³Ô¹ÏÍøÕ¾

Covid vaccine safety report – 09-02-23

TGA

Four main are currently in use in Australia – Comirnaty (Pfizer), Spikevax (Moderna), Vaxzevria (AstraZeneca), and Nuvaxovid (Novavax). Bivalent vaccines for both mRNA vaccines are also now registered in Australia – and . All of these COVID-19 vaccines have met the .

The TGA closely monitors reports of suspected side effects (also known as adverse events) to the COVID-19 vaccines. This is the most intensive safety monitoring ever conducted of any vaccines in Australia.

We encourage people to report suspected side effects, even if there’s only a very small chance a vaccine was the cause. Learn more about and our .

Summary

  • Vaccination against COVID-19 is the most effective way to reduce deaths and severe illness from infection. The protective benefits of vaccination far outweigh the potential risks.
  • Like all medicines, COVID-19 vaccines may cause some side effects. The most frequently reported include injection-site reactions (such as a sore arm) and more general symptoms, like headache, muscle pain, fever and chills. This reflects what was seen in the clinical trials.
  • The most are available from the Australian Technical Advisory Group on Immunisation (ATAGI).
  • Reporting rates of adverse events following COVID-19 vaccination are very stable. More detail on vaccine safety in children, adolescents and adults following vaccination is available in the .
  • We are carefully monitoring and reviewing reports of myocarditis and pericarditis (inflammation of the heart or membrane around the heart) following vaccination. These are usually temporary conditions, with most people getting better within a few days.
  • Myocarditis is a known but very rare side effect of the mRNA vaccines. It is reported in around 1-2 in every 100,000 people who receive Comirnaty (Pfizer) and around 2 in every 100,000 of those who receive Spikevax (Moderna). It occurs in males and females but is more common after the second dose in boys aged 12-17 years (13 cases per 100,000 Comirnaty doses and 24 cases per 100,000 Spikevax doses) and men under 30 (9 cases per 100,000 Comirnaty doses and 20 cases per 100,000 Spikevax doses).
  • We are also closely monitoring reports of thrombosis with thrombocytopenia syndrome (TTS), Guillain-Barre syndrome (GBS) and immune thrombocytopenia (ITP) following Vaxzevria (AstraZeneca) in adults. However, since the end of 2021 very few doses of this vaccine are being used. Detailed information of our analysis of these adverse effects is available in a previous .

Total adverse event reports following immunisation to 5 February 2023

  • 2.1

    Reporting rate per 1,000 doses

  • 137638

    Total adverse event reports

  • 64680108

    Total doses administered

  • 48681

    Total reports for Vaxzevria

  • 81130

    Total reports for Comirnaty

  • 7441

    Total reports for Spikevax

  • 980

    Total reports for Nuvaxovid

  • 735

    Total reports for brand not specified

Reported side effects for COVID-19 vaccines

The most frequently reported side effects suspected to be associated with the vaccines include headache, muscle and joint pain, fever, chills and nausea. Skin reactions at the site of the injection are also common and can include pain, swelling, redness and an itchy rash. These are recognised side effects of vaccination and are usually transient and mild.

Vaccine safety in children and adolescents

The most are available from the ATAGI.

The TGA is closely monitoring adverse event reports in people aged under 18 years. Reporting rates of adverse events following COVID-19 vaccination, including those for children and adolescents, are very stable. More detail on vaccine safety in children and adolescents following vaccination is available in the .

Booster doses

The most are available from ATAGI.

The TGA continues to monitor the safety of booster vaccine doses in adults. A booster dose is an additional vaccine dose given after the primary vaccine course. In people who have recently had COVID-19, a 3-month interval is recommended before having their next scheduled dose.

Reporting rates of adverse events following COVID-19 vaccination, including those from booster doses, are very stable.

A small number of myocarditis and pericarditis cases have been reported for booster doses. This is a recognised risk with the Comirnaty (Pfizer) and Spikevax (Moderna) vaccines and we are closely monitoring these events. So far, reports of myocarditis after a booster dose are very rare, occurring in less than 1 in every 100,000 vaccinated people.

Information on vaccine safety following booster doses is available in the .

Reports of death in people who have been vaccinated

Vaccines can lead to death in extremely rare instances. However, most deaths that occur after vaccination are not caused by the vaccine. In large populations in which a new vaccine is given, there are people with underlying diseases who may die from these diseases. When a vaccine is given in that same population, the link between the vaccine and death is usually coincidental – not caused by the vaccine. These deaths are carefully reviewed for whether vaccines could be the cause and for the vast majority that is not the case.

The TGA closely reviews all deaths reported in the days and weeks after COVID-19 vaccination. . Since the beginning of the vaccine rollout to 5 February 2023, almost 65 million doses of COVID-19 vaccines have been given in Australia. The TGA has identified 14 reports where the cause of death was linked to vaccination from 973 reports received and reviewed.

More detail on the 14 vaccine-related deaths is available in the .

Comirnaty (Pfizer) mRNA vaccines

The for adults and children aged 5 years and over. A is also available as a booster dose in adults.

To 5 February 2023, over 44 million doses have been administered in Australia , as well as about 74,500 doses of the bivalent booster vaccine.

The TGA is actively investigating reports of myocarditis (inflammation of the heart) and/or pericarditis (inflammation of the membrane around the heart) associated with mRNA vaccines. We continue to work with international regulators on this safety signal. See below for reporting rates of myocarditis and pericarditis associated with the Comirnaty (Pfizer) vaccines.

Go to the to find out more about these vaccines.

Spikevax (Moderna) mRNA vaccines

The original is provisionally approved for adults and children aged 6 years and over. A of the original vaccine is available for children aged from 6 months to 5 years (or less than 6 years) as well as a new for use as a booster dose in adults. To 5 February 2023, over 5 million doses have been administered in Australia, as well as about 353,000 doses of the bivalent booster vaccine.

The TGA is actively investigating reports of myocarditis (inflammation of the heart) and/or pericarditis (inflammation of the membrane around the heart) associated with mRNA vaccines. We continue to work with international regulators on this safety signal. See below for reporting rates of myocarditis and pericarditis associated with the Spikevax (Moderna) vaccines.

Go to the to find out more about these vaccines.

Nuvaxovid (Novavax) vaccine

The for adults. To 5 February 2023, over 241,000 doses of Nuvaxovid (Novavax) have been administered in Australia.

The TGA is actively investigating reports of myocarditis (inflammation of the heart) and pericarditis (inflammation of the membrane around the heart) following vaccination.

Myocarditis is reported in around 3-4 in every 100,000 people who receive a Nuvaxovid dose. Overall, pericarditis is reported in 12 in every 100,000 people but is more common in men aged 18-49 years (estimated at 26 per 100,000* people).

To date, there have only been about 1,600 Nuvaxovid doses administered in people aged 12-17 years and no adverse events following immunisation have been reported.

Go to the to find out more about this vaccine.

* This reporting rate for pericarditis is less certain than for Comirnaty and Spikevax vaccines due to the low number of Nuvaxovid vaccine doses given.

Vaxzevria (AstraZeneca) vaccine

The for adults. To 5 February 2023, just under 14 million doses of Vaxzevria (AstraZeneca) have been administered in Australia. Very few doses of this vaccine have been used since 2021.

Go to the to find out more about this vaccine.

Myocarditis and pericarditis after COVID-19 vaccination

Myocarditis and pericarditis have been reported for the mRNA vaccines and Nuvaxovid (Novavax) vaccine. For more details about what these adverse effects are, their severity and what symptoms to look out for, please refer to the .

ATAGI continues to emphasise that .

ATAGI has advised that people who have had suspected vaccine-related myocarditis or pericarditis should defer further COVID-19 vaccine doses until at least 6 weeks after their symptoms have resolved. They should also discuss future vaccine doses with their treating doctor. Refer to expert for more information.

What does the TGA know about myocarditis and pericarditis in Australia?

Reports of suspected myocarditis and pericarditis received by the TGA have been reviewed against internationally accepted criteria to classify if they are likely to be related to vaccination.

Tables 1-3 summarise the most up-to-date reporting rates of likely myocarditis and pericarditis for the mRNA vaccines to the 5 February 2023. Rates for the Nuvaxovid (Novavax) vaccine are given above.

Reporting rates of myocarditis

Table 1. Rates of likely myocarditis cases following Comirnaty (Pfizer)‡

Age (years)

All doses

Second doses

Rate* per 100,000 doses

Rate* per 100,000 doses

Male

Female

Male

Female

5-11

0.3

0.1

0.2

0

12-17

8.1

1.7

13.2

2.8

18-29

5.1

1.6

9.3

2.8

30-39

2.3

0.9

3.1

1.0

40-49

1.0

1.0

1.5

1.8

50-590.70.40.70.4
60-690.40.30.40.4
70+0.10.300.4
All ages*2.40.94.71.6
Table 2. Rates of likely myocarditis cases following Spikevax (Moderna) †

Age (years)

All doses

Second doses

Rate* per 100,000 doses

Rate* per 100,000 doses

Male

Female

Male

Female

12-17

12.1

2.9

23.6

5.0

18-29

9.8

1.7

20.2

4.7

30-39

3.3

0.7

5.0

0

40-49

1.7

1.1

3.2

2.0

50-590.91.52.02.5
60-6900.200
70+00.100
All ages*3.21.011.22.7

Notes for Table 1 and Table 2

* The rate includes cases of myocarditis that occurred after vaccination but may not be vaccine related.

‡ To 5 February 2023, from about 2.3 million vaccine doses given, 4 likely cases of myocarditis have been reported in children aged 5-11 years following vaccination with Comirnaty (Pfizer).

† The rates for Spikevax (Moderna) are less certain due to low numbers of cases overall and small changes in case number can lead to fluctuations in the rates for different groups.

Reporting rates of likely pericarditis

Table 3. Rates of likely pericarditis cases following the mRNA vaccines

Age (years)

Rate* per 100,000 doses

Comirnaty (Pfizer)

Spikevax (Moderna)

5-11‡0.3

12-17

2.4

0.8

18-29

4.1

5.2

30-39

4.4

4.9

40-49

2.7

2.7

50-591.61.3
60-690.80.4
70+0.20.2
All ages*2.62.4

Notes for Table 3

* The rate includes cases of pericarditis that occurred after vaccination but may not be vaccine related.

‡ To 5 February 2023, from about 2.3 million Comirnaty (Pfizer) vaccine doses given, one probable and 6 possible cases of pericarditis have been reported in children aged 5-11 years. No cases of pericarditis have been reported following Spikevax (Moderna) in this age group.

For more information, see developed by ATAGI and the Cardiac Society of Australia and New Zealand (CSANZ).

/Public Release. View in full .