • cover your cough or sneeze with a tissue, then throw the tissue in a bin and wash your hands
  • clean and disinfect frequently touched objects and surfaces in the home

Symptoms

Symptoms

If you have serious symptoms such as difficulty breathing, call 000 for urgent medical help.

Symptoms include:

  • fever
  • coughing
  • sore throat
  • fatigue
  • shortness of breath

If you are sick and think you might have COVID-19, check your symptoms using healthdirect’s Coronavirus (COVID-19) Symptom Checker.