Royal Perth and Fiona Stanley Hospital Rheumatology Departments – COVID information

COVID-19 information for people who are immunocompromised

This information should be used in conjunction with information from the Australian Government Department of Health website, Healthy WA website and the Australasian Society of Clinical Immunology and Allergy.

How to live with COVID-19 and omicron – taking precautions

1. How many COVID-19 vaccine doses should I have?

• People who are immunocompromised should receive four doses of a COVID-19 vaccine.
  • Immunocompromised people require three doses of a COVID-19 vaccine in their primary course; this is an extra dose compared to the standard advice for the general community. The third dose should be an mRNA vaccine (Pfizer or Moderna), regardless of what vaccine you received for the first two doses and can be given two months after the second dose.
  • You should receive a booster (fourth) dose of COVID-19 vaccine three months after your third dose.
• You can seek advice from your doctor about whether to plan the timing of your vaccine doses around any potential changes to your treatment. You should not stop taking any regular medications before or after your COVID vaccines, unless discussed with your doctor.
• There are some instances where you might not require a third primary vaccine (e.g. hydroxychloroquine therapy alone). If you are unsure, please email our support line for further clarity. 

2. How can I reduce my and my family’s risk of COVID-19?

• Sanitise your hands frequently.
• Avoid touching your face.
• Wear a mask when interacting with others and consider using a high-quality medical grade N95 mask.
• Improve ventilation of indoor areas that you share with other people.
• Avoid unnecessary exposure to public places. Crowded, poorly ventilated indoor enclosed spaces are higher risk for COVID-19 transmission than outdoor areas.
• Arrange for shopping home delivery or have a family member obtain your groceries for you.
• Arrange telehealth medical appointments for routine check-ups or medication prescriptions.
• Arrange travel in private vehicles with members of your household.
• Ask your employer if you can work from home.
• Seek medical attention and get tested if you have had contact with a person who has COVID-19 or if you develop symptoms.

3. What if I need to visit a public setting such as the shopping centre or attend a medical appointment in hospital?

• Practise social distancing and avoid busy areas.
• Wait outside (or in an open well-ventilated area) where possible.
• Upgrade your mask to a high-quality medical grade mask such as an N95 mask. (If this is not possible double mask with surgical mask and cloth mask).
• Use hand sanitiser prior to touching your mask.
• Avoid touching your face as much as possible.

4. What if I need to travel and cannot avoid public transportation?

• When catching public transport (e.g. plane, train or bus) upgrade your mask to a high-quality medical-grade mask such as an N95 mask. (if this is not possible double mask with surgical mask and cloth mask).
• Use hand sanitiser prior to touching your mask.
• Avoid touching your face as much as possible.
• Avoid eating while travelling on public transport or eat after everyone else has put their mask back on.
• When travelling by car, bus or train try to sit next to an open window where ventilation is best.

5. What if I am unable to complete my work from home?

• Talk to your employer about your circumstances; a letter from your doctor may help.
• Ensure your workspace is well ventilated and allows for appropriate social distancing.
• Upgrade your mask to a high-quality medical grade mask such as an N95 or double mask.

6. What are the differences between different types of masks?

• Face masks reduce the spread of COVID-19 by reducing both the amount of the virus that is released into the air by a person with COVID-19, and that is breathed in by people who are in close contact with an infected person.
• Fabric masks are the least effective at preventing the spread of COVID-19 and are not recommended for people who are immunocompromised.
• The effectiveness of a mask depends on how well the material filters virus particles in the air, and how well the mask fits around the nose and mouth of the person wearing it.
• High-quality medical grade respirators (masks that fit snugly around the nose and mouth) are the most effective masks, as they filter most virus particles from the air and stop unfiltered air from leaking around the sides of the mask.
• Masks labelled as “N95” are regulated by the Therapeutic Goods Administration. Registered brands can be searched on the Australian Register of Therapeutic Goods website.
• N95 masks are recommended for use by healthcare workers at risk of exposure to COVID-19. Surgical masks are recommended in current WA Health guidelines for people who have risk factors for more severe COVID-19. You may, however, consider upgrading to an N95 respirator in situations where there is a higher chance of contracting COVID-19.
• There are other masks labelled as “KN95” or “KF94” that are not regulated in Australia but may provide better protection than a surgical mask by providing a better seal around the nose and mouth, and better filtration by the mask material.
• There are videos available online with instructions on how to put on and take off different types of respirators (Overview, KN95 cupped respirator, N95/P2 duckbill, flat fold respirator, P2/N95 foldable, P2/N95 cupped respirator), and advice on how they may be reused.
• N95 masks are more expensive than surgical masks, however, they may be reusable if they are not damaged or visibly contaminated. Make sure you sanitise your hands before taking off your mask, and then immediately again after you remove it. You can store you mask somewhere to dry out (i.e. not in a sealed plastic bag) and use it again a few days later, up to 5 times.

7. Ensure all family members and household contacts are vaccinated and have received their booster shots

• Everyone 5 years and older can now book an appointment for a COVID-19 vaccine.
• Booster doses are available to everyone 18 years and older who have received the primary course of COVID-19 vaccines ≥ 4 months ago

8. What are the benefits of booster shots?

• COVID-19 boosters reduce the risk of infection with the omicron variant, with the benefits starting within days of receiving the booster shot.
• People who have received a booster can still get COVID-19, but their infection will be less severe.

9. I am planning a social gathering with family/friends – what should I do to stay safe?

• Ask anyone who has symptoms (runny nose, cough, fever or unwell) to stay at home.
• Ensure all attendees are fully vaccinated for COVID-19 if they are eligible and that those vaccinated receive the booster shot.
• Once available, ask guests to obtain a rapid antigen test in the hours prior to the gathering. Alternatively, a laboratory PCR test could be used, however this does not ensure that the person has not been infected in the meantime
• Ask guests not to attend if they have been to a high-risk COVID-19 exposure site.
• Encourage attendees to reduce activities that might potentially expose them to the virus (e.g. public transport, shopping centres) 72 hours before the gathering.
• Encourage guests to use hand sanitiser when they enter.
• Don’t share cups or utensils or serve finger foods.
• Gather outside. If this is not possible, open windows to improve ventilation.
• You should send your guests this information before the gathering.

10. I am planning a social gathering at my household – what if some people attending are not vaccinated?

• Given that omicron is highly contagious we would discourage any unvaccinated persons from visiting your household.
• If you must spend time with an unvaccinated person, we recommend you do so outside, socially distanced and wearing masks.
• Consider asking all guests to complete a negative rapid antigen test a few hours before the event to reduce your risk of exposure.

11. What if someone has been infected with COVID-19 before but has not been vaccinated – does that mean they have natural immunity?

• Studies have shown that previous COVID-19 infection is not very effective in protecting a person from re-infection, particularly with the omicron variant.
• All people should receive COVID-19 vaccinations to prevent spread as well as protect against severe infection with COVID-19 and omicron.

12. What should I do if I become exposed to COVID-19 in the community?

• You should follow any public health advice on testing and isolation if you have been exposed to COVID-19.
• You should also contact your doctor for further advice on whether any additional testing may be recommended depending on your situation. The advice on when to have a COVID-19 test, and which sort of test
• you should have, is frequently changing and your doctor will be able to give you up-to-date advice.

13. What if I become unwell with COVID-19 symptoms (fever, cough, sore throat and shortness of breath)?

• You should have a COVID-19 test, isolate and contact your doctor as soon as possible (even if you are still waiting for your result).
• If you feel short of breath, or feel very unwell in any other way, you should go to your nearest emergency department.

14. What should I do if I have a positive COVID-19 test?

• Even if you have mild or no symptoms, you should contact your doctor as soon as possible if you get COVID-19.
• The management of COVID-19 in people who are immunocompromised or have other risk factors for more severe disease may be different to the advice provided to the general community, so you should contact your doctor (GP or hospital specialist) as soon as possible to make sure you are given the right advice for your situation.

If you test positive for COVID-19, please ring the Rheumatology helpline on 615 23717 OR email rheumatology support – FSH.RheumSupport@health.wa.gov.au.