Health

Novak Djokovic: What are the grounds for a medical exemption from Covid-19 vaccination?

Dr Muiris Houston: In Ireland, medical exemptions from vaccination are rare

Novak Djokovic celebrates after winning against Russia’s Daniil Medvedev in the 2021 Australian Open in Melbourne. Photograph: David Gray / AFP via Getty Images

Dr Muiris Houston's face
Dr Muiris Houston
Thu Jan 6 2022 - 16:45

As the controversy around reigning Australian Open tennis champion Novak Djokovic’s attempt to enter the country for this year’s event rumbles on, what are the possible reasons he might use to claim an exemption from Australia’s strict Covid-19 entry requirements?

People must be fully vaccinated as defined by the Australian Technical Advisory Group on Immunisation (ATAGI) to be allowed enter the country without having to quarantine. Fully vaccinated, according to this body means having had two doses of a Covid-19 vaccine. Overseas visitors who have contracted Covid-19 within the previous six months but have not been vaccinated cannot enter Australia.

It seems Djokovic was relying on evidence of recent Covid-19 infection to gain an exemption to compete. He could also have used a medical exemption to circumvent the requirements – although crucially such a medical certificate must be provided by a doctor registered to practise in Australia.

However, such exemptions are indicated for domestic travel and specifically do not apply to international border entry.

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In Ireland medical exemption from Covid-19 vaccination is granted infrequently. According to the National Immunisation Advisory Committee (NIAC), there are very few people who cannot receive one of the current Covid-19 vaccines due to pre-existing allergies or history of anaphylaxis (a severe allergic reaction).

World number one men's tennis player Novak Djokovic failed to provide sufficient proof to receive a medical exemption to enter Australia, prime minister Scott Morrison has confirmed. Video: Reuters/Anadolu Agency

Comirnaty (Pfizer-BioNTech) and Spikevax (formerly COVID-19 Vaccine Moderna) both contain polyethylene glycol/high molecular weight macrogol (PEG), which is a known allergen found in some medicines and also in household goods and cosmetics. Anaphylaxis to PEG is extremely rare but would contraindicate receipt of these two vaccines.

A history of clotting problems may mean you will be advised against Covid-19 vaccination. Your doctor may advise temporary postponement of immunisation if you are acutely unwell.

People who are immunocompromised as a result of medical treatment may have to postpone getting the vaccine. And anyone who develops heart inflammation (myocarditis) after the first dose of a vaccine should not have a second dose.

CoronavirusNovak Djokovic