Should Victorian general practices be prioritised in the vaccine rollout?

Anastasia Tsirtsakis

3/06/2021 3:54:44 PM

While vaccine hesitancy remains in many parts of the country, Melbourne GPs have reported a ‘phenomenal increase’ in uptake, forcing them to turn eligible patients away.

A man waiting after receiving his vaccine.
GPs in Victoria have seen a significant increase in people over 50 rolling up their sleeve to be vaccinated.

Victorian GPs are calling on the Federal Government to increase supply of AstraZeneca COVID vaccines, as they face unprecedented demand from people aged over 50.
GP and practice owner Dr Nathan Pinskier is among them. He told newsGP he has had to roster additional staff to deal with the influx of phone calls across his six practices since confirmed cases of the virus started to climb.
‘We’ve gone from vaccine hesitancy to vaccine demand; it’s unprecedented,’ he said.
‘We were sending out every day in all our clinics 100–300 text messages and were getting about a 5–10% response on those. It was hard work to fill up the sessions. Now we aren’t sending any texts and we’re probably getting a 1000–2000% increase in response. It’s phenomenal.
‘Every one of our clinics, as soon as we open up 50 or 100 slots, within about an hour all those slots disappear. I’ve never seen the amount of demand being placed on general practice as it is at the moment.’

Another Melbourne GP, Dr Philip Carter, is seeing a similar trend.
‘We’ve gone from struggling to fill 10 spaces to doubling capacity and booked out for several weeks. Had to bring in a locum doctor to meet the demand,’ he Tweeted.
The significant uptick is similar across the state. Data shows Victorian primary care services administered more than 22,000 doses in the 24-hour period to 1 June, compared to just under 14,000 on 25 May before the snap lockdown was announced. 
However, for GPs outside of Victoria like Dr Natasha Yates on the Gold Coast, vaccine hesitancy and concerns around potential side effects associated with AstraZeneca persist.
She told newsGP her practice had to cancel a vaccine clinic on Thursday afternoon after fewer than 10 patients had booked in, with those interested rebooked for another day to ensure doses are not wasted.
‘It’s just really frustrating,’ she said. ‘It has actually happened to me once before.
‘It does seem to be people responding in the moment to what’s happening in the media at the time. We had quite an upsurge of people starting to take it a couple of weeks ago.
‘Now, I’m not sure what’s happened in the media recently to freak them all out again. But obviously something has spooked them again, and it might be social media rather than general media.’
Dr Pinskier believes vaccine allocation should now be increased and prioritised where there is a spike in demand.
His practices collectively vaccinated 2000 people in the past seven days, but he says they have the demand and capacity to be doing between 4000–5000 a week, if not more.
Already having to turn patients away, many GPs also fear the insufficient supply will worsen in two weeks’ time when practices are due to commence the second round of AstraZeneca vaccinations for those who received their first dose 12 weeks ago.
‘So we’re going to be hammered again if we continue at this demand, and I can’t see why we wouldn’t. We will certainly not have enough supply,’ Dr Pinskier said.
Responding to the query during the Department of Health’s (DoH) latest webinar on Thursday, Dr Lucas de Toca, the DoH’s First Assistant Secretary for the COVID-19 Primary Care Response, said while the prospect of GPs having to turn patients away is ‘concerning’, it is unlikely to be the case.
‘That’s a concerning hypothetical, but luckily one that won’t happen because all the clinics that commenced with 50 doses a week … were tripled … now three or four weeks ago,’ he said.
‘So all the low-allocation practices that were starting with delivering 50 doses a week are now getting 150 doses a week, and then the practices that were doing 100 a week have now been getting 200 a week.
‘We’ve had a further increase just a couple of weeks ago where 1300 practices that regularly have been using 80% or more of their allocation had a further increase.’
For GPs like Dr Pinskier it is not a hypothetical scenario, but rather one he is already seeing unfold.
Dr Yates says while she appreciates that it can be difficult to predict precisely which practices will need more vaccines at any one time, they should be given more autonomy regarding their supply.
‘We are told constantly that we have enough in the country now because we’re making it locally. So I think more autonomy needs to be given to practices to make the decision based on our demographics and how many we actually need,’ she said.
‘We’ve never had a problem with doing this with the influenza vaccines.’
While people also have the option of going to vaccination hubs, Dr Pinskier says the overall consensus is that those eligible for AstraZeneca are looking to be vaccinated locally.
‘There aren’t a huge number of vaccination hubs on the south side of [Melbourne]. The big ones are located within the CBD and one in Geelong. While the hospitals are running them … people find it easy to relate to their own regular practice,’ he said.
‘I put in calls to the [DoH] asking them to urgently reconsider the delivery supply to Melbourne. They need to … double the doses immediately.
‘I don’t want to disadvantage the rest of Australia, but I think there should be a preferential redistribution towards Victoria and Melbourne because we need to get out of this mess.’
While Dr de Toca did not confirm that there would be an increase in doses, he did not entirely rule it out.
‘We are continuing to monitor the system,’ he said.
‘We’ve had a number of requests of additional allocations in Victoria that we have action on and we will see what capacity we have in the system to do further increases as the program continues.
‘The most important point for us, though, is that you continue to submit weekly your stock management form, that you submit your stock acceptance form every time you get a delivery, and of course the wasted form if there’s a major wastage incident.
‘It is through those stock management forms that we know what stock you have on hand, how many vaccines you’ve administered, and then we can flag for an eventual increase.’
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