Use of sotrovimab
In August 2021, the Therapeutic Goods Administration provisionally approved the use of sotrovimab for the treatment of COVID-19 in adults. This drug is for the treatment of mild COVID-19 that is likely to progress to severe disease. It is available in limited supply.
As per the National Taskforce Guidelines, sotrovimab is appropriate for use in adults or children over the age of 12 weighing at least 40 kilograms, with the following:
- COVID-19 positive with symptom onset equal to or less than 7 days
- 0 or 1 dose of COVID-19 vaccination
- no oxygen therapy or ventilation required
and the presence of at least one of the following:
- immunosuppressed (irrespective of vaccination status)
- age ≥ 50 years
- diabetes (requiring medication)
- obesity (BMI > 30 kg/m2)
- chronic kidney disease (that is, eGFR < 60 by MDRD)
- congestive heart failure (NYHA class II or greater)
- cardiovascular disease including hypertension treated with medication
- chronic lung disease (including asthma treated with regular medication)
- moderate-to-severe asthma (requiring an inhaled steroid to control symptoms or have been prescribed a course of oral steroids in the previous 12 months)
- chronic liver disease
- paediatric patients 12 years or over with significant co-morbidities including sickle-cell disease, paediatric complex chronic conditions (PCCC), congenital and genetic, cardiovascular, gastrointestinal, malignancies, metabolic, neuromuscular, renal and respiratory conditions.
Please note eligibility has been altered to align with the use of ronapreve for mild cases of COVID-19.
The Taskforce undertakes continuous evidence surveillance to identify and rapidly synthesise emerging research in order to provide national, evidence-based guidelines for the clinical care of people with COVID-19. Their guidelines address questions that are specific to managing COVID-19 and cover the full disease course across mild, moderate, severe and critical illness.
Use of ronapreve
In November 2021, the COVID-19 treatment ronapreve was provisionally approved for use in Australia. A limited supply is available in Victoria.
There are three indications for this medication (refer to the National COVID-19 Clinical Evidence Taskforce for updates)
- mild COVID-19
- moderate to critical COVID-19
- post-exposure prophylaxis.
Criteria for use in Victoria has been developed by a working group convened by the Department of Health with clinician involvement.
This product is complex and should be prepared within pharmacy.
What are the recommendations for influenza vaccination?
With COVID-19 spreading across Australia, this year it is more important than ever to ensure that patients receive the seasonal influenza vaccination. Influenza vaccination should be given as soon as possible. The regular influenza season may coincide with the peak of the current COVID-19 pandemic, potentially placing additional burden on the Australian health system.
Influenza vaccine distribution to immunisation providers has commenced. Adjuvanted influenza vaccines are available for people aged 65 years and over.
Claims that influenza vaccination may increase the risk of COVID-19 infection have been circulating on social media. There is no evidence to support these claims.
Can Tamiflu still be given to patients with mild flu-like symptoms?
The antiviral medication Tamiflu (oseltamivir) is not effective against COVID-19. Tamiflu is used to treat influenza. In otherwise healthy adults who have a low risk of complications, treatment with a neuraminidase inhibitor (such as Tamiflu) reduces duration of influenza symptoms by less than one day on average, when treatment is started within 48 hours of symptom onset. Such benefit must be balanced against the potential adverse effects of antiviral treatment, including nausea, vomiting, headaches and neuropsychiatric events.
It is recommended that Tamiflu be reserved for use in patients:
- who need to be admitted to hospital for management of influenza
- with moderate-severity or high-severity community-acquired pneumonia, during the influenza season
- who are at higher risk of poor outcomes from influenza (for example, pregnant women).
Information about COVID-19 vaccines
- information about the COVID-19 vaccines available in Australia
- training for COVID-19 vaccine providers
- site readiness for COVID-19 vaccination clinics
- administering the vaccines and managing side effects
- supporting COVID-19 vaccine recipients
- an information hub.
Reviewed 29 November 2021