Four main COVID-19 vaccines 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 – Spikevax bivalent vaccine and Comirnaty bivalent vaccine. All of these COVID-19 vaccines have met the TGA’s high standards for quality, safety and effectiveness.
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 causality and our COVID-19 vaccine safety monitoring and reporting activities.
Publication of this report was postponed one day due to Australia Day. The next vaccine safety report will be published on 9 February 2023.
- 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 up-to-date recommendations for use of the COVID-19 vaccines 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 safety report published on 15 December 2022.
- 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 vaccine safety report.
Total adverse event reports following immunisation to 22 January 2023
Reporting rate per 1,000 doses
Total adverse event reports
Total doses administered
Total reports for Vaxzevria
Total reports for Comirnaty
Total reports for Spikevax
Total reports for Nuvaxovid
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 up-to-date vaccine recommendations for children 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 safety report published on 15 December 2022.
The most up-to-date vaccine recommendations for booster doses 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 safety report published on 15 December 2022.
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. Read more about this process in a previous report. Since the beginning of the vaccine rollout to 22 January 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 960 reports received and reviewed.
More detail on the 14 vaccine-related deaths is available in the safety report published on 15 December 2022.
Comirnaty (Pfizer) mRNA vaccines
The Comirnaty (Pfizer) vaccine is provisionally approved for adults and children aged 5 years and over. To 22 January 2023, over 44 million doses have been administered in Australia. A bivalent vaccine from Pfizer is also available as a booster dose in adults.
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 Comirnaty (Pfizer) information page to find out more about these vaccines.
Spikevax (Moderna) mRNA vaccines
The original Spikevax vaccine is provisionally approved for adults and children aged 6 years and over. To 22 January 2023, over 5 million doses have been administered in Australia. A paediatric formulation 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 Spikevax bivalent vaccine for use as a booster dose in adults.
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 Spikevax (Moderna) information page to find out more about these vaccines.
Nuvaxovid (Novavax) vaccine
The Nuvaxovid (Novavax) vaccine is provisionally approved for adults. To 22 January 2023, over 239,000 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 1,500 Nuvaxovid doses administered in people aged 12-17 years and no adverse events following immunisation have been reported.
The Product Information document for Nuvaxovid has been updated to include tinnitus, under ear and labyrinth disorders. This has been included following reports of tinnitus being reported to the TGA post vaccination.
Go to the Nuvaxovid (Novavax) information page 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 Vaxzevria (AstraZeneca) vaccine is provisionally approved for adults. To 22 January 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 Vaxzevria (AstraZeneca) information page 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 vaccine safety report published on 15 December 2022.
ATAGI continues to emphasise that the protective benefits of the vaccines far outweigh the rare risk of these side effects.
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 Guidance on myocarditis and pericarditis after COVID-19 vaccines 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 22 January 2023. Rates for the Nuvaxovid (Novavax) vaccine are given above.
Reporting rates of myocarditis
Rate* per 100,000 doses
Rate* per 100,000 doses
Rate* per 100,000 doses
Rate* per 100,000 doses
Notes for Table 1 and Table 2
* The rate includes cases of myocarditis that occurred after vaccination but may not be vaccine related.
‡ To 22 January 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
Rate* per 100,000 doses
Notes for Table 3
* The rate includes cases of pericarditis that occurred after vaccination but may not be vaccine related.
‡ To 22 January 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 guidance on myocarditis and pericarditis developed by ATAGI and the Cardiac Society of Australia and New Zealand (CSANZ).