Released 19 February 2021
COVID-19 vaccination decision guide for frail older people, including those in residential aged care facilities – from the government
This decision guide is to help a person who is frail or very old, including those living in residential aged care facilities (and their substitute decision maker), make an informed decision about getting a COVID-19 vaccine.
The COVID-19 vaccine: Comirnaty (Pfizer, Australia)
- COVID-19 vaccine Comirnaty is safe for older people. It has been safely given to millions of people in residential aged care facilities around the world.
- Comirnaty is highly effective in preventing COVID-19 infection in older people.
- We do not know exactly how much the vaccine will benefit frail people, but we expect it will be protective.
- Having a COVID-19 vaccine will lower the chance of you getting sick. This means the infection is less likely to spread to others.
Coronavirus (COVID-19) risks for older people
- The Coronavirus disease (COVID-19) is much more likely to be severe in older people and people with certain medical problems than in young healthy people.
- About 1 of every 3 people over the age of 80 years who get COVID-19 will die from it. It is a very serious disease. It is causing millions of people worldwide to go to hospital and to die.
- COVID-19 can spread very quickly in residential care facilities because people are close to each other.
- COVID-19 vaccination is voluntary, but strongly encouraged.
- A residential care facility may want as many residents as possible to be vaccinated to reduce the chance of spreading COVID-19.
Current known side effects of Comirnaty (Pfizer, Australia)
- The COVID-19 vaccine is given as an injection in the upper arm muscle. The needle will be uncomfortable when it goes in for a few seconds.
- Most people will have a slightly sore arm where the needle was given for 1-2 days after receiving it.
- Some people will feel a bit tired for 1-2 days after receiving the vaccine and may have a headache, muscle aches or chills.
- These side effects show your body is responding to the vaccine. They are usually mild and unlikely to limit your usual activities.
- You can have paracetamol or take extra care after the vaccine if you need it.
Further considerations for people close to the end of their life
- If you are close to the end of your life you may have many things to weigh up when making your decision about whether to have the COVID-19 vaccine.
- There will be different considerations for each person.
- Being vaccinated may help you to protect your family and carers from being infected if you are exposed to COVID-19.
- You, your family, carers and decision makers can also choose to engage with clinical staff at your facility, a GP or other health professionals to discuss the benefits and risks of vaccination, and whether it is suitable for you to receive the COVID-19 vaccine.
- For more information visit the information factsheet on COVID-19 Pfizer vaccine (Comirnaty) on our website.
Information for aged care and healthcare providers, workers and substitute decision makers
What are the risks of the COVID-19 disease in older people?
- Older people who get COVID-19 are much more likely to require admission to a hospital for treatment compared to younger people.
- Among people who got COVID-19 in Australia, 1 in 14 died if they were aged 65–79 years; but about 1 in 3 died if they were aged 80 years or over.
- Among adults who got COVID-19, those who were frail were more likely to die compared with those who were not frail.
- Many older people have chronic medical conditions that further increase their risk of severe COVID-19, such as chronic heart or lung disease or diabetes mellitus.
- The much higher likelihood of death from COVID-19 in people over 80 years of age remains, even when the medical conditions that they had were taken into consideration.
- Residents of aged care facilities are more likely to get COVID-19 than others because they live in a communal (shared) environment. Aged care facilities have been the setting for a number of serious COVID-19 outbreaks in Australia.
Has the COVID-19 vaccine Comirnaty been tested on older people?
- The Comirnaty vaccine has been tested in older persons up to about 90 years of age. These included people with stable chronic diseases such as chronic heart disease or lung disease or diabetes mellitus.
- Older people who lived in aged care facilities were not included in the clinical trials of Comirnaty.
- Millions of older people around the world have now received the Comirnaty vaccine. It has been shown to be safe in vaccine programs in many other countries, such as the United Kingdom and United States of America.
What are the benefits of getting the Comirnaty vaccine?
- The vaccine is highly effective for preventing older people from getting COVID-19. Around 95% of people were protected from getting COVID-19 after two doses of this vaccine. Comirnaty is just as effective in older adults (aged 65 years or over) as in younger adults.
- The vaccine was also shown to be very effective in older adults who had stable chronic medical conditions.
- We do not know exactly how much the vaccine will benefit frail older people, but we expect it will be very protective.
What is the chance of side effects after getting the Comirnaty vaccine?
- People getting the vaccine will likely have some mild side effects for a day or so after the vaccine.
- The most common side effects are injection site pain, fever, fatigue and headache.
- Pain at the injection site is very common, occurring in about two-thirds of people.
- Up to 1 in 9 people aged 55 years or over will have a fever for 1–2 days, more commonly after the second dose. The fever is usually mild to moderate and goes away after 1-2 days.
- About 1 in 3 people will have side effects such as tiredness and headache. These most commonly begin 1–2 days after getting the vaccine and go away after around 1–2 days.
- Side effects are milder and less common in older adults (aged 55 years or over) than younger adults.
- Most people who have these side effects can still carry on their usual daily activities. Less than 1 in 4 people may experience tiredness that lowers their ability to carry out daily activities, and 1 in 40 may have tiredness severe enough to prevent their daily activities, for up to a few days.
- Anaphylaxis, a rare but severe type of allergic reaction, can occur after receiving any vaccine. Experience in the USA showed the chance of an adult having anaphylaxis after the Comirnaty vaccine was about 1 in every 200,000 people vaccinated.
Other things to consider
- As for any vaccine, it is good to ensure that if a person has any expected side effects they can take simple steps to help them feel better. For example, if an older person feels tired in the days after the vaccine, they may need more rest at that time. If there is pain at the injection site or fever, then taking paracetamol can help.
- Some health problems or symptoms may occur after vaccination by coincidence. In the clinical trials of Comirnaty long term side effects were not shown to be caused by the vaccine. However, if a person who has been vaccinated (or their carer) is concerned about an unexpected or serious health problem after vaccination they should report it to their healthcare provider.
- There were reports of deaths occurring after a COVID-19 vaccine dose in older people, including some living in aged care facilities, in some countries overseas. This has been investigated. It was found that receiving COVID-19 vaccine did not make dying more likely. The deaths were thought to have occurred because of the age or health of the person.
Visit the Department of Health’s website Health.gov.au/covid19-vaccines for more information.