Flu season brings a steady stream of patients through the door for a flu vaccine — and it’s an ideal opportunity to also talk about their COVID vaccine requirements and offer it on the same day.

The two vaccines can be given together, and patients can be reassured that this is both safe and effective – and convenient.

Setting up systems that support opportunistic vaccination

Good intentions need good infrastructure. I encourage practices to embed opportunistic vaccination into their day-to-day processes rather than leaving it to chance.

One approach I find practical is setting short-term, focused in-house targets.

For example, deciding that for a specific week this month, the whole team will offer COVID vaccination co-administered with every other vaccine given to eligible patients. This creates momentum, accountability, and a culture of proactive vaccination within the practice.

I also encourage practices to consider working with their Primary Health Network to set up a quality improvement activity around vaccination rates — a structured way to ensure every provider is asking every patient, and that progress is being tracked and acted on.

While it can be difficult to find the time, it is important for providers to take the time to explore hesitancy rather than dismissing it. What are a patient’s concerns about having the vaccine if they are eligible but choosing not to consider it? Asking that question, and really listening to the answer, builds trust and keeps the door open.

For patients who are unsure, the clinical case for getting vaccinated is compelling. COVID vaccination reduces the risk of severe disease and hospitalisation — and there is emerging evidence that it also lowers the incidence of long COVID. Even if someone has had COVID three, four, or five times, without major issues, the next time they get COVID, it may end up being severe, or the catalyst for long COVID.

Reassuring patients

One of the most common concerns patients have is that their immune system will struggle to cope with two vaccines at once, and they’d rather let it concentrate on one vaccine at a time.

We reassure these patients that our immune system is very clever. It is exposed to multiple different antigens every single day, and giving multiple vaccines on the same day does not overload an immunocompetent person’s immune system.

The Doherty Institute conducted a randomised controlled trial at the University of Melbourne which found there were no important differences in key immune responses (neutralising antibodies) to either Flu or COVID, when vaccines were co-administered either in the same arm, or in opposite arms. This can be reassuring to patients that are concerned that the vaccines might not be as effective if given at the same time.

The most common downside of co-administration in separate arms is soreness in two arms rather than one — but getting both vaccines at the same time means they don’t have to book another appointment. This is certainly important for patients who find it difficult to get time away from study, work, or home commitments.

Identify your risk groups

ATAGI recommends a COVID-19 vaccine dose every 6 months for adults aged ≥75 years and every 12 months for adults aged 65—74 years, as well as adults aged 18—64 years with severe immunocompromise.

The latter two groups are also eligible for a dose every 6 months, based on a benefit-risk assessment. People with medical risk conditions and/or those living in residential aged care homes are most likely to benefit.

All adults aged 18—64 years are eligible to receive a COVID-19 vaccine every 12 months, based on a benefit-risk assessment, as are children and adolescents aged 5—<18 with severe immunocompromise.

Read ATAGI’s full statement here.

Key takeaways

• Ask every eligible patient
• Co-administer where you can
• Set a team target
• The systems are straightforward — and the benefit to your patients is real

Angela Newbound is an immunisation education consultant and registered nurse with 26 years of experience in Australia’s national immunisation programme.

Note: This article was supported by an independent educational grant from Pfizer.