Waiting Area CCMC COVID-19 Vaccine clinic perth cbd
Central City Medical Centre Vaccine Clinic Perth CBD Observation Area

COVID-19 Vaccination

 

CCMC has been approved be a COVID-19 vaccination provider and we are now vaccinating eligible patients in our new dedicated COVID vaccine clinic situated opposite us in the old Myer Megamart building on the corner of Roe St and Beaufort St in the centre of Perth. MAP

 

We are currently offering the Oxford-AstraZeneca COVID-19 vaccine (2 doses, 12 weeks' apart) to all those over 60 years old. From early July we will start giving the Pfizer COVID-19 (Comirnaty) vaccine (2 doses, 3 weeks apart) to patients aged between 40 and 59, and those aged 18-39 with a chronic health problem. (Check your eligibility here). If you are under 60 and already had your first AstraZeneca vaccine then you should carry on and have the second - the risk of blood clots is even smaller than with the first injection)

Given the expected unprecedented huge demand for the vaccine, appointments at our vaccine clinics will be short (although you will have to remain on site for 15 minutes after the injection), there will be no time for detailed discussion - we expect people turning up to have already made the decision to have the injection; if you are unsure please make an appointment with your GP to discuss further. We also hope that the information on this page is of help in making this decision. Please fill in and bring this consent form along with you to the appointment together with your proof of eligibility.

How can I make an appointment?

 

WE ARE NOT MAKING APPOINTMENTS YET FOR THE PFIZER VACCINE.

 

If you have Medicare and are over 60 or are over 18 with chronic health problems or an Aboriginal Torres Strait Islander, a Healthcare worker, or other critical worker e.g. Police Officer then you may make an appointment here. It is recommended that those aged 18-60 wait for the Pfizer vaccine but can still have the AstraZeneca vaccine if they chose to accept the very small increased risk of blood clot complications. Due to supply constraints, the government is only providing us with 300 doses per week so there is currently limited availability. We expect this to improve over the next few weeks and that we will then be able to open up more vaccination appointments to be freely booked.

 

You can check your eligibility here.

 

If you are under 40 to prove eligibility for a 1b vaccination you will need a print out of the health summary from your My Health Record (MHR) or if, you don't have an MHR then a letter from your GP/specialist (please - only if you haven't got an MHR as we don't want to burden other doctors at this very busy time). A letter from your employer is needed for the employment categories.

 

It is not possible to pay to jump the queue and have the vaccine before you are eligible or to have the Pfizer vaccine.

 

 

We will only be supplied with vaccine for those with Medicare; those without will still be able to get the vaccine but will need to attend one of the health department vaccination clinics.

How much does it cost?

The government is paying for both the vaccine itself and the appointment - these will be bulk billed to Medicare

Will I get a certificate of vaccination?

No. The details of your immunisation will be uploaded to the Australian Immunisation Register, you can download a statement of your immunisations from there.

Which vaccine will I get?

At this stage we can only provide the AstraZeneca vaccine to those over 60 but from early July we will also be providing the Pfizer vaccine to those between the ages of 40 and 59 or to those between 18-39 with chronic health conditions. If you are under 60 and already had your first AstraZeneca vaccine then you should carry on and have the second - the risk of blood clots seems to be limited to the first injection)

Does the vaccine work?

In initial trials the AstraZeneca vaccine has been shown to be about 80% effective at stopping COVID-19 disease (we do not know if it, or any of the other vaccines, prevents/reduces transmission but recent data on this are very promising). However it is more effective at stopping serious disease or death (about 90%). The Pfizer vaccine is about 95% effective. These efficacy rates are better than the effectiveness of the annual influenza vaccine. A recent study of 5.4 million people in Scotland showed that a single shot of the Pfizer option was 85 per cent effective at preventing hospitalization at 28-34 days post-vaccination, whereas one shot of the AstraZeneca vaccine was 94 per cent effective at preventing hospitalization in the same interval (This is not the case for the "Indian" strain where 2 doses of either vaccine are needed for good protection.) The AstraZeneca vaccine has also been shown to be effective against the highly infectious "UK"  strain of COVID-19 but not at preventing mild or moderate cases of the "South African" strain (AstraZeneca expect to produce a newer version of the vaccine to be effective against this towards the end of the year). We do not know yet if it is effective against serious cases of COVID-19 caused by this strain (as mentioned above it is better at stopping serious disease than mild for other variants). Similarly while the Pfizer does offer better protection against the mild/moderate disease with the South African strain we don't know how effective it is for serious disease. We also do not know how long the protection from the immunisation will last i.e. whether we will need annual immunisations as we do for influenza. The vaccine is just one part, albeit an important part, of how we will get on top of COVID-19 - we will need to carry on with good hygiene, social distancing, testing and restricted international travel for a while yet.

 
Is the vaccine safe?

One of the main concerns people have is around the safety of the vaccines; they worry that they have been brought out too quickly and that corners must have been cut to enable this. In the Therapeutics Goods Administration (TGA), we have one of the strictest regulators in the world and they are happy with the safety of the vaccine. Australia, as a result of relative isolation and good management, has been spared the worst of the pandemic and the TGA has therefore not had to rush into giving the emergency approval for use of the vaccine that has happened in other parts of the world and has had time to make a full appraisal of all the safety data. The TGA is continuing to monitor the long term safety data as it comes in.

All the COVID-19 vaccines that the TGA has approved have gone through the standard series of safety trials that all medication has to undertake. It has been faster for several reasons; firstly research has been ongoing on coronavirus vaccines since the SARS (or SARS-CoV-1, COVID-19 is SARS-CoV-2) outbreak in 2002-2004 - this knowledge was readily applied to the development of the COVID-19 vaccine and has given the scientists a head start into which avenues of research and development were best to follow. Secondly, all the bureaucratic processes have been hugely accelerated; when drug trials are formulated they have to be approved by various regulators and ethics committees, this takes months and months largely because it takes this long for your trial to get to the top of the pile - with the COVID-19 vaccine trials these requests were assessed immediately. Thirdly, pharmaceutical companies and governments have taken large financial risks by pumping millions of dollars into the process so large trials can be conducted straightaway rather than doing smaller ones first.

We now have the benefit of seeing many millions of people having the vaccine around the world and these are being actively monitored to give ongoing efficacy data but also looking for the possibility of rare (< 1 in 100,000 chance) serious side effects that would not necessarily have been picked up in the initial trials.

With the AstraZeneca vaccine there is a small risk of central venous thrombosis (blood clots) associated with low blood platelet counts. The risk in Australia is approximately 1 in 75000 and is more common in younger people. There are different levels of severity and the TGA is now classifying these as either more serious Tier 1 clots or less serious Tier 2 clots. To date, after 3.6 million doses in Australia, there have been 15 Tier 1 clots and 33 Tier 2 clots giving a risk for the serious clots of about 1 in 240,000. There have tragically been 2 deaths - a risk of 1 in 1.8 million. There is no increased risk of the common deep vein thrombosis (DVT - in the leg) or pulmonary embolism (lung blood clots). It is recommended that patients with a history of Central Venous Sinus Thrombosis or Heparin Induced Thrombocytopenia not receive the vaccine. To put this risk into perspective, the background risk of an individual having a venous thrombosis in a given year is about 1 in 5000, for a women on the combined oral contraceptive pill this rises to between 3-12 in10,000, pregnant women the risk is between 2-3 in 1000. The risk of a blood clot after a 4 hour flight is approximately 1 in 5000 (higher for longer flights).

More context (UK data, but illustrates the point):

AZ Vaccine risk:benefit CCMC COVID-19 Vaccine Clinic Perth

The risk:benefit ratio of the COVID-19 vaccination depends on the background prevalence of COVID-19 in the country. Currently the prevalence in Australia is very low but, as borders open, the prevalence will increase and as it does the risk of serious COVID-19 complications rise rapidly. It is important to remember that vaccination does not prevent you catching COVID-19 and passing it onto others but rather markedly reduces the chance of serious disease. Therefore you cannot rely on everyone else getting vaccinated.

These tables compare the number of deaths, intensive care and hospital admissions admissions with the chance of getting vaccine-related blood clots for different age groups with the AstraZeneca vaccine at different levels of COVID-19 prevalence:

Risk low.png
risk medium.png
Who shouldn't have the vaccine?
  • The vaccines are not for use in those under 18yrs old. The Pfizer vaccine is recommended for those over 50 years of age. The AstraZeneca vaccine can still be used in those under 50yrs old but you may prefer to wait for the Pfizer vaccine given the very small risk of thrombosis with the AstraZeneca vaccine in this age group.

  • If you have ever had a severe allergic reaction to any of the vaccine ingredients:

    • AstraZeneca: L-histidine, L-histidine hydrochloride monohydrate, magnesium chloride hexahydrate, polysorbate 80, ethanol, sucrose, sodium chloride, disodium edetate dihydrate .

    • Pfizer: ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl) bis(2-hexyldecanoate) (ALC-0315), 2-[(polyethylene glycol)-2000]-N (PEG), N-ditetradecylacetamide, Distearoylphosphatidylcholine (DSPC), Cholesterol, Potassium chloride, Monobasic potassium phosphate, Sodium chloride, Dibasic sodium phosphate dihydrate, Sucrose

  • If you have had a severe allergic reaction to any other vaccination

  • If you currently have an illness with a fever over 38°C

  • If you have a bleeding disorder or on blood thinning agents - you will probably be able to have the injection but discuss first with the doctor or nurse.

  • If your immune system does not work properly (immunodeficiency) or you are taking medicines that weaken the immune system (such as high-dose corticosteroids, immunosuppressants or cancer medicines) - again, you will probably be able to have the injection but discuss first with the doctor or nurse.

  • If you have had Central Venous Sinus Thrombosis, Heparin Induced Thrombocytopenia, Idiopathic Splanchnic Venous Thrombosis (a blood clot in the abdominal veins), Anti-Phospholipid Syndrome with Thrombosis you should not have the AstraZeneca vaccine.

Are there side effects from the vaccine?

Yes, as with all medications there is the possibility of side effects, these are similar to what we see in the annual influenza vaccination The common side effects, which include fever, sore muscles, tiredness and headache usually start within 24 hours of vaccination and last for 1–2 days. These side effects are expected and are not of concern unless severe or persistent and can be managed with paracetamol, fluids and rest. The reports of the rare clotting complications have occurred later (between day 4 and 20 after vaccination) and have generally been severe, requiring hospitalisation.
 
Patients should seek immediate medical attention if, a few days after vaccination, they develop symptoms such as:

  • as a severe or persistent headache or blurred vision

  • shortness of breath, chest pain, leg swelling or persistent abdominal pain

  • unusual skin bruising and/or pinpoint round spots beyond the site of injection.

Very Common (may affect more than 1 in 10 people)

tenderness, pain, warmth, redness, itching, swelling or bruising where the injection is given

generally feeling unwell

feeling tired (fatigue)

chills or feeling feverish

headache

feeling sick (nausea)

joint pain or muscle ache

Common (may affect up to 1 in 10 people)

a lump at the injection site

fever

being sick (vomiting)

flu-like symptoms, such as high temperature, sore throat, runny nose, cough and chills

Uncommon (may affect up to 1 in 100 people)

feeling dizzy

decreased appetite

abdominal pain

enlarged lymph nodes

excessive sweating, itchy skin or rash

In clinical trials there were very rare reports of events associated with inflammation of the nervous system, which may cause numbness, pins and needles, and/or loss of feeling. However, it is not confirmed whether these events were due to the vaccine.

If you have a severe or unusual side effect it is important that this is reported to the TGA - you can either ask your GP to do this or report it directly yourself.

 

Can I have the influenza (flu) vaccine at the same time?

No, there needs to be a 1 week gap between the COVID-19 vaccines and any other vaccine.

COVID-19 vaccine myths
  • It makes women infertile - there is no evidence to support this claim or any theoretical reason why this might be the case. It is more likely that COVID-19 itself might cause problems with fertility given its vascular inflammatory effects.

  • It will give you COVID-19 - this is not possible; as with the influenza vaccine and may other vaccines none of the COVID-19 vaccines contain the actual virus. If you catch COVID-19 after having the vaccine it simply means either that it has not had time to work, not worked or worn off.

  • It will incorporate the COVID-19 genetic material into our DNA - this is a fear relating to the Pfizer/Moderna vaccines which use Messenger RNA (mRNA) to instruct our cells to create a fragment of the COVID-19 virus (the spike protein) which, in turn, stimulates our immune system to recognize the COVID-19 virus in the future and attack it. Once the mRNA has done its job it is destroyed - it is very unstable (hence the reason the vaccine has to be stored at -70°C). mRNA is made by DNA to take instructions to cells to make proteins and can not combine with DNA.

  • It contains a microchip that Bill Gates is going to use to track you - if you believe this then you probably won't have read this far down the page.

How's the vaccine rollout going?

Where's the vaccine clinic?

The vaccine clinic is a short 1 minute walk from our main clinic and has parking beneath it.