Vaccinations

Vaccination aims to protect you, your loved ones and everyone else in the community. We know that the trans community in Australia have been disproportionately negatively affected by social restrictions and the COVID-19 pandemic. Getting vaccinated will help reduce the health, social and economic impacts on our community.

How do I get a vaccine?

Everyone 5 years and over can now be vaccinated at a range of places, find a clinic and book here. COVID-19 vaccination is a safe and effective way of reducing your likelihood of contracting COVID-19. 

If you have any questions specifically regarding COVID vaccines for your health situation, please have a chat to your GP or a trusted health professional. 

If you have not already received your primary vaccination course, it is highly recommended that you do so. It is recommended that your primary vaccination course is completed with the same vaccine. Additional booster doses can be different types of vaccine to your primary vaccination course.

The Commonwealth Government recommends COVID vaccine boosters to maintain immunity against COVID-19. New vaccine boosters are available over time to help protect against new strains and to keep your level of immunisation high.

If your last COVID-19 vaccine dose or confirmed COVID-19 infection was 6 months ago or more (whichever was the most recent), you may be recommended to receive an additional vaccine booster dose. It does not matter how many boosters you have received before.

65 years or older

If you are aged 65 years or older you are recommended to receive a booster dose in 2023.

18 to 64 years

If you are aged 18 to 64 years and are at higher risk of severe illnesslaunch from COVID-19, or have a disability with significant or complex health needs it is recommended you receive a 2023 booster dose.

If you are not at higher risk of severe illness, and you are aged 18 to 64, consider getting a 2023 booster dose. Speak to your doctor or vaccination provider about your next COVID-19 vaccine booster dose. 

People aged 5 to 17 years

A booster dose may be considered for children and adolescents aged 5 to 17 years who are at higher risk of severe illness from COVID-19 or have a disability with significant or complex health needs. This should be based on a discussion with your child’s doctor or vaccination provider.

This applies to children and adolescents whose last COVID-19 vaccine dose or confirmed infection (whichever is the most recent) was 6 months ago or more. It does not matter how many doses the child or adolescent has received before. 

A booster dose is not currently recommended for children and adolescents aged under 18 years who are not at higher risk of severe illness from COVID-19.

Pregnant people

Booster doses are recommended and safe for pregnant people, or for people who are breastfeeding.

Official information about COVID-19 and pregnancy does not always use affirming language, and so it can be helpful to have a loved one or friend read through the official guidelines for COVID-19 vaccines and pregnancy and translate the language so it is affirming to you.

Symptoms post-vaccination

It is normal for minor side effects to occur after your vaccination or booster against COVID-19. Most side effects last no more than a few days and recovery will occur without any long term issues.

If you are feeling any symptoms after your COVID-19 vaccination, it can be helpful to rest from normal activities and recover as if you were from a regular cold or flu.

There are anecdotal reports of some vaccines having the side-effect of lymph node swelling. This can in some cases lead to the chest getting bigger for a short period of time. This will pass and the swelling will decrease, and using a binder during this period is fine.

This section was gratefully developed by Dr. Ada Cheung - Endocrinologist, Trans and Gender Diverse in Community Health consortium, Victoria and Trans Health Research Group, The University of Melbourne. Thanks, Ada!

Many trans and gender diverse people may be wary about getting vaccinated against COVID-19, particularly as medical institutions have often pathologised trans people. Messaging has been complex, frequently changing and at times misinformed. Moreover, the word “blood clots” can cause alarm for many trans people on gender affirming hormone therapy and lead to hesitancy to consider the AstraZeneca vaccine. Let’s tackle some common questions specifically around gender affirming hormones and COVID-19 vaccines.

I’m on HRT, am I at higher risk of blood clots with AstraZeneca?

The AstraZeneca vaccine is associated with a rare side-effect called thrombosis with thrombocytopenia syndrome (TTS). This is different to the more common types of blood clots (deep vein thrombosis or pulmonary embolus) that are known to occur more often in people using estradiol or progestin therapy. Blood clots in people using estradiol therapy are uncommon and thought to be due to increased liver coagulation “sticky” factors and are typically treated with blood thinners. TTS is different from other clotting conditions. TTS is triggered by an immune response to the AstraZeneca vaccine causing the platelet levels (the blood cells responsible for clotting) levels to drop (thrombocytopenia), malfunction and in turn clot, typically affecting different parts of the body such as the brain (cerebral venous thrombosis) or abdomen (portal vein thrombosis). The mechanism of TTS is not fully understood but it is an immune-driven disease that causes platelet overactivity. TTS is treatable with blood thinners and intravenous immunoglobulins are used in more severe cases.

The rate of TTS appears to be higher in younger adults but there is no evidence to suggest that anyone on estrogen or progestin therapy, anyone on testosterone therapy or even anyone who has had previous blood clots are at higher risk of TTS with the AstraZeneca vaccine. The only caution is in people who have had the very rare heparin-induced thrombocytopenic thrombosis, antiphospholipid antibody syndrome with blood clots, or people who have had cerebral venous thrombosis or abdominal vein thrombosis in the past. Based on real world data from the many hundreds of millions of AstraZeneca vaccines administered, people with other chronic conditions, using the contraceptive pill, having a history of cancer or history of blood clots face no additional risks. Being on gender-affirming hormones does not appear to increase the risk of TTS but note that due to small number of cases of TTS, it has not been specifically studied in the trans population. When we don’t have specific data, we often draw upon first principles, and being on estrogen would be unlikely to increase the immune reaction that leads to TTS.

Does Pfizer cause menstrual bleeding in trans people on testosterone therapy?

There have been some anecdotal reports that cis and trans people have experienced changes to their menstrual cycles after having a COVID (particularly Moderna) vaccine. The Pfizer vaccine in Australia is an mRNA vaccine similar to Moderna. This has since been investigated by the TGA and European Medicines Agency and found no link between vaccines and menstrual issues.2

Do the benefits outweigh the risks?

Both vaccines have clear benefits in reducing the risk of infections and reducing deaths or hospitalisations due to COVID-19. In areas where there are significant outbreaks of the COVID-19 delta variant, the risks of being infected with COVID-19 are higher, which shifts the risk-benefit ratio. The health benefits increase when the risk of exposure to COVID-19 is higher (see “Weighing up the potential benefits against risk of harm from COVID-19 Vaccine AstraZeneca”). In addition to health risks, there are also economic and social risks to consider. People aged 18 to 59 living in areas experiencing an outbreak should carefully consider the benefits of AstraZeneca vaccination weighed with the risks of rare but potentially serious side-effects (which are not increased by gender-affirming hormone therapy).

How common are blood clots?

Research has explored the risks of COVID vaccines and the rare blood clotting condition cerebral venous thrombosis (CVT). CVT is higher in people having the AstraZeneca vaccine than the general population but there is also a slightly higher risk with people having Pfizer or Moderna COVID vaccines. Notably, having COVID-19 infection itself is associated with 8 – 10 times greater likelihood of developing CVT than those who have been vaccinated against it. In addition to the risk of CVT, COVID-19 infection also appears to increase the risk of other brain conditions 6 months after diagnosis and a range of long-term sequelae.

Save the below on your phone (screenshot) or print it, in case you need urgent medical attention it may be handy to have.