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‘Major problem’: Winter COVID-19 vaccine doses under scrutiny


Jolyon Attwooll


16/06/2022 4:00:40 PM

Aged care facilities are being pushed to give all eligible residents a vaccine before the end of June, the Department of Health has confirmed.

Old man receiving COVID-19 vaccination
Aged care winter doses lag behind the broader population, the most recent statistics indicate.

The fourth ‘winter’ dose of COVID-19 vaccine in aged care is in the spotlight this week as the new Federal Government pushes to increase uptake and limit the disease’s toll among the most vulnerable.
 
Federal Minister for Health and Aged Care Mark Butler and the Minister for Aged Care Anika Wells have written to residential aged care providers, requesting they do as much as possible to ensure vaccination rates increase. Minister Butler has called the winter does rollout in aged care facilities ‘too slow’, according to The Guardian.
 
The ministers also encouraged providers to seek assistance from primary care providers to administer the vaccines if residents become eligible before a clinic is due on site.
 
As of this week, just over half of the country’s eligible aged care residents – 63,515 in total or 51.3% – had received the supplementary winter dose, the Department of Health (DoH) confirmed on Thursday. The supplementary dose in aged care facilities was approved by the Australian Technical Advisory Group on Immunisation (ATAGI) in March.
 
Dr Khayyam Altaf, Chair of RACGP Specific Interests Aged Care, said the figures come as a surprise.
 
‘It’s the first time I’ve heard anything of that nature,’ he told newsGP. ‘If that data is correct, then there’s a major problem we’ve got on our hands.’
 
Other DoH statistics show aged care residents are tracking below the level of the broader population aged 65 and over, with 53.8% of those eligible nationwide now having had a winter dose, according to government figures released on 16 June.
 
Dr Altaf said his sense of the latest phase of the rollout is that it had been relatively smooth – at least compared to the primary course rollout, of which he and many other GPs were highly critical.
 
The four-month gap recommended by ATAGI after an initial booster or three months after COVID-19 infection is complicating the process, Dr Altaf believes.
 
‘My experience actually has been the reason many patients may not have had the fourth dose yet is because they’ve had the third not long ago, or they’ve had COVID,’ he said.
 
‘I’m not hearing the same issues that we had at the start with the initial rollout, where it was really difficult to get providers in.
 
‘I’m finding, from the information I am given anyway, [the vaccine providers are] more approachable. They’re willing to opt in for just a few vaccines, as opposed to only doing the whole facility once and then disappearing.’
 
In a statement to newsGP, the DoH confirmed a concerted campaign aimed at boosting the rates, with a focus of ensuring all possible vaccinations take place by the end of the month.
 
‘Operation Covid Shield is targeting communications at aged care facilities with a winter surge to reinforce the importance of the winter dose program,’ a DoH spokesperson said.
 
‘The program is being delivered by both primary care and vaccine in-reach providers. All eligible homes will be encouraged to book in a visit by the end of June for residents eligible for a fourth dose.
 
‘We are also encouraging providers to keep their reporting of vaccinations up-to-date.’
 
The push comes in the context of a rising number of deaths attributed to COVID-19 in aged care facilities – although the number of outbreaks has diminished in recent weeks.
 
Nearly one in three aged care residents has had COVID-19 since the pandemic began, with 52,914 of the reported 176,794 residents having been confirmed with the disease.
 
Of the 9146 deaths reported so far in Australia, there have been 2724 in aged care as of 16 June – or around 30% of the total.
 
It represents a shift in the burden of COVID-19 from early in the pandemic, when acute disease and death was overwhelmingly seen in aged care.
 
The Australian Institute of Health and Welfare (AIHW) reports that 7% of COVID-19 cases in 2020 were in residential aged care facilities, and these accounted for 75% of all deaths.
 
The aged care mortalities have also been significantly fewer than in many other parts of the world. The DoH, for example, cites the death rate in Canada as being six times that of Australia.  
 
For Professor Dimity Pond, a GP with a special interest in aged care, the recent government push is timely.
 
‘I personally would like to see [the winter dose vaccination rate] higher, I must admit,’ she told newsGP.
 
While acknowledging that Australia has comparatively been safer for aged care residents during the pandemic than in many other countries, Professor Pond said geography has played a part and that the latest data shows there is ‘no room for complacency’.
 
 ‘We are better off than most other places in the world so we should be faring better,’ she said.
 
‘We’re well resourced comparatively, so we should be be able to protect our senior citizens.’
 
However, Professor Pond believes the processes for COVID-19 vaccination in aged care facilities need improving.
 
‘It would be nice if it could be streamlined. Is it the facility responsible? Or is it me as a GP? And if it’s going to be us as GPs, we need to know, and then we need to have a system for doing it,’ she said.
 
‘A lot of us are really under the pump at the moment so it would be great if the facility could do it, but they’re under the pump as well, I understand that.’
 
It is not a one-off issue, but one likely to be ongoing for some time, Professor Pond warns.
 
‘We’ve now got the antiviral medications, and they are quite effective. I think we’re going to have to have a combination of regular boosters, and the oral antiviral availability for residential aged care.
 
‘And I’d love to see a flu vaccine/COVID vaccine combination shot that we can give everyone. Maybe that’s on the agenda, I don’t know.’
 
With boosters likely to feature regularly in aged care facilities for the foreseeable future, Professor Pond believes plans need to be clearly put in place.
 
‘We need to be resourced to do that,’ she said.
 
‘We need to stop thinking this is exceptional, and start thinking “how are we going to manage this?”’
 
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