‘It’s a dangerous strategy for people to hold off’: GPs urge eligible patients to get vaccinated now

Both prior to and during the COVID-19 vaccine rollout, one message has been consistent: Australians will not have a choice of vaccine.
 
Yet despite warnings against vaccine shopping, the message appeared to take a different tone on Thursday. Asked whether Australians over 50 concerned about the AstraZeneca vaccine would be able to get access to Pfizer or Moderna, Federal Health Minister Greg Hunt responded by stating that by the end of the year there would be enough doses for every Australian.
 
‘Right now, we want to encourage everybody over 50 to be vaccinated as early as possible,’ he said during a press conference.  
 
‘But we’ve been very clear that as supply increases later on in the year, there will be enough vaccine of mRNA vaccines for every Australian.’
 
The comments, which suggested that people would have a choice after all, caught a number of healthcare professionals off guard, including Melbourne GP Dr Vyom Sharma.
 
‘This feels like a eulogy for AZ [AstraZeneca],’ he commented on Twitter.
 
Dr Kat McLean, a GP and clinical lead at a Commonwealth Vaccination Centre on the Gold Coast, told newsGP neither she nor her colleagues have been informed that patients would be given a choice of vaccine.
 
‘We’ve certainly not had communication [of that],’ she said. ‘Everything that we’ve received recently is that there is no choice between that age cut-off.
 
‘It’s challenging, because it may falsely set up these expectations in the community. And don’t underestimate the pressure it puts on our admin team; they just get inundated by the community with these phone calls and, and wanting to go on waiting lists for Pfizer, when there’s no certainty that we’ll have supply within general practices.’
 
Like many other GPs, Dr McLean has been overwhelmed with requests from people over 50 for the Pfizer vaccine since the Australian Technical Advisory Group on Immunisation (ATAGI) advised against the AstraZeneca vaccine for people under 50 due to the risk of a rare clotting syndrome.
 
Adelaide GP and practice owner Dr Alvin Chua believes that the hesitancy is largely due to Australians perceiving COVID is a low level risk, and says the messaging around the strategy needs to be both clear and consistent.
 
‘We are in a position of privilege in Australia whereby community cases are almost zero and other than in Medi-hotels, we have little or no patients with COVID. Unfortunately with privilege comes complacency,’ he told newsGP.
 
‘Highlighting Moderna and Pfizer possibilities being available later in the year for over 50s is only going to maintain the “privileged refusers” in my opinion.
 
‘What needs to be made clear by the Health Minister is that if you are serious about reducing community risks, then the more of the herd that is immunised, the better it is for one and all.’
 
While the majority of the 40 million Pfizer doses are expected to arrive in Australia in the final quarter of the year, distribution issues early on in the rollout have Dr Chua erring on the side of caution.
 
‘Reality is that a lot of patients asking [for Pfizer] seem to think that if they hold out and wait, they may get Pfizer in a couple of months – something I doubt is magically going to happen,’ he said.
 
‘In [the] meantime, I’ve had my AstraZeneca [shot], as have most of my staff, and most of us are under 50.’
 
RACGP Vice-President Dr Bruce Willett told newsGP the unpredictable nature of COVID-19, evidenced by Singapore and Taiwan’s return to lockdown, means that Australians need to be prepared for when the virus inevitably returns.
 
‘We can’t predict when that will happen,’ he said. ‘So it’s a dangerous strategy for people to hold off and wait for a so-called “better vaccine”, and by no means is that decided.’
 
Dr McLean says it is important to respect patients and not dismiss any concerns they may have about vaccination, and thinks the prospect of patients having a choice of vaccine could assist with reaching herd immunity.
 
But for the moment, she says the lack of a clear timeline on vaccine arrivals makes it hard for GPs to help patients make an individual risk assessment.
 
‘We recognise that things change, and as GPs we roll with that uncertainty,’ Dr McLean said.
 
‘[But] without an indication of what [the Government’s] timeline is, or of when they would potentially have access to that vaccine, it’s almost impossible to guide people through that decision making process.
 
‘So it’s almost seeding false hope for the current situation, unless there’s much more of plan or dates that can be communicated to us.’
 
Dr Willett says he will be continuing to follow the science by urging his patients over 50 to get the AstraZeneca vaccine ‘as soon as possible’.

‘GPs needs to be very consistent in the advice that we’re providing to our patients and the importance of vaccination; we need to continue with that,’ he said.
 
‘The risk–benefit analysis is clearly in favour, particularly in that age group where the risk of death is very significant – up to 15% in some age groups, versus one in a quarter of a million risk of serious complications from the vaccine.’
 
Minister Hunt’s office was contacted for clarification, but a spokesperson did not answer questions about whether people over 50 will be given a choice over what vaccine they receive once more doses of Pfizer and Moderna are delivered.
 
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