COVID-19 vaccines: Frequently asked questions (FAQs)

Icon image: vaccine vial
Icon image: vaccine vial

Key points

  • COVID-19 is a disease caused by the SARS-CoV-2 virus. SARS-CoV-2 can change over time, leading to new variants of COVID-19.  
  • Older people and people with certain medical conditions – including infants and children – are at the highest risk of severe illness or death from COVID-19.  
  • COVID-19 vaccines are safe and effective, and are available free of charge under Australia’s National Immunisation Program. 
  • COVID-19 vaccine recommendations are based on several factors, including age, time since last dose and presence of any medical conditions. New recommendations are made based on the changing COVID-19 situation.
  • Omicron XBB.1.5 variant vaccines are now preferred for individuals aged 5 years and over. 
  • COVID-19 vaccines can be co-administered with other vaccines, including influenza vaccines.

Until additional ATAGI advice is provided in 2024, recommendations for further ‘2023’ doses are still valid.  

FAQs

Which COVID-19 vaccines are currently being used in Australia?

Who is recommended to receive a COVID-19 vaccine?

Which COVID-19 vaccines are approved for use in which age groups? 

How do the COVID-19 vaccines work?

What is the difference between the original COVID-19 vaccines and the vaccines that have recently been approved for use in Australia?  

Why have the new Omicron XBB.1.5 variant COVID-19 vaccines been developed?

What is meant by a ‘primary dose’ and a ‘primary course’ of the COVID-19 vaccine?

How many primary doses of COVID-19 vaccines are recommended?

Who should receive further COVID-19 vaccine doses?

Should people get an XBB.1.5 variant COVID-19 vaccine if they have already had their recommended 2023 doses?

What are the common side effects of COVID-19 vaccines?

How can potential side effects after immunisation be reported?

Can COVID-19 vaccines be co-administered with other vaccines (e.g. the influenza vaccine)?

Will ongoing or annual COVID-19 vaccine doses be required?

Is there a maximum number of doses for older people or people who are at increased risk of severe COVID-19?

Are COVID-19 vaccines, including any further doses, recommended for people who have had COVID-19 infection in the past?

Are COVID-19 vaccines recommended for people who are immunocompromised?

Are COVID-19 vaccines recommended for women who are pregnant, breastfeeding or planning pregnancy?

Are further COVID-19 vaccines recommended before travel?

Can a recommended further dose be administered sooner than 6 months after a previous dose?

How effective are COVID-19 vaccines in children, adults and elderly people?

How long does protection from a COVID-19 vaccine last?

What is long COVID?

Do COVID-19 vaccines protect against long COVID?

What are myocarditis and pericarditis, and what is the risk of developing these conditions after receiving a COVID-19 vaccine?

How is vaccine safety monitored after a COVID-19 vaccine is approved for use?

Can people have COVID-19 vaccines for free if they don’t have a Medicare card?


Which COVID-19 vaccines are currently being used in Australia? 

There are two types of approved COVID-19 vaccines: 

  1. messenger RNA (mRNA) vaccines, including Comirnaty (Pfizer) and Spikevax (Moderna) 
  2. protein-based vaccines, including Nuvaxovid (Novavax). 

All COVID-19 vaccines available in Australia are expected to provide benefit to eligible people; however, the new monovalent Omicron XBB.1.5 variant mRNA vaccines are now preferred over other vaccines for all persons aged 5 years and over. 


Who is recommended to receive a COVID-19 vaccine?

COVID-19 vaccination is recommended for all people aged 5 years and over. It is also recommended for children aged 6 months to less than 5 years if they have one or more of the following: 

  • severe immunocompromise
  • disability with complex care requirements
  • complex and/or multiple medical conditions that increase the risk of severe COVID-19.

Which COVID-19 vaccines are approved for use in which age groups? 

Different COVID-19 vaccines are approved for use in different ages. Specifically:

  • the Pfizer original vaccine is approved for children aged 6 months to less than 5 years
  • the Pfizer XBB.1.5 (light blue cap) variant vaccines are approved for all individuals aged 5 years and over 
  • the Pfizer and Moderna bivalent, Pfizer XBB.1.5 (dark grey cap), and Moderna XBB.1.5 and Novavax original vaccines are approved for all persons aged 12 years and over.

A summary of all vaccines approved for use in Australia is available here


How do the COVID-19 vaccines work?

COVID-19 vaccines work by ‘teaching’ and ‘reminding’ the immune system how to recognise SARS-CoV-2, the virus that causes COVID-19.

The Pfizer and Moderna COVID-19 vaccines are mRNA vaccines that contain the genetic code for a part of the SARS-CoV-2 virus called the spike protein. After getting the injection, your body ‘reads’ the genetic code and makes copies of the spike protein. Your immune system then detects these spike proteins and responds. The genetic code is quickly broken down and cleared away by the body. 

Novavax is a protein-based vaccine. The proteins contained in the vaccine resemble the SARS-CoV-2 virus spike protein and trigger a response from your immune system. Like the mRNA vaccines, this vaccine does not contain any live component of the virus.

COVID-19 vaccines cannot cause COVID-19 disease.


What is the difference between the original COVID-19 vaccines and the vaccines that have recently been approved for use in Australia?  

The original COVID-19 vaccines – Pfizer, Moderna and Novavax – contain the original (ancestral) variant of SARS-CoV-2. The Moderna and Pfizer bivalent vaccines contain both the original (ancestral) variant and the Omicron BA variants of the virus. The latest Omicron XBB.1.5 vaccines contain a more current Omicron XBB.1.5 variant.


Why have the new Omicron XBB.1.5 variant COVID-19 vaccines been developed?

These new vaccines target more current COVID-19 variants. In Australia, Pfizer Omicron XBB.1.5 and Moderna Omicron XBB.1.5 vaccines are available and are now preferred over other available COVID-19 vaccines.


What is meant by a ‘primary dose’ and a ‘primary course’ of the COVID-19 vaccine?

Primary doses are the first doses of the COVID-19 vaccine given to an individual, to ‘introduce’ their immune system to the SARS-CoV-2 virus. 

The full set of ‘introductory’ doses that an individual receives is known as the primary course.


How many primary doses of COVID-19 vaccines are recommended? 

The recommended schedule for COVID-19 vaccines depends on a person’s age and the presence of other medical conditions.

Most people need 2 primary doses of the COVID-19 vaccine. However, some people whose immune systems are affected by medical conditions may need 3 COVID-19 primary doses. 

For people aged 5 years and over without severe immunocompromise, a primary course of 2 doses is recommended.

For people aged 5 years and over with severe immunocompromise, a primary course of 3 primary doses is recommended. Further information on the use of a 3rd primary dose of COVID-19 vaccine in individuals who are severely immunocompromised can be found here.

For infants and children aged 6 months to less than 5 years, only those who have severe immunocompromise, disability, or complex or multiple health conditions that increase their risk of severe COVID-19 are currently recommended to receive COVID-19 vaccines. All eligible children in this age group are recommended to receive 3 doses in their primary course. Further information on COVID-19 vaccines for children can be found here

Some people who have completed their primary course are recommended to receive further doses; details are given in the following question. 


Who should receive further COVID-19 vaccine doses?

Some people who have completed their primary course are recommended to follow the Australian Technical Advisory Group on Immunisation’s (ATAGI’s) 2023 advice and receive further doses regardless of how many vaccine doses they have had in the past.

One or two further COVID-19 vaccine doses are recommended to the groups listed below 6 months after receiving the most recent COVID-19 vaccine dose. There should be a gap of at least 6 months between each further COVID-19 vaccine dose.

One further dose is recommended for:

  • all adults aged 65 years and over
  • adults aged 18–64 years who have medical conditions that increase their risk of severe COVID-19, as well as those who have a disability with significant or complex health needs.

Adults aged 18–64 years who do not have at-risk medical conditions can consider one further 2023 dose after completing their primary course.

A second further dose is recommended for:

  • all adults aged 75 years and over with an interval of 6 months between doses. 

Adults aged 65–74 years and those with severe immunocompromise can consider a second further 2023 dose.


Should people get an XBB.1.5 variant COVID-19 vaccine if they have already had their recommended 2023 doses?

For those who have already had their recommended 2023 COVID-19 vaccine doses, further doses of an XBB.1.5 variant vaccine are not recommended at this time.


What are the common side effects of COVID-19 vaccines?

The most common side effects of COVID-19 vaccines include pain at the injection site, tiredness, headache, muscle pain, chills, joint pain and fever. These symptoms are temporary and usually go away without treatment in 1–2 days. Paracetamol or ibuprofen can be taken to reduce side effects.


How can potential side effects after immunisation be reported?

Both individuals and their healthcare providers can report side effects to the relevant state or territory health authority or directly to the Therapeutic Goods Administration

In some states and territories, it is mandatory for healthcare providers to report side effects after COVID-19 vaccines.

Reporting of side effects supports the TGA in detecting any safety concerns relating to the use of COVID-19 vaccines.


Can COVID-19 vaccines be co-administered with other vaccines (e.g. the influenza vaccine)?

Yes, in people aged 5 years and over, a COVID-19 vaccine can be co-administered with (i.e. given on the same day as) other vaccines, including the influenza vaccine, childhood and adolescent vaccines, and vaccines given later in life

For children aged 6 months to less than 5 years who are recommended to receive a COVID-19 vaccine, it is preferable to separate administration by 7–14 days, given there is currently limited evidence on co-administration in this age group.


Will ongoing or annual COVID-19 vaccine doses be required?

It is likely that some people will need additional doses of COVID-19 vaccines in the future, but the timing and frequency of these further doses is not yet known. Future recommendations will depend on factors such as:

  • the evolving epidemiology of COVID-19
  • the potential emergence of new variants
  • the duration of protection against serious illness that existing and new vaccines provide. 

New and emerging evidence is reviewed on an ongoing basis.


Is there a maximum number of doses for older people or people who are at increased risk of severe COVID-19?

There is no recommendation relating to the maximum number of doses for elderly people or people who are at increased risk of severe or complicated COVID-19. All people are recommended to have at least a primary course of COVID-19 vaccines and then follow the most current advice on further doses.


Are COVID-19 vaccines, including any further doses, recommended for people who have had COVID-19 infection in the past?

Yes, COVID-19 vaccines are recommended for people with a history of COVID-19. 

Protection against COVID-19 disease after a previous COVID-19 infection is higher in vaccinated individuals than in unvaccinated individuals. This is known as hybrid immunity.

Immunity against COVID-19 may reduce over time. Further dose(s) of COVID-19 vaccine can provide greater protection against infection and severe illness.

There is no need to delay a dose of COVID-19 vaccine due to a recent COVID-19 infection.


Are COVID-19 vaccines recommended for people who are immunocompromised? 

Yes. Immunocompromised people are at higher risk of severe COVID-19 disease and are encouraged to keep up to date with the number of vaccine doses recommended for them. 

The level of immunocompromise and age of the person will determine the number of recommended doses. 

Individuals receiving an immune system-weakening treatment, including chemotherapy, should discuss the timing of vaccination with their treating healthcare provider. 

A summary of ATAGI’s recommendations on COVID-19 vaccination doses for individuals who are severely immunocompromised is available here.


Are COVID-19 vaccines recommended for women who are pregnant, breastfeeding or planning pregnancy? 

Yes, it is safe for COVID-19 vaccines to be administered during pregnancy, while breastfeeding or when planning pregnancy – and vaccination is recommended at these times. 

Unvaccinated pregnant women are at increased risk of severe illness from COVID-19. Pregnant women who have previously been vaccinated should discuss with their healthcare provider whether to have an additional dose during their pregnancy, based on an individual risk–benefit assessment.

mRNA vaccines are preferred in pregnancy, and ATAGI considers the latest XBB.1.5 variant mRNA vaccines equivalent to the other mRNA vaccines in terms of suitability and safety for pregnant women. 

There are limited safety data on use of Novavax during pregnancy; however, it can be used if the benefits to the individual are judged to outweigh the risks. 

Women who are breastfeeding do not need to stop breastfeeding after COVID-19 vaccination. 

Women who are planning pregnancy do not need to delay pregnancy after COVID-19 vaccination.


Are further COVID-19 vaccines recommended before travel? 

There is no specific recommendation to get a further COVID-19 vaccine prior to travel. 

However, individuals aged between 18 and 64 years should discuss the potential benefits of receiving a further dose before travelling with their healthcare provider, since this can reduce the risk of severe COVID-19 in the weeks immediately after receiving the vaccine.


Can a recommended further dose be administered sooner than 6 months after a previous dose?

Individuals can receive recommended further doses earlier than the 6-month interval in certain circumstances, such as: 

  • before starting immunosuppressant therapy
  • before overseas travel
  • if they cannot reschedule vaccination easily, such as in an outreach vaccination program.

How effective are COVID-19 vaccines in children, adults and elderly people?

Several real-world studies of vaccination programs in countries including the US and the UK have shown COVID-19 vaccines provide strong protection against severe disease in children, adults and elderly people. 

The protection provided to an individual after either vaccination or infection decreases over time, however. This decrease in protection is driven by both a decrease in immunity over time and the development of new variants of SARS-CoV-2.


How long does protection from a COVID-19 vaccine last?

While protection from COVID-19 vaccines reduces over time, many studies have shown protection against severe disease remains high 6 months after vaccination. Further 2023 doses are recommended for people at higher risk of serious illness to provide ongoing protection.


What is long COVID? 

Long COVID (also known as ‘post-COVID-19 condition’) is a condition in which people with COVID-19 experience persistent symptoms for many months. Common symptoms include fatigue, shortness of breath and cognitive dysfunction (‘brain fog’). Symptoms can fluctuate or relapse (come back) over time. 

Long COVID can affect both children and adults. It is not yet known how long symptoms last.

Treatment for long COVID depends on symptoms. A healthcare professional can outline the options available.


Do COVID-19 vaccines protect against long COVID?

Yes – vaccines are effective at preventing COVID-19 infection and therefore reduce the risk of complications of COVID-19, such as long COVID. 

There is some evidence that vaccinated people who develop a COVID-19 infection may be less likely to experience long COVID symptoms than unvaccinated people. If an individual is suffering from long COVID at the time of receiving a dose of the COVID-19 vaccine, it is unclear whether the vaccine will reduce the severity or duration of their long COVID symptoms.


What are myocarditis and pericarditis, and what is the risk of developing these conditions after receiving a COVID-19 vaccine?

Myocarditis and pericarditis are rare conditions where the heart muscle (myocarditis) or the lining around the heart (pericarditis) become inflamed. They can occur separately or concurrently. They can occur as a result of a range of different causes, including COVID-19 itself. 

Myocarditis and pericarditis have been associated with COVID-19 vaccines. The risk is very small but is more likely after the second dose of mRNA vaccines (Moderna and Pfizer) in young males under 40 years of age. 

For individuals who have symptoms potentially consistent with myocarditis and/or pericarditis after a COVID-19 vaccine, assessment from a healthcare professional is recommended.
ATAGI gives detailed advice on assessment, management and follow-up.


How is vaccine safety monitored after a COVID-19 vaccine is approved for use?

The TGA assesses the quality of every batch of vaccine before it is distributed in Australia. It also collects, analyses and reports data on vaccine side effects once a vaccine is in use. Individuals and healthcare providers can also report side effects directly to the TGA. 

Additionally, programs such as AusVaxSafety collect information from individuals regarding side effects experienced after vaccination. Experts analyse this information to detect any safety issues as soon as possible.


Can people have COVID-19 vaccines for free if they don’t have a Medicare card?

Yes, everyone in eligible age groups, including those without a Medicare card, can receive free COVID-19 vaccination. Further details about how to receive free COVID-19 vaccination can be found here.


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