NSW Health confirmed an investigation concluded that respiratory virus complications (pneumonia) was the cause of death, and not an adverse reaction to the COVID vaccine.

The two men, aged in their 90s, were residents at the Uniting Mingaletta Residential Aged Care Facility.

The first Pfizer/BioNTech vaccinations commenced roll out across 15 residential aged care facilities, seven in Ballina/Alstonville and eight in Port Macquarie, last month.

These locations were chosen as first priority regional areas because of the higher proportion of residents aged over 65 years.

Healthcare Australia is the organisation contracted by the Commonwealth Government to administer COVID-19 vaccinations for residents of residential aged care facilities (RACFs) on the Mid North Coast.

They are being supported by Healthy North Coast.

NSW Health is monitoring progress of the vaccination program and liaising with RACFs to talk through any issues or concerns.

A Healthy North Coast spokesperson said an adverse event following immunisation, known as an AEFI, is any negative reaction, including death, that follows vaccination.

"It does not necessarily follow that the adverse event was caused by the vaccine," the spokesperson said.

"There are reporting guidelines that must be followed when a serious or unexpected AEFI occurs. Healthy North Coast understands that all reporting guidelines were followed at Mingaletta."

NSW Health is responsible for investigating serious AEFIs.

An expert panel reviews any serious AEFIs reported with COVID-19 vaccination. The expert panel may also assist the National Vaccine Safety Investigation Group (VSIG) in conducting an assessment to determine the cause of a serious AEFI.

If a 'causality assessment' is required, the expert panel provides their findings and offers guidance to the VSIG.

The expert panel includes the local Public Health Unit, one or more immunisation specialists from the NSW Immunisation Specialist Service, and invited medical experts in fields relevant to the AEFI notified.

A NSW Health statement said all the correct procedures were followed.

"The two cases were reviewed promptly by the NSW Vaccine Safety Expert panel on 17 March. The panel found that both cases had a common respiratory virus which contributed to their deaths," a spokesman for NSW Health said.

It has been reported that both men developed pneumonia and both tested positive to rhinovirus which causes the common cold in well people, but can cause pneumonia in the very old and frail.

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