GPs to take central role in vaccine booster rollout

GPs will be at the centre of a vaccine booster program that is expected to begin on 8 November, the Federal Government has confirmed.
 
The Therapeutic Goods Administration (TGA) announced on Wednesday morning that the Pfizer COVID-19 vaccine has been provisionally approved for use as a booster among adults.
 
It paves the way for the widely expected rollout of a COVID-19 vaccine booster program, pending final approval from the Australian Technical Advisory Group on Immunisation (ATAGI).
 
ATAGI is expected to provide detailed advice on the use of boosters imminently.
 
Subject to ATAGI approval, the booster program is likely to mean people aged over 18 will be eligible for a third vaccine dose six months after the second dose of their primary vaccination course. The aged care and disability sectors are set to be targeted for the first phase of the program.

RACGP President Dr Karen Price welcomed the announcement as ‘great news’, saying it makes perfect sense for general practices to continue their work on the vaccination rollout after delivering more than 19 million doses across Australia so far.

GPs are also ready to help deliver booster doses through in-reach teams to priority patients in aged care and disability residences, she said.

However, Dr Price told newsGP the Government has not yet confirmed billing details for the booster program.

‘We are advocating for a Level C to cover off the many questions that people will still have. We are still seeking clarification on that,’ she said.
 
‘We have also made it very clear that members are not in favour of mandated bulk billing, as we have mixed cohorts of patients. We have heard very clearly from members that this is something GPs are able to determine for themselves.’

Constructive discussions on funding with Government are ongoing, Dr Price said – including around the PIP component of vaccination if patients do not have two vaccine doses in the same place.

Dr Price also said she hopes the program will ultimately become routine patient care, with boosters potentially being part of a general preventive healthcare check.
 
‘GPs deliver the vast bulk of the National Immunisation Program schedule of vaccines,’ she said.
 
‘People are used to coming to us for vaccines in the context of their holistic healthcare, so I would hope this would be centred again as part of more routine care, if we can call a pandemic “routine”.’
 
Federal Minister for Health and Aged Care Greg Hunt said state vaccination hubs and pharmacies will also be involved alongside GPs. He called the announcement of a booster program ‘an important milestone’ in Australia’s pandemic response.
 
Speaking to the media, Minister Hunt said the program will ensure Australia is among the countries with the highest protection rates against COVID-19 globally.
 
‘The boosters will mean that we will be one of the most highly vaccinated societies, one of the most recently vaccinated societies, and as a consequence one of the best protected societies in the world,’ he said.
 
TGA national manager Professor John Skerritt said Pfizer was approved as a booster at a TGA meeting on Tuesday night.
 
‘It is important to reinforce that two doses of each of the approved vaccines do provide excellent protection against serious illness, hospitalisation and death,’ Professor Skerritt said.
 
‘But we do know that boosters may give additional protection against mild COVID and they may have an impact on transmission.
 
‘And we do know that in the elderly, and people of various shades of immunocompromised that an additional dose is particularly valuable, and it may provide reassurance for frontline health workers.’
 
Professor Skerritt said around 1.6 million people will be eligible for the booster – ie more than six months after their second dose – by the beginning of 2022.
 
He said he did not yet know if subsequent boosters would be necessary after a third dose.
 
Pfizer is currently the only vaccine to have been approved for the booster program and will also be used to top up the immunity levels of patients who have received different vaccines in the primary rollout, including AstraZeneca and Moderna.
 
However, those who received the latter will not be eligible for several months as the Moderna vaccine only became available in Australia last month.
 
Earlier this month, ATAGI approved opening a third vaccine dose to the severely immunocompromised as part of the primary vaccination program.
 
Booster programs are now a central issue in the pandemic response around the world. The World Health Organization (WHO) said this month that implementing broad booster programs ‘risks exacerbating inequities in vaccine access’.
 
Israel was the first country to begin a such a program, starting its rollout in July, while emergency use of COVID-19 booster vaccines has also been approved in the United States, European Union and the United Kingdom.
 
Several studies indicate that the vaccines’ efficacy against infection wanes over time, although protection against severe illness and death remains relatively high.
 
Last week, Pfizer and BioNTech released top level results of a randomised controlled trial designed to assess booster efficacy. It showed much higher protection rates against symptomatic COVID-19 across all ages for those that received a booster compared to a control group that received a placebo.
 
The results have not yet been peer reviewed, but the companies have said they will share the data with regulatory authorities across the world.
 
Moderna is also expected to seek approval to use its vaccine as a booster, although the company has not yet submitted a formal application through the TGA.

Updated: Following this article's initial publication, the Department of Health responded to a newsGP inquiry about billing and MBS numbers for the booster rollout as follows:

'The Government is currently considering the booster program and awaiting advice and recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI) before the booster program arrangements are finalised. It is anticipated that guidance on the implementation of boosters into the National Vaccine Program will be provided in coming days.'

'There are already MBS items in place for assessment of patients for second and subsequent doses of COVID vaccines (see for instance item 93644) which may be used. Also, an in-depth patient assessment item can be claimed, if clinically relevant and the patient has not had an in depth patient assessment before.'

boosters COVID-19 Pfizer TGA vaccination vaccine roll-out