FAQs for clinicians about covid-19 vaccines and people living with Hepatitis B/Hepatitis C-related chronic liver disease

ASHM COVID-19 Taskforce interim recommendations 

 

Prepared by ASHM COVID-19 Taskforce  Members

 

UPDATED ON: 05 August 2021.

ATAGI has recommended:

Following the 23 July 2021 TGA approval of the Pfizer vaccine for children aged 12-15 years , on 2 August 2021 ATAGI issued a statement regarding vaccination of adolescents 12-15 years. ATAGI reviewed available evidence on specific medical conditions in children that have been identified to be associated with an increased risk of severe COVID-19. ATAGI recommends the following groups of children among those aged 12-15 years be prioritised for vaccination using the Comirnaty (Pfizer) vaccine:

  • Children with specified medical conditions that increase their risk of severe COVID-19 (including asthma, diabetes, obesity, cardiac and circulatory congenital anomalies, neuro developmental disorders, epilepsy, immuno-compromise, chronic liver disease and trisomy 21)
  • Aboriginal and Torres Strait Islander children aged 12–15 years
  • All children aged 12–15 years in remote communities, as part of broader community outreach vaccination programs that provide vaccines for all ages (≥12 years).

ATAGI recommendation in areas of increased community COVID-19 cases in Australia:

On 13 July ATAGI issued a statement on the use of COVID-19 vaccines in an outbreak setting. These new recommendations relate only to areas of increased community COVID-19 cases in Australia:

  • the re-assessment of benefits versus risks of COVID-19 Vaccine AstraZeneca for adults under 60 years old; under 60 yrs who do not have immediate access to Comirnaty (Pfizer) should reassess the benefits of being vaccinated with AstraZeneca versus the risk of serious side effects
  • updated advice about the optimal interval between the two doses of COVID-19 Vaccine AstraZeneca in an outbreak setting. The recommended interval between first and second doses is between 4 and 12 weeks. In outbreak situations, an interval between 4 and 8 weeks is preferred

ATAGI recommendations for vaccination in non-outbreak settings remain:

  • the COVID-19 Pfizer vaccine be preferred over AstraZeneca for adults aged under 60 years. This is because there is a potentially higher risk of thrombosis with thrombocytopenia in people aged under 60, who receive the AstraZeneca vaccine
  • the AstraZeneca vaccine be used in adults aged under 60, if the benefits outweigh the risks for that person – and they have made an informed decision based on the risks and benefits
  • people who have had the first dose of AstraZeneca without any serious adverse effects, can be given the second dose. This includes people aged under 60.

Healthcare providers may wish to continue having detailed discussions with patients about the risks and benefits of the AstraZeneca vaccine in line with ATAGI advice, regardless of the age of the patient, ensuring fully informed consent before vaccination.

Updated safety advisory – rare and unusual blood clotting syndrome (thrombosis with thrombocytopaenia): https://www.health.gov.au/news/atagi-statement-on-revised-recommendations-on-the-use-of-covid-19-vaccine-astrazeneca-17-june-2021

 

• The Pfizer-BioNTech BNT162b2 mRNA vaccine (COMIRNATY) for people ≥12 years of age [1]

• The AstraZeneca ChAdOx1 nCoV-19 (AZD 1222) vaccine for people ≥18 years of age [2] See ATAGI related guidance at the top of this page


• ATAGI has recommended that people with chronic liver disease be vaccinated[3] and this includes HBV/HCV-related chronic liver disease

• Viral hepatitis is a disease of the liver and people who have been living with hepatitis B or hepatitis C for more than six months are determined to have chronic infection.


• Yes [4]
• Age is the only eligibility criterion that restricts access to these vaccines:

     o Pfizer-BioNTech vaccine: ≥12years (children aged 12-15 with underlying medical conditions - see ATAGI recommendations at the top of this page)

     o AstraZeneca vaccine: ≥60 years. See ATAGI related guidance at the top of this page

• Otherwise, all people living with HIV (PLWHIV) are eligible for these vaccines irrespective of whether they have a Medicare number, whether they are here on temporary visas, whether they are incarcerated, homeless or in migrant detention centres [4]

 

• Yes, if they have no contraindications to these vaccines [3] See ATAGI related guidance at the top of this page


• Yes

• The COVID-19 vaccine roll-out is an excellent opportunity to recommend testing for HIV, blood-borne viruses and STIs to all people who are sexually active and to people who may have been exposed to HIV, viral hepatitis and STIs in the past

• It is also a good opportunity to conduct a comprehensive liver health check if one has not been done in the last 6 months


• People with HBV/HCV-related chronic liver disease who meet the eligibility criteria for Phase 1a can receive a vaccine without declaring their HBV/HCV status

• All other people with (HBV/HCV-related) chronic liver disease will be eligible to receive a vaccine during Phase 1b


• People living with HBV/HCV-related chronic liver disease will qualify to receive COVID-19 vaccines during Phase 1a if they are quarantine or border workers, frontline healthcare workers, aged care and disability care staff, or aged care and disability care residents [5]

• These criteria alone should be sufficient for people living with HBV/HCV-related chronic liver disease to be offered a COVID-19 vaccine and their hepatitis status should not have to be cited as a reason to be vaccinated 


• People will qualify to receive COVID-19 vaccines during Phase 1b if they are: [5]

  • A critical and high-risk worker
  • Indigenous and ≥ 55 years of age
  • Non-Indigenous and ≥ 70 years of age
  • A younger adult with an underlying medical condition or a disability


For people under 69, underlying medical conditions include:

  • Haematological diseases or cancers
  • Organ transplant recipients who are on immune suppressive therapy
  • Bone marrow transplant recipients or those on CAR-T therapy or immune suppressive therapy for graft versus host disease
  • who have haematological diseases or cancers, diagnosed within the last 5 years
  • Non-haematological cancer having chemotherapy or radiotherapy
  • Adult survivors of childhood cancers
  • Chronic inflammatory conditions requiring medical treatments 
  • Primary or acquired immunodeficiency (this includes HIV infection)
  • Chronic renal (kidney) failure with a eGFR of <44mL/min
  • Heart disease (including coronary heart disease and cardiac failure)
  • Chronic lung disease (excludes mild or moderate asthma)
  • diabetes
  • Severe obesity with a BMI ≥ 40kg/m2
  • Chronic liver disease  (note: includes chronic liver disease related to HBV and HCV)
  • Chronic neurological conditions (stroke, dementia, other)
  • Chronic inflammatory conditions and treatments
  • Poorly controlled blood pressure (defined as two or more pharmacologic agents for blood pressure control, regardless of recent readings)
  • Significant disability requiring frequent assistance with activities of daily living
  • Severe mental health conditions

Detailed information about the health conditions included in Priority Groups for COVID Vaccination Program Phase 1b

For those patients who will attend a vaccination site and may not have a referral letter or other evidence of their 1b eligibility status (e.g. My Health Record, medical history etc) and may often be Medicare Ineligible please use this statutory declaration form: https://www.health.gov.au/resources/publications/covid-19-vaccination-eligibility-declaration-form

 


• We recommend that clinicians should err towards assuming that chronic liver disease may be present in their patients with chronic HBV and patients with current, or prior HCV. This is because the majority of people with chronic HBV infection have not been assessed for the presence of chronic liver disease and are not receiving HBV antiviral treatment. Also a significant proportion of people with current, or prior HCV infection may not have been assessed for the presence of chronic liver disease.  


• Patients will need to access the vaccine eligibility checker to find a vaccine centre near them if their usual medical service is unable to provide the COVID-19 vaccine

• Clinicians who are not accredited to offer COVID-19 vaccines will have to refer their patients to an accredited general practice, or a purpose-built COVID-19 vaccine clinic

• Determine with the patient if they are comfortable for their hepatitis status to be recorded as the reason for eligibility for the COVID-19 vaccine under the chronic liver disease criteria

• Where the patient is not comfortable for their referral letter to state that they have (HBV/HCV-related) chronic liver disease, you can state the patient has any other eligible underlying medical condition/s

• If the patient’s only underlying medical condition is HBV/HCV-related chronic liver disease and they do not wish for this status to be disclosed, you can state the following in your referral letter:

  • That your patient qualifies as a younger adult with an underlying medical condition as per guidance from ATAGI and the Australian Government Department of Health
  • That the patient has had appropriate treatment assessment
  • That you have discussed with the patient any benefits and the effectiveness of the COVID-19 vaccine in relation to the patient’s underlying medical condition

• Once the patient does attend the new clinic, if they are asked about the specifics of their underlying medical condition that makes them eligible for the COVID-19 vaccine, they should state that they are not comfortable discussing this and if the clinician has any concerns about their eligibility for the vaccine, to contact the doctor who referred them

• Clinicians may also wish to inform patients that their My Health record may be accessed for the purpose of identifying eligibility for the vaccine. Although the access, use and disclosure of this information are still bound by rules of confidentiality the information may include the person’s HBV/HCV infection as well as diagnostics related to liver disease depending on their individual control settings. Patients may want to discuss My Health Record access with their clinician or seek advice from a relevant support service if they wish to change these settings or what information can be accessed ahead of attending for vaccination under Phase 1b

• Patients should also know that their COVID-19 vaccination will be recorded on the Australian Immunisation Register. This will also allow them to be recalled for the second dose

• Clinicians may wish to discuss strategies patients could use to deal with other people who may question their need for early vaccination on the grounds they are young and look well


• No, specific data about vaccine hesitancy in people with HBV/HCV-related chronic liver disease in Australia are not yet available


• Both the Pfizer-BioNTech and the AstraZeneca vaccines are highly effective in preventing severe COVID-19 disease in individuals [7-8]


• No


• Yes: Pfizer included people with pre-existing stable HBV or HCV infections. They also included people with liver disease[9]. There were 217 people with liver disease but just 3 with moderate to severe liver disease.[10]

• No: AstraZeneca excluded people with severe or uncontrolled liver disease, and suspected or known current drug or alcohol dependency,   [11]

• Pfizer’s inclusion criteria for HBV positive people were [12,13]:

  • Confirmed inactive chronic HBV infection, defined as HBsAg present for ≥6 months and the following:
    • HBeAg negative, anti-HBe positive
    • Serum HBV DNA

• Pfizer’s inclusion criteria for HCV positive people were:[12,13]

  • History of chronic HCV with evidence of sustained virological response (defined as undetectable HCV RNA) for ≥12 weeks following HCV treatment or without evidence of HCV RNA viremia (undetectable HCV viral load). 


• No data are available about how well these vaccines protect HBV or HCV-positive people against COVID-19 disease. Data will come from ‘real-world’ investigation.[10]


• The number of people living with liver disease enrolled in the Pfizer- vaccine studies was small (Pfizer, n=217 and AstraZeneca did not include anyone with liver disease) [9-10]

• The Pfizer-BioNTech vaccine contains messenger RNA from the SARS-CoV-2 virus.

• The AstraZeneca vaccine contains a replication-defective chimpanzee adenovirus, which serves as a vector for the SARS-CoV-2 spike glycoprotein [8]

• Both vaccines are likely to be safe in people with HBV or HCV or other forms of liver disease

 


• Clinicians should broadly explain that there are very limited data currently available on the safety and efficacy of the Pfizer-BioNTech and the Astra-Zeneca COVID-19 vaccines in people living with HBV/HCV-related chronic liver disease, but that data will be available in the near future. See ATAGI advice above 

• All Australians, including people living with HBV/HCV-related-chronic liver disease, need to be advised that they have to take ongoing protective measures against SARS-CoV-2 infection because COVID-19 vaccines were designed to prevent COVID-19 disease, not to prevent SARS-CoV-2 infection or transmission. Further data are expected about these vaccines’ ability to prevent SARS-CoV-2 infection and transmission.


• Yes

• Please note that although ATAGI recommends that a person who has had PCR-confirmed SARS-CoV-2 infection may defer their COVID-19 vaccine for six months from the time of infection (3), clinicians should not delay offering COVID-19 vaccines to their patients with HBV/HCV-related chronic liver disease with prior SARS-CoV-2 infection

• Vaccinating someone with prior COVID-19 has been shown to result in higher levels of antibodies, which likely means enhanced immunity to future infections

• There have not been any safety concerns for people who have had prior SARS-CoV-2 infection and go on to receive the Pfizer-BioNTech or the AstraZeneca vaccine[3].

Note: Several studies [14-20] have shown that infection with SARS-COV19 can cause liver injury particularly in more severe cases. People with HBV or HCV and COVID-19 co-infection are at a higher risk of morbidity and mortality [14,21] than people with COVID-19 without HBV/HCV


• The advice that ATAGI provides regarding offering these two vaccines to pregnant HIV-negative people should be applied to pregnant HIV-positive people. The advice is as follows [3,22]
     o  RANZCOG and ATAGI recommend that pregnant people be offered Pfizer mRNA vaccine (Cominarty) at any stage of pregnancy
     o The risks of severe outcomes from COVID-19 is significantly higher for people who are pregnant and their unborn baby
     o Global surveillance data[23,24,25] have not identified any significant safety concerns at any stage of pregnancy 
     o There is also evidence of antibody in cord blood and breastmilk which may offer immunity protection to infants(26,27,28,29]

• There are no data available about the safety of either vaccine in HIV-positive people who are pregnant and ATAGI has not provided specific advice for HIV-positive people who are pregnant


• The advice that ATAGI provides regarding offering these two vaccines to people not living with HBV or HCV who are planning pregnancy, or who are breastfeeding should be applied to people living with HBV or HCV who are planning pregnancy, or who are breastfeeding. The advice is as follows [3,22]:

  • People who are breastfeeding or who are planning pregnancy can receive a COVID-19 vaccine. There are no theoretical concerns regarding the safety of either vaccine in these groups
  • There is evidence of antibody in cord blood and breastmilk which may offer immunity protection to infants[26,27,28,29]


• No

• ATAGI does not recommend testing for anti-spike antibodies or neutralising antibodies against SARS-CoV-2 following COVID-19 vaccines [3]. This is because there is currently no recognised immune correlate of protection against infection with SARS-CoV-2 or COVID-19 disease [3]

 

• ATAGI recommends that the minimal interval between either COVID-19 vaccine and the annual influenza vaccine and all other vaccines should be 7 days [3]

See  ATAGI recommendations above.

  • Organ transplant recipients who are on immune suppressive therapy
  • Those who have had a bone marrow transplant
  • Those on immune suppressive therapy for graft versus host disease
  • Those who have haematological cancers, for example, leukaemia, lymphoma or myelodysplastic syndrome
  • Those having chemotherapy or radiotherapy
  • Adult survivors of childhood cancers
  • Those with chronic renal (kidney) failure
  • Those with heart disease (including coronary heart disease and cardiac failure)
  • Those with chronic lung disease (excludes mild or moderate asthma)
  • Those who have a non-haematological cancer diagnosed within the last 5 years
  • Those who have diabetes
  • Severe obesity with a BMI ≥ 120% of the 95% percentile for age or absolute BMI ≥ 35 kg/m2 whichever is lower.  
  • Those with chronic liver disease (including liver disease caused by hepatitis)
  • Those with some neurological conditions (stroke, dementia, other)
  • Those with some chronic inflammatory conditions and treatments
  • Those with other primary or acquired immunodeficiency
  • Those with poorly controlled blood pressure
  • Those living with significant disability requiring frequent assistance with daily living
  • Those with severe mental health conditions (including schizophrenia and bi-polar disorder)
  • Children with complex chronic disease
  • Pregnant people

 


• Yes. Pfizer enrolled 2,259 children aged 12-15 years into a study[30]. In March 2021 Pfizer commence a study of children aged 6 months -11 years [31,32]

• Moderna has completed a study which vaccinated 3,000 12-17-year-old children. The study showed “an efficacy consistent with 100%” and effective at stopping mild cases 14 days after vaccination.[33]

• Moderna has also begun a Phase 2/3 study vaccinating 6750 children between 6 months to 12 years[34]

• AstraZeneca suspended their trial [35] in April over blood-clot fears[36]

• Johnson & Johnson has commenced phase 2 studies in adolescents aged 12 – 17[37]

1.  COVID-19 vaccine: Pfizer Australia - COMIRNATY BNT162b2 (mRNA) - approved for use in individuals 12 years and older https://www.tga.gov.au/covid-19-vaccine-pfizer-australia-comirnaty-bnt162b2-mrna-approved-use-individuals-12-years-and-older

2. TGA provisionally approves AstraZeneca's COVID-19 vaccine. [Internet] 16 February 2021 https://www.tga.gov.au/media-release/tga-provisionally-approves-astrazenecas-covid-19-vaccine

3. Australian Government Department of Health, COVID-19 vaccination – ATAGI clinical guidance on COVID-19 Vaccine in Australia in 2021 (v2.0). 24 February 2021 Updated 17 June 2021 https://www.health.gov.au/resources/publications/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021   

4. ASHM Taskforce, Statement from the ASHM COVID-19 Taskforce regarding the Prioritisation of COVID-19 Vaccines for People Living with HIV. 18 February 2021 https://ashm.org.au/covid-19/clinical-care/statement-regarding-the-prioritisation-of-covid-19-vaccines/

5. Australian Government Department of Health, COVID-19 vaccination – Australia's COVID-19 vaccine national roll-out strategy. https://www.health.gov.au/resources/publications/covid-19-vaccination-australias-covid-19-vaccine-national-roll-out-strategy

6. Australian Government Department of Health, Advice for people at risk of coronavirus (COVID-19). https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/advice-for-people-at-risk-of-coronavirus-covid-19

7. Polack FP, Thomas SJ, Kitchin N et al, Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine December 31, 2020, N Engl J Med 2020; 383:2603-2615 DOI: 10.1056/NEJMoa2034577 https://www.nejm.org/doi/full/10.1056/NEJMoa2034577

8. Voysey M, Costa Clemens SA, Madhi SA et al, Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. The Lancet Volume 397, Issue 10269, P99-111, January09, 2021 Published: December 08, 2020 DOI: https://doi.org/10.1016/S0140-6736(20)32661-1 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32661-1/fulltext

9. Australian Technical Advisory Group on Immunisation (ATAGI, Clinical guidance on use of COVID-19 vaccine in Australia in 2021.Version 1.0 5 February 2021 https://www.health.gov.au/sites/default/files/documents/2021/02/covid-19-vaccination-atagi-clinical-guidance-on-covid-19-vaccine-in-australia-in-2021.pdf

10. Marjot T, Webb GJ, Barritt A et al, SARS-CoV-2 vaccination in patients with liver disease: responding to the next big question The Lancet, Gastroenterology & Hepatology Volume 6, Issue 3, P156-158, March 01, 2021 Published: January 11, 2021 DOI: https://doi.org/10.1016/S2468-1253(21)00008-X. Accessed 16.03.202

11. U.S. National Library of Medicine, Investigating a Vaccine Against COVID-19 [Internet] https://clinicaltrials.gov/ct2/show/NCT04400838

12. Pfizer Coronavirus Scientific Resources: A Phase 1/2/3, Placebo-Controlled, Randomized, Observer-Blind, Dose-Finding Study To Evaluate The Safety, Tolerability, Immunogenicity, And Efficacy Of SARS-COV-2 RNA Vaccine Candidates Against COVID-19 In Healthy Individuals. [Internet] Accessed 16.03.2021 at: https://cdn.pfizer.com/pfizercom/2020-11/C4591001_Clinical_Protocol_Nov2020.pd

13. Therapeutic Goods Administration, Australian Product Information –COMIRNATY™ (BNT162b2 [mRNA]) COVID-19 Vaccine https://www.tga.gov.au/sites/default/files/auspar-bnt162b2-mrna-210125-pi.pdf

14. Moon AM, Webb GW, Aloman C, et al., High Mortality Rates for SARS-CoV-2 Infection in Patients with Pre-existing Chronic Liver Disease and Cirrhosis: Preliminary Results from an International Registry. Journal of Hepatology, 2020. Published May 21 2020, DOI: https://doi.org/10.1016/j.jhep.2020.05.013. Accessed 09.03.2021

15. Ji, D, Qin E, Xu J et al., Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study. Journal of Hepatology, 2020. Volume 73, Issue 2, P451-453, August 01, 2020 DOI: https://doi.org/10.1016/j.jhep.2020.03.044. Accessed 09.03.2021

16. Garrido I., Liberal R, and Macedo G, Review article: COVID-19 and liver disease—what we know on 1st May 2020. Alimentary Pharmacology & Therapeutics, 2020 First published: 13 May 2020 https://doi.org/10.1111/apt.15813. Accessed 09.03.2021

17. Harrison SL, Fazio-Eynullayeva E, Lane DA, et al Comorbidities associated with mortality in 31,461 adults with COVID-19 in the United States: A federated electronic medical record analysis. PLoS Med. 2020 Sep 10;17(9):e1003321. doi: 10.1371/journal.pmed.1003321. PMID: 32911500; PMCID: PMC7482833. https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.100332. Accessed 09.03.2021

18. Kim D, Adeniji N, Latt N, et al. Predictors of Outcomes of COVID-19 in Patients with Chronic Liver Disease: US Multi-center Study. Clin Gastroenterol Hepatol. 2020 Sep 17:S1542-3565(20)31288-X. doi: 10.1016/j.cgh.2020.09.027. Epub ahead of print. PMID: 32950749; PMCID: PMC7497795. Accessed 09.03.2021

19. Mahamid M, Nseir W, Khoury T, et al. Nonalcoholic fatty liver disease is associated with COVID-19 severity independently of metabolic syndrome: a retrospective case-control study. Eur J Gastroenterol Hepatol. 2020 Aug 28. doi: 10.1097. Epub ahead of print. PMID: 32868652. doi: 10.1097/MEG.0000000000001902. Accessed 09.03.2021

20. Saviano A,  Wrensch F, Ghany MG; et al, American Association for the Study of Liver Diseases Liver disease and COVID‐19: from Pathogenesis to Clinical Care First published: 17 December 2020 https://doi.org/10.1002/hep.31684. Accessed 03.03.2021

21. Butt AA, Yan P, Chotani RA, et al; Mortality is not increased in SARS‐CoV‐2 infected persons with HCV virus infection First published: 03 February 2021 https://doi.org/10.1111/liv.14804. Accessed 03.03.2021

22. COVID-19 vaccination- Shared decision making guide for women who are pregnant, breastfeeding or planning pregnancy Updated 18 June 2021 https://www.health.gov.au/resources/publications/covid-19-vaccination-shared-decision-making-guide-for-women-who-are-pregnant-breastfeeding-or-planning-pregnancy

23. Shimabukuro TT, Kim SY, Myers TR, et al. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med. April 2021. doi:10.1056/nejmoa2104983 5

24. Gray KJ, Bordt EA, Atyeo C, et al. Coronavirus disease 2019 vaccine response in pregnant and lactating women: a cohort study. Am J Obstet Gynecol. 2021;0(0). doi:10.1016/j.ajog.2021.03.023 6

25. Collier AY, McMahan K, Yu J, et al. Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women. JAMA. May 2021. doi:10.1001/jama.2021.7563

26. Prabhu M, Murphy EA, Sukhu AC, et al. Antibody Response to Coronavirus Disease 2019 (COVID-19) Messenger RNA Vaccination in Pregnant Women and Transplacental Passage Into Cord Blood. Obstet Gynecol. 2021:10-1097. health.gov.au/covid19-vaccines 7 12

27. Mithal LB, Otero S, Shanes ED, Goldstein JA, Miller ES. Cord blood antibodies following maternal coronavirus disease 2019 vaccination during pregnancy. Am J Obstet Gynecol. April 2021. doi:10.1016/j.ajog.2021.03.035 13

28. Perl SH, Uzan-Yulzari A, Klainer H, et al. SARS-CoV-2–Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women. Jama. 2021. 14

29. Kelly JC, Carter EB, Raghuraman N, et al. Anti–severe acute respiratory syndrome coronavirus 2 antibodies induced in breast milk after Pfizer-BioNTech/BNT162b2 vaccination. Am J Obstet Gynecol. 2021

30. Pfizer, Pfizer-Biontech COVID-19 Vaccine Trial Overview, [Internet] https://www.pfizer.com/science/coronavirus/vaccine

31. Pfizer: Pfizer Studies in Additional Populations [Internet] https://www.pfizer.com/science/coronavirus/vaccine/additional-population-studies

32. Pfizer-Biontech Announce Positive Topline Results of Pivotal COVID-19 Vaccine Study in Adolescents https://www.pfizer.com/science/coronavirus/vaccine [Internet]

33. Moderna Files for Emergency Use Authorization for its COVID-19 Vaccine in Adolescents in the United States https://investors.modernatx.com/news-releases/news-release-details/moderna-files-emergency-use-authorization-its-covid-19-vaccine

34. KidCove Study - A COVID-19 vaccine study for children https://connect.trialscope.com/studies/0e8fc8e6-5782-46fd-8b03-0994a5ad8b41

35. COVID-19 Oxford Vaccine Study in Children – FAQs {Internet} https://covid19vaccinetrial.co.uk/faqs-childrens-trial

36. Oxford pauses AstraZeneca COVID-19 vaccine study on kids after reported blood clots https://www.abc.net.au/news/2021-04-07/astrazeneca-pauses-vaccine-study-on-kids-blood-clots/100052424

37. A Study to Evaluate a Range of Dose Levels and Vaccination Intervals of Ad26.COV2.S in Healthy Adults and Adolescents https://clinicaltrials.gov/ct2/show/NCT04535453

* This document was written by Ms. Karen Seager and was reviewed by the ASHM Taskforce Chair and Co-Chair, members of the Virology, HBV, HCV, Research and Understanding Data, Clinical Practice and Nursing Cluster Groups and the ASHM CEO.

ASHM COVID-19 Taskforce Chair: A/Prof Edwina Wright

ASHM COVID-19 Taskforce Co-Chair: Mr. Scott McGill

Members of the Virology, HBV, HCV, Clinical Practice, Nursing and Research & Understanding the Data Clusters

Virology


Prof. Martyn French 
Prof. Sharon Lewin 
Dr. Thomas Rasmussen 

HBV

Prof. Ben Cowie 

Dr. Nicole Allard 

Dr. Michelle Giles 

Mr. Kevin Marriott 

Dr. Nick Medland 

Dr. Anne Balcombe  

Dr. Jacqui Richmond 

Ms. Jana Van der Jagt 

Ms. Nafisa Yussf 

Ms. Sally Watkinson 

Mr. Jack Wallace 

Ms. Gabrielle Bennett  

Ms. Sandy Davidson 

Dr. Thao Lam 

Dr. Jessica Howell 

HCV

Prof. Greg Dore 

Prof. Margaret Hellard 

Mr. Joseph Doyle 

Dr. Jessica Howell 

Dr. Michelle Giles 

Mr. Kevin Marriott 

Dr. Nick Medland 

Dr. Anne Balcombe  

Dr. Jacqui Richmond 

Ms. Jana Van der Jagt 

Dr. Thao Lam 

Ms. Sally Watkinson 

Ms. Sandy Davidson 

Ms. Justine Doidge (JD) 

Ms. Jude Byrne 

Clinical Practice  

Dr. David Baker  

Dr. Elizabeth Crock  

Ms. Penny Kenchington 

Ms. Alison Duncan  

Mr. Bruce Hamish Bowden 

Dr. Nick Medland  

Ms. Sally Watkinson  

Ms. Donna Tilley  

Ms. Leanne Myers 

Nursing

Dr. Elizabeth Crock  

Ms. Penny Kenchington  

Dr. Jacqui Richmond  

Ms. Jana Van der Jagt  

Ms. Marrianne Black  

Ms. Sally Watkinson  

Ms. Shannon Woodward  

Ms. Bradley Whitton  

Ms. Donna Tilley  

Ms. Melissa Cromarty  

Ms. Gabrielle Bennett  

Ms. Leanne Myers  

Research and Understanding the Data  

Prof. Carla Treloar  

Prof. Charles Gilks  

Ms. Gail Matthews  

Mr. Graham Brown  

Mr. Jack Wallace  

Dr. James McMahon  

Mr. John Rule  

A/Prof. Julian Elliott 

Ms. Lisa Maher  

ASHM Staff Members who are members of these Cluster Groups 

Mr. Scott McGill, Ms. Karen Seager, Ms. Bianca Leber, Ms. Sami Stewart, Ms. Shelley Kerr 

ASHM CEO, Mr. Alexis Apostolellis 

 

 

Disclaimer: This ASHM document is designed to provide available, relevant information to clinicians and other healthcare providers to optimise the health and wellbeing of people living with HIV (PLWHIV) during the COVID-19 pandemic. The recommendations provided are the opinions of the authors and are not intended to provide a standard of care, or practice. This document does not reflect a systematic review of the evidence, but will be revised to include relevant future systematic review findings of the National COVID-19 Clinical Evidence Taskforce(1) and other relevant information.