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About COVID-19 vaccination:

People who have a COVID-19 vaccination have a much lower of getting sick from the disease called COVID-19. The COVID-19 vaccination is free. You choose whether to have the vaccination or not. To be vaccinated you will get a needle in your arm. You need to have the vaccination two times on different days. There are different brands of vaccine. You need to have the same brand of vaccine both times. The person giving you your vaccination will tell you when you need to have the second vaccination. Medical experts have studied COVID-19 vaccines to make sure they are safe. Most side effects are mild and don’t last for long. They may start on the day of vaccination and last for around 1-2 days. As with any vaccine or medicine, there may be rare and/or unknown side effects. A possible rare side effect of blood clots in the brain or other body sites is currently being investigated. It is not known if this condition is caused by the vaccine – this is currently being investigated. This condition has been reported in the 4-20 days after vaccination with COVID-19 AstraZeneca vaccine at a rate of about 1 to 8 people for every one million people vaccinated. This safety concern is not being raised with Comirnaty (Pfizer COVID-19 vaccine). You can still receive the COVID-19 AstraZeneca vaccine. You and your health care provider will be advised of how to act early on any signs of this rare condition. You can tell your healthcare provider if you have any side effects like a sore arm, headache, fever or any other side effect you are worried about. You may be contacted by SMS within the week after receiving the vaccine to see how you are feeling after vaccination. Vaccination providers record all vaccinations on the Australian Immunisation Register, as required by Australian law. You can view your vaccination record online through your: Medicare account or MyGov account or MyHealthRecord account.

About COVID-19 vaccination:

For information on how your personal details are collected, stored and used visit
https://www.health.gov.au/covid19-vaccines.

On the day you receive your vaccine

Before you get vaccinated, tell the person giving you the vaccination if you:
1 -Have had an allergic reaction, particularly anaphylaxis (a severe allergic reaction) to a previous dose of a COVID-19 vaccine, to an ingredient of a COVID-19 vaccine, or to other vaccines or medications.
Are immunocompromised. This means that you have a weakened immune system that may make it harder for you to fight infections and other diseases. You can still have a COVID-19 vaccine, but may wish to consider the best timing of vaccination depending on your underlying condition and/or treatment.
Wait at the practice for 15 minutes after the vaccination is completed and inform the staff prior to leaving or if you have any allergic reactions to the vaccination.

(Below are relevant only for those receiving AstraZeneca vaccine)

* Comirnaty/Pfizer is the preferred vaccine for people in these groups but if not available, AstraZeneca COVID-19 vaccine can be considered if the benefits of vaccination outweigh the risk. For more information refer to the: Patient information sheet on thrombosis with thrombocytopenia syndrome (TTS)

Below are relevant only for those receiving Comirnaty/Pfizer vaccine

Patient information

Next of Kin / Emergency Contact Details:

Consent to receive COVID-19 vaccine

  •  I confirm I have received and understood information provided to me on COVID-19 vaccination

  •   I confirm that none of the conditions above apply, or I have discussed these and/or any other special circumstances with my regular care provider and/or vaccination service provider

  •   I agree to receive a course of COVID-19 vaccine (two doses of the same vaccine)

  • I am the patient’s guardian or substitute decision-maker, and agree to COVID-19 vaccination
    of the patient named above
  • For provider use:

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