Australia’s first Covid vaccinations of elderly and disabled unlikely to be from own GP | Health

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Elderly Australians and those with a disability are expected to receive a dose of the AstraZeneca vaccine from as early as next month, but it’s unlikely that they’ll be able to get it from their local doctor.

On Thursday Dr Lucas de Toca, acting first assistant secretary to the Covid-19 Primary Care Response at the Department of Health, confirmed that initially only “a handful” of Australian general practices would be able to offer their patients the AstraZeneca vaccine.

“Unfortunately, we cannot go to every GP practice in the country at the same time, it’s just logistically unfeasible, and we don’t have enough doses for it,” he said at a webinar aimed at Australian GPs.

Phase 1b of the national Covid-19 vaccine rollout, to begin next month, will target adults aged 70 years or over, Aboriginal and Torres Strait Islander people aged over 55 years, healthcare workers and adults with an underlying medical condition, including those with a disability.

The Department of Health told Guardian Australia that sites are yet to be finalised, however general practices will initially be prioritised for participation based on capacity, readiness and geographic spread to ensure equitable access and maximise the success of the national vaccination effort.

But with so few doses of the AstraZeneca vaccine expected to be available by the start of phase 1b, a majority of general practices will be temporarily barred from immunising their eligible patients.

More than 5,000 GP practices have expressed their interest in becoming a Covid vaccination clinic, including 130 GP respiratory clinics and more than 100 Aboriginal community-controlled health services.

The health department said it would be calling on more of these practices to participate once more doses of the AstraZeneca vaccine were secured.

Adequate supply of the AstraZeneca vaccine is predicted by the end of March, when local manufacturing begins at the CSL facility in Victoria.

Dr Karen Price, president of the Royal Australian College of General Practitioners, said while some patients might have wanted to be vaccinated at their local GP clinic, this shouldn’t deter them from trying to get vaccinated as soon as possible.

“There’s been estimates that we’re going to have to do 200,000 vaccinations a day to be finished by the end of October – which is also likely to be later now that there is a 12-week interval between the first and second AstraZeneca dose,” she said.

That is in contrast to the three-week recommended gap between the first and second dose of the Pfizer vaccine, which will be offered to more than 70, 000 Australians from the start of next week.

It’s unclear whether there will be any requirements for patients to attend the same clinic for both of the vaccine doses. Some clinics said they would be encouraging patients to book in for both doses of the vaccine at the same time – to ensure patients don’t forget their second jab, and to make sure enough vaccine doses are available on the appropriate day.

Price also said it was wrong for the public to assume that a vaccination program of this scale would be as simple as getting the annual flu jab.

“It’s a much more complicated process because it’s a new vaccine, it’s two doses and we’re in the middle of a pandemic,” she said.

“And it’s really hard to know if elderly people who are still living in their own homes will feel more comfortable going to a mass vaccination clinic or going to see their own GP [for the vaccine].”

“I’m explaining to my patients that they might choose to go to a mass vaccination clinic because it could have the AstraZeneca vaccine before I have it in my fridge – but obviously if I have it first, I’ll be able to vaccinate them.”

More than 1,000 general practices are currently being overlooked as potential Covid vaccination clinics because they don’t hold the status of being accredited.

To be labelled an accredited general practice, clinics have to pass a review by an independent agency every three years, and meet a list of standards devised by the Australian College of General Practitioners.

Dr Andrew Baird, a GP in Brighton in Victoria, told Guardian Australia that despite his clinic administering all routine vaccinations, it was precluded from immunising patients against Covid-19.

“We’ve met all the Department of Health requirements for having the appropriate fridges, the workflow, sterility and infection control,” he said.

But in the eyes of accrediting authorities, these measures are not enough.

De Toca defended the stringent requirements, saying the criteria devised for practice accreditation is similar to the standards the government expects of the Covid vaccination program.

Several of Baird’s patients have told him they are disappointed they won’t be able to get a Covid vaccine from their usual GP.

“Some have said they would be hesitant being vaccinated at an unfamiliar clinic,” he said.

“My patients have also been asking if they need to take a copy of their medical history with them if they go to another clinic for the vaccine, and if so, how they would go about this,” he said.

Dr Chris Moy, vice-president of the Australian Medical Association, told Guardian Australia that the details of how patients would prove their eligibility to receive a Covid vaccination from phase 1b were still being determined.

“You don’t want to stop people getting vaccinated if they fit the criteria, especially if they can’t go to see their normal GP,” he said. “There’s still details to work out, but it might be that patients can either take their medical record from their usual doctor, or show their information using their My Health Record – if they have one.”

The AMA has also hit out at the differences in workforce requirements for community pharmacies, who are expected to join the rollout from phase 2a in May.

Both general practices and pharmacies are required to have a minimum staff made up of a team leader (to direct clinic flow), clerical staff, health workers who are immunisation-trained and first aid staff (who must be different from the vaccinating staff).

General practices will also need to have a doctor present at the vaccination clinic at all times – which may or may not be the same person as the authorised immunisation provider.

Moy said while having a GP on the premises is already a given for most medical centres, doctors also have the training and skills to respond in an emergency.

“We have so many questions about how it’s possible to do Covid vaccination in a pharmacy, including their lack of knowledge about the medical history of a person, whether they can vaccinate in a Covid-safe manner in a busy pharmacy with privacy, and whether they can observe the patient afterwards and respond in an emergency – all those things are really concerning,” he said.

Hafta Ichi
Source: The Guardian
Keyword: Australia’s first Covid vaccinations of elderly and disabled unlikely to be from own GP | Health

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