This update provides information to help primary care providers tackle current challenges, including COVID-19. Submissions can be sent to covax@murrayphn.org.au

Flood recovery
Murray PHN staff are continuing to contact primary care providers to determine service status, support and advocacy needs. For additional support:

• The General Practice Management During a Disaster HealthPathway includes ways to provide general assistance to your patients as well as those in recovery centres, tips on medication safety, and disaster contacts. The updated Rural Community Support During Adversity page provides links to support services.
• The Department of Home Affairs has collated information about accessing disaster recovery payments in affected LGAs in Victoria and NSW.
• The RACGP has resources for general practices, including factsheets on mental health, floods and managing emergencies in general practice.
• Flood and storm information and support is available from the Department of Health and Aged Care. This factsheet also outlines health support available for flood-affected people, including for pharmaceuticals and mental health.
• The Victorian Government's Flood Recovery Hotline (1800 560 760) is available daily between 7.30am and 7.30pm for help with services and support.
• Emergency Relief Centres are listed here.

• Contaminated floodwater can increase the risk of infections, see advice from Loddon Mallee PHU, NSW Health, Healthdirect and WorkSafe QLD.
• A growth in mosquitos may increase the risk of mosquito-borne diseases. Share 'Beat the Bite' messaging.
• Look out for signs that you or those around you might be struggling with trauma. The Victorian Department of Families, Fairness and Housing has a short video on preventative measures

Flood preparation
Many flood warnings are still current. Key things to consider:

• Location of nearest generator
• Sufficient supplies of medications and consumables
• The needs of at-risk patient groups e.g. those requiring methadone
• Patients have physical prescriptions
• Cold-chain requirements.

COVID vaccination provider bulletin 20 October

Flood affected areas
Sites in flood affected areas will be contacted if deliveries of vaccines and consumables are impacted. If you are experiencing difficulties, contact the VOC on 1800 318 208 or COVID19VaccineOperationsCentre@Health.gov.au

Moderna ancestral allocation
Vaccinating sites have had their allocation of Moderna ancestral set to zero in CVAS. No more orders can be made for this vaccine.

Moderna bivalent administration
The Vaccine Operations Centre (VOC) has had several vaccine administration errors (VAEs) reported since the Moderna bivalent rollout began. Providers are reminded that the correct dosage is 0.50mL NOT 0.25mL. Five doses are contained within each vial. Full dosage, storage and handling instructions are available here. The bulletin has a table comparing dosages for each Moderna vaccine and important practice points to follow.

CVAS review of stock management reporting
The COVID-19 Vaccine Program is reviewing reporting in the COVID-19 Vaccine Administrative System (CVAS). Sites need to ensure accuracy of reports – weekly usage, wastage, transfers and current stock on hand should equate to the number of vaccines on hand at the start of the week. Discrepancies should be explained. These guidelines outline the process step by step for each report required.

Japanese Encephalitis Virus (JEV)
Not everyone in flood affected areas is eligible for the JEV vaccine. Access is limited to specific priority groups as outlined in the Victorian Department of Health's Immunisation news bulletin. The Loddon Mallee PHU reports, there is currently no evidence of JEV in mosquitos in flood-affected areas.

The vaccine is free for eligible people and general practices are encouraged to bulk bill for the service whenever possible.

Due to JEV supply, providers cannot stockpile or use public stock for travel vaccinations. Orders will be limited and potentially delayed - when ordering, delays will be listed.

Providers of the vaccine in the Murray PHN region can be found here and local public health units are also providing JEV vaccines. Please call ahead to ensure stock is on hand and note some sites will be closed due to floods. 

• GV Health COVID-19 vaccination buses - including Pfizer, Moderna bivalent boosters and JEV vaccines.
• Bendigo Health COVID-19 vaccination clinics - including influenza and JEV via outreach only.
• Ovens Murray PHU vaccination clinics – including influenza and JEV vaccines at Wodonga site.

COVID care in the community 
The COVID-19 Positive Community Care and Treatment pathway contains information on the prescription of antivirals and face-to-face home assessment and monitoring service.

Supporting the disability sector

Murray PHN is helping disability providers and liaison officers to engage primary care providers for in-reach vaccinations. If your practice can assist, email: covax@murrayphn.org.au

Practices can also access support and resources from disability liaison officers in: 

• Albury/Wodonga
• Bendigo/Loddon Mallee
• Shepparton/Goulburn Valley
• Wangaratta/North east

Education and training

Upcoming events

• Victorian PHNs: Statewide PHN Immunisation Forum (Japanese Encephalitis Virus, Monkeypox, Shingles, Meningococcal) | 17 November, 6.30 – 8.30pm

Online learning

• Victorian Department of Health Immunisation eLearning – JEV and Influenza
• Victorian Department of Health and VICNISS: Infection prevention and control free online learning package
• NSW Health: Fit testing and fit checking videos

• Murray PHN: Monkeypox (MPX) update for general practice (8 September)
• Murray PHN: COVID+ home visits: Infection, prevention and control (15 Dec 2021)

New and updated resources

• NCCET – drug treatment flowcharts for adults, children and adolescents, and pregnant and breastfeeding women with COVID-19
• Victorian DoH – Evusheld prescribing resources
• Victorian DoH – forms to request access to medications for patients with COVID-19
• DoHAC – updated poster - COVID-19 vaccines in Australia (27 September)
• Victorian DoH – COVID medicines eligibility tracker
• DoHAC – Getting help for Long COVID (24 August)
• Victorian DoH – clinical decision-making tool for COVID-19 medication selection for at risk people who do not require oxygen (10 August)
• ATAGI poster – Fourth Dose Eligibility (18 July)
• ATAGI clinical guidance for COVID-19 vaccine providers in Australia