Government calls on GPs to reach out to vaccine hesitant patients

Anastasia Tsirtsakis

6/09/2021 4:42:27 PM

GPs are being asked to spearhead a plan designed to ensure vulnerable cohorts do not fall through the cracks. But is this logistically possible?

A GP speaking to a patient on the phone.
GPs are being encouraged to reach out to unvaccinated patients as the country looks towards easing restrictions.

The move, flagged by Federal Health Minister Greg Hunt, comes as Australia inches closer to 70% of its population aged 16 and over having at least one dose of a COVID-19 vaccine.
With 4.5 million additional Pfizer doses secured in swap deals with the UK and Singapore last week, Australia is expecting nine million doses of the mRNA vaccine will arrive in September, taking the focus from supply to uptake, particularly among vulnerable and hard to reach cohorts.
‘In the next two months our GP network will be calling in infrequent visitors, people who are disconnected from the health system … that they have on the books … to get vaccinated,’ Minister Hunt said.
‘We want to maximise the coverage and get as many people as possible.’
As a result, GPs are being encouraged to identify unvaccinated patients in particularly vulnerable cohorts – such as those who rarely see a GP, live in a remote setting or are from non-English speaking backgrounds – by calling or texting, or offering home visits for those who are unable to come into the practice.
RACGP President Dr Karen Price said GPs are well-placed for the task.
‘I would imagine that most GPs are already doing it, but it’s just a reminder as we get closer to that target,’ she told newsGP.
‘In our clinic, we’ve already done some home visits for patients and people who are still hesitant we encourage to come in. We have been continuing to reach out during every consultation to check people’s vaccination status.’
However, Dr Price said that she understands it will be a ‘big ask’ for many practices depending on the resources at their disposal, and that it will be ‘very much up to the individual practices’ as to how they manage the request.
‘It’s a resource problem; the staff, time and effort to do that is significant and the practices are already stretched,’ she said.
‘And this is going to be much harder work. The “heck yes” people, we’re getting through those and thank goodness for them. But it’s the people who are still wavering, hesitant, isolated or marginalised, as well as the people who are refusing … that’s where we’re going to have to do some really hard work.
‘Everyone’s aware that there will be people who will just refuse vaccination, so you can’t do anything about that; it is a voluntary vaccination program. I do hope for everyone’s sake that is a really small number.
‘However, the vulnerable and isolated people are the ones no community should leave behind.’
For most practices, trying to work out which patients have yet to be vaccinated, Dr Price said, would be a ‘logistical challenge’. She suggested Services Australia, which runs the Australian Immunisation Register (AIR), should develop a report feature to help practices easily identify unvaccinated patients.
‘It’s extremely time consuming … to search [each patient] individually, one by one,’ Dr Price said.
‘Our databases will tell us who’s had one [dose], but it won’t tell us who hasn’t had one because there are people with nothing in the practice software box, but who might have had one at a state hub, another general practice, or pharmacy.
‘So it’s a whole database issue for finding out who hasn’t had a vaccine, [and] the AIR would be the source of truth in that regard.’
The call to action comes as the first shipments of Pfizer from the UK and Singapore arrive in Australia, which is expected to boost general practice supply and see the number of practices delivering Pfizer to double by mid-September to 4500.
Dr Price praised the efforts of GPs thus far in the rollout who have proven that there are a ‘whole lot of different ways to reach the very hard to reach people’.
She highlighted the efforts of Dr Magdalena Simonis and Dr Joe Garra who have been working to address misinformation and hesitancy in culturally and linguistically diverse (CALD) communities, as well as NACCHO and community elders who have been working to protect Aboriginal communities in Western New South Wales.
‘People trust their GP,’ Dr Price said. ‘We have to do this in a way that’s not seen as coercion; it’s got to be informed consent with every single vaccine.’
However, Dr Price said that while GPs are committed to the public health effort, meeting the vaccination targets will require a community effort.
‘We are ready to work together, as always, for our patients and the community,’ she said.
‘But it can’t only come down to the GPs – it’s not possible for us to do all of that.
‘We need everyone on this from state and federal governments through to community agencies, through to people in their own families identifying people who haven’t yet got a vaccine, to encourage them to come and talk to their GP about getting a vaccine if they’ve still got questions.’
As of 4 September, more than 20 million doses have been administered in Australia, of which 11.2 million have been delivered by primary care.
COVID-19 Taskforce Commander Lieutenant General John James Frewen said that a lot of work is being done to address any hesitancy, and that people have access to the right information to make well-informed choices.
‘We can already look down into the jurisdictions and find pockets, whether they’re areas where there might be some cultural issues or there might be very remote communities,’ he said.
‘That’s the sort of priority we’re giving now to where the messaging needs to get to make sure that everybody’s coming along and everybody’s taking the opportunity to get vaccinated.’
Dr Price said the COVID-19 pandemic and subsequent vaccine rollout has been yet another example that any efforts need to be made as ‘one health system and one whole community’.
‘This needs to be all of us working together,’ she said.
‘When we leave people behind or we fragment care that doesn’t work – it never has worked, and we need to look at that as a lesson.
‘Any crisis will show you where the leaky parts of the boat are and a system under crisis is only as strong as those parts that are perhaps wobbling.
‘Many have discovered that during this pandemic crisis and general practice is absolutely the engine room of healthcare in Australia and that should never be forgotten.’
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Dr Moya Gaye Wood   7/09/2021 7:18:15 AM

Is this not we already do? Can any of us do more about this? I do not think so. I have asked for more advertising to Canberra months ago but no response initially. Personally I find it insulting to ask us to do more, as if we are not already working to the max on this.

Dr Matthew Laurence Byrne   7/09/2021 7:38:06 AM

If we had been involved from the start things would have been easier . We have 3000 patients over 60 on our books , we have vaccinated 2000 . Is our nurse supposed to ring the 1000 we don’t know about who have been possibly vaccinated elsewhere ? We are already too stretched but being the practice we are and having the dedicated nurses we work with , yes she will troll through and look up the 1000 missing mainly in her own time at night . General practice will once again fill in the gaps left by everybody else !

Dr Alvin Chua   7/09/2021 8:34:38 AM

Perhaps the govt should be writing to all the specialist colleges to ensure their members familiarise themselves with ATAGI guidelines and absolute contraindications to AZ-Vaxzevria! For example a previous DVT 25 years ago after surgery is NOT a contraindication! As recently as 2 weeks ago, a 66 year old patient with diabetes, HT and severe anxiety was seen post op by her orthopaedic surgeon who told her to wait for Pfizer! Undoing all the advice and convincing and long consults we’d had over the preceding weeks where she had agreed to get her vax 8 weeks post arthroscopy! I’m beyond livid with these “experts” who’re not staying within their lanes! Perhaps an AHPRA report should be forthcoming?