Will vaccine supply issues delay the return to school and impact kids’ mental health?

GPs are sceptical that enough doses will arrive in time to vaccinate children prior to school returning, which could impact some kids’ mental health.
 
Much like the early stages of Australia’s COVID vaccine rollout, GPs are again warning that there are not enough doses to meet demand ahead of 5–11-year-old children joining the vaccine rollout.
 
The first vaccinations are due to take place on Monday, but with some general practices reportedly only receiving enough supply to administer vaccines at one tenth of their capacity, there are growing concerns many children will not be protected once school returns at the end of January and beginning of February.
 
Queensland Premier Annastacia Palaszczuk has already indicated the return to in-school learning could be delayed in her state due to low coverage and the recent explosion of Omicron cases in Australia.
 
‘I want to assure Queensland parents there will be no return to primary school at the peak of the Omicron wave,’ she tweeted on Friday.
 
‘We are looking at the option of delaying the return to school.’
 
Perth GP Dr Andrew Leech, who has a special interest in children’s mental health, told newsGP it is difficult to know what impact a delayed rollout – and potential delay in the return to school – could have on young children.
 
‘It’s going be variable, because I think kids have different takes on COVID and the significance of it,’ he said.
 
‘Some kids are quite immune to the stress of it all and are resilient and not fazed either way – they just sort of go with the flow – whereas other children will be more anxious and involved in the discussions around it.
 
‘There are so many different home situations and so many different ways that parents and families are reacting to it, and that may also affect children.’
 
Melbourne-based Dr Shea Wilcox is one GP whose practice has reportedly been overwhelmed with parents desperately seeking appointments ahead of the school year.
 
He told The Guardian his clinic is slated to receive only 100 doses for children a week, despite having the capacity to administer 10 times that amount.
 
‘One hundred doses per week is laughable,’ he said. ‘What’s that, about 30 families with three children each?
 
Meanwhile, GP and practice owner Dr Maria Boulton is not accepting any vaccine appointments until the doses arrive in her practice’s fridge, having been affected by supply issues at the start of the rollout.
 
It was in March last year that Dr Boulton told newsGP the lack of doses meant navigating the rollout was like organising a concert ‘when you are not sure whether the performers will be there or when they will arrive’.
 
Aside from a lack of supply, ‘technical glitches’ have also resulted in the inadvertent mass cancellation of children’s appointments.
 
Both issues plagued Australia’s main vaccine rollout last year, leaving general practices inundated with phone calls when the national booking system was launched before doses became available.
 
At the time, Adelaide GP and practice owner Dr Alvin Chua told newsGP the sequence of events had left him feeling ‘ambushed’.
 
‘When we signed up for the COVID vaccine clinic rollout, we were under the impression that a national online system would be available. But, unfortunately, this has not happened,’ he said.
 
Supply issues that existed at the start of the vaccine rollout in March 2021 were then transferred to the onboarding of Pfizer when it came online in July.
 
But despite these experiences, RACGP Victoria Chair Dr Anita Munoz told The Guardian the lack of doses being delivered to GPs remains a significant issue.
 
‘It is frustrating for GPs,’ she said. ‘We would definitely like to see more doses with each delivery.
 
‘I have concerns about getting all the kids vaccinated before then. I’m not sure it’s going to happen.’
 
According to a Department of Health (DoH) webinar on Thursday 6 January, there have been ‘no delays’ on the delivery of paediatric COVID vaccines, the first shipment of which reportedly arrived ahead of schedule on 31 December last year.
 
‘The majority of deliveries will be completed by the end of this week ahead of the 10th of January,’ First Assistant Secretary of the DoH’s COVID-19 Primary Care Response Dr Lucas de Toca said.
 
‘There’s a small number of practices in urban settings that will receive deliveries on Monday and Tuesday, so on the 10th and the 11th itself. But all those practices were notified on the 23rd of December, so they know when to expect those deliveries.
 
‘All the other ones will receive their delivery no later than [Friday, 7 January], as planned.’
 
However, on Friday afternoon Dr Chua appeared to once again be a victim of missed delivery targets, with his scheduled allotment of doses still yet to arrive 15 minutes prior to the close of business.
 
‘We’re supposed to be rolling out paediatric Pfizer [vaccines] from Monday 10th January,’ he tweeted. ‘Small problem – it’s 4.45 pm Friday and our scheduled delivery has still not arrived!’
 
Other GPs are also reporting that their allocation has been halved, with one practice manager telling Nine Newspapers they have already had to reschedule 100 appointments due to issues with shipments.
 
There is also uncertainty over when practices will be able to increase the number of doses they are able to order.
 
A DoH spokesperson also told newsGP two million paediatric Pfizer doses have cleared Therapeutic Goods Administration (TGA) testing and will be distributed ‘over the coming weeks’.
 
‘The [Federal] Government has secured sufficient supply of the 5–11-year doses to offer all children a first dose by the end of January,’ the spokesperson said.
 
‘Week-by-week allocations depend on ordering rates by individual vaccine providers.’


Children aged 5–11 will be eligible to receive a lower-dose formulation of Pfizer’s COVID-19 vaccine of 10 µg (0.2 mL). (Image: AAP)

With 2.3 million children becoming vaccine-eligible from Monday, an additional 2.6 million doses will need to clear TGA testing in the coming weeks to supply two doses to every child. It is not clear if those doses have yet arrived in Australia or what the remaining schedule is.
 
However, a Victorian GP who spoke to newsGP on the condition of anonymity, said that while supply at their practice is ‘adequate’, the funding required to administer the doses is not.
 
‘Kids are hard to vaccinate. It is slow going, so the rebate and forced bulk billing makes it virtually impossible to deliver the vaccines without running at a loss financially,’ the GP said.
 
‘[There is] very little incentive to do it, to be honest. The rebate needs to be doubled for kids.
 
‘We’re doing [the] bare minimum but will probably pull out as soon as schools and state government step up and run it.’
 
In Western Australia, Dr Leech said his clinic has not experienced any delivery issues and is fully booked for children’s vaccinations until March, which he described as ‘really positive’, despite there being a backlog.
 
‘It’s really good … because there is a little bit of hesitancy out there, [and] there’s a little bit of nervousness from parents around actually getting it, because it’s something new,’ he said.
 
However, he also said reports from overseas of increased hospitalisations among children due to Omicron have added to the urgency with which the rollout needs to be completed.
 
‘The data around children seems to be that the Omicron strain is affecting children more often, is actually giving them more significant symptoms, and children are having longer term symptoms as well,’ he said.
 
‘It’s generally a mild illness and I don’t want to create anxiety … but it’s important to let [parents] know that it’s an effective vaccine we can use to protect against potential harms from COVID and these longer-term issues.
 
‘There really is no reason not to have it.’
 
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