Supply issues remain despite positive start to general practice Pfizer rollout

On Monday, more than 500 general practices around Australia were due to begin immunising patients aged 40–49 with the Pfizer COVID-19 vaccine.
 
RACGP Victoria Chair Dr Anita Muñoz’s practice in Melbourne’s CBD was among them, administering 60 doses on day one. She told newsGP it was a ‘very positive’ experience for both staff and patients.
 
‘We had the system really well set up,’ she said. ‘We’d thought about it in quite a lot of detail, how to run it as effectively as possible. So from a clinical point of view and from a staff point of view, it was very positive that it was run very efficiently.
 
‘We really didn’t have any problems.’
 
RACGP NSW&ACT Chair Associate Professor Charlotte Hespe reported a similar experience at her Sydney-based practice.
 
They received 150 doses on Friday and a timely delivery of their syringe and needle kits, which she says was a real contrast to the experiences of practices with the AstraZeneca rollout.

‘Everything’s been brilliant,’ Associate Professor Hespe told newsGP. ‘We were very happy that they … delivered what they said they would.’
 
But that certainly hasn’t been the experience of all practices.
 
Dr Muñoz said the sentiment among GPs online indicates there has been a ‘variety of experiences’ during the first week of the Pfizer rollout, with ‘some difficulties with deliveries, and uncertainty about dosage numbers and delivery times’.
 
Among them is Western Australia-based GP Dr Alan Leeb. He said his first delivery of Pfizer won’t be arriving until next Monday, and that demand is far exceeding the 300 doses he has been allocated.
 
‘I think all of us [GPs] have been so burnt by the process, we will wait until we have the vaccine in the fridge before taking bookings,’ Dr Leeb told Seven West Media.
 
The move to general practices delivering Pfizer has also been welcomed as a way to tackle access issues out of urban centres, with 40% of practices taking part located in rural areas. But last Friday RACGP Rural Chair Dr Michael Clements expressed concerns that many rural GPs had yet to receive supplies.
 
‘I’d have to say most of rural and remote Australia don’t have access to Pfizer full stop,’ he told the ABC.
 
‘The whole town of Cooktown, I’m told, hasn’t had access to Pfizer yet, they do have AstraZeneca available from the GP clinic. But the population under 60 that are recommended to have Pfizer just don’t have it.
 
‘Often in our rural and remote areas we do feel there is a bit of an urban divide, and an urban preferencing, but I think that really does feel accentuated at the moment by this access to the vaccine.’
 
Also joining the Pfizer rollout this week are 62 Commonwealth Vaccination Clinics and 15 Aboriginal and Torres Strait Islander community controlled health services.
 
National supplies of Pfizer remain low, with 300,000 doses this week and 500,000 expected next week, with the bulk of deliveries not expected to start arriving from overseas until October. 
 
As with Dr Muñoz’s practice, Associate Professor Hespe has been given a weekly allocation of 150 doses for this week and next, before being scaled up the next week to 300 to start catering to second doses.
 
But since being included in the COVID-19 Vaccine Clinic Finder last week, she says her practice has been inundated with hundreds of daily calls from patients from other practices.
 
‘I’m very open to us doing patients from other practices that need to be vaccinated as soon as possible, but we’ll do that more on a case-by-case rather than us opening it up widely,’ Associate Professor Hespe said.
 
‘We need to prioritise our own patients and then we’ll be able to open it up a little bit more widely. That’s not to sound selfish, it’s more about there’s only so much you can do with 150 a week.
 
‘We’ve been ready and waiting for it. But ... we won’t book until we’ve got the supplies, and that’s the tricky thing.’
 
Dr Muñoz says there is certainly a need for supply to be ‘consistent and certain’ from here on out.
 
‘I don’t think that anyone feels totally confident about supply because we’ve seen things go wrong in the past when we were otherwise expecting good numbers of doses,’ she said.
 
‘So until the supply is steady and guaranteed, week in week out, and the processes of replenishing and receiving doses are tried and true, there’s only going to be cautious optimism about it.
 
‘If the doses start arriving reliably and consistently, I think there’ll be nothing but delight in general practice and we will ramp up our efforts to match that supply.’
 
More than 8.2 million COVID vaccinations have been delivered to date, with primary care having administered more than half.
 
Federal Health Minister Greg Hunt said the numbers prove that primary care is the ‘backbone’ of the vaccine rollout.
 
‘This is an incredible achievement and a true reflection of the commitment of GPs to support their local communities,’ he said.
 
Dr Muñoz said while the acknowledgement of general practice’s central role in the rollout is ‘very positive’, more work still needs to be done to improve communication.
 
‘There are delays in communication and that can be unhelpful in terms of relationship building, but also in terms of the success of a program this complex. So I do think communication needs to be improved,’ she said.
 
‘We’ve been doing this for so very long, we do have a lot of very powerful and important insights that the more that they are heeded [by decision makers], the greater the likelihood that we’ll have greater efficiencies and greater success.
 
‘I hope that we won’t see repeated mistakes being made.’
 
It is anticipated that 1300 general practices will be administering Pfizer by the end of July, along with up to 135 Commonwealth Vaccination Clinics and 130 Aboriginal and Torres Strait Islander community controlled health services, before eventually ramping up to all 5100 GPs participating in the rollout.
 
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