COVID-19 booster clinics are inevitable. But how will they run?

The Federal Government announced on Sunday it had secured 85 million booster doses of the Pfizer vaccine, which will arrive next year and into 2023.
 
While the focus has been on the immediate push to give the population their initial vaccination, the announcement is the most obvious public acknowledgement yet that the COVID-19 vaccination drive will far outlast the initial rollout and is set to endure many years into the future.
 
So what shape are COVID-19 booster clinics likely to take within primary care when those supplementary doses start to arrive?
 
Dr Emil Djakic, a member of RACGP Expert Committee – Funding and Health System Reform (REC–FHSR), believes they should be worked into a system that already functions well in primary care.
 
‘I would see this as something that would become integrated into what was the normal vaccine process,’ he told newsGP.
 
While Dr Djakic recognises the role played by state-run COVID-19 vaccination clinics for ‘surge capacity’ in the current vaccination program, he does not think mass-vaccination clinics will be needed beyond the initial push.
 
‘There is absolutely no need to create an alternative chain of supply systems and pop-up clinics if it’s organised in collaboration with our industry, which is clearly the biggest provider of this sort of service in the country,’ Dr Djakic said.
 
He also recognises the extraordinary circumstances in which the vaccine program has evolved – but says the basic economics need to be in place for GPs to participate.
 
‘There’s an element of public health emergency about this, that this is our bit to do,’ Dr Djakic said.
 
‘But the business case for this has to stack up so you can choose to deliver so many vaccines per hour to a population of booked patients to make it viable.
 
‘I don’t think there is a way to do this as an added-on service opportunistically in a consult, without there being any added funding on the table.’
 
Dr Djakic believes general practice is the obvious choice due to the way it works with the Australian Immunisation Register, as well as GPs’ existing relationships with patients.
 
‘We have got a pathway to deliver a service, we have got an industry that has got the horsepower and the willingness to do it,’ he said.
 
‘Patients love the opportunity to come into their general practice and have their vaccine inside the system they are already familiar with.’
 
Dr Jason Cooke is a solo practitioner in Newington, a western suburb of Sydney. For him, simplifying the process would be a key for any booster clinics that run in the future, with the hope paperwork will be cut. He cites the consent process as a particular burden as it stands.
 
‘There’s no recognition of the complexities involved. It’s not like giving the flu vaccine – and that creates a lot of extra work,’ he told newsGP. ‘They could easily simplify this process, but they haven’t.’
 
Dr Cooke also believes authorities should reconsider increasing patient rebates, by changing existing MBS items to at least a Level B.
 
‘Unless you have got a big practice with lots of resources [it is difficult]. And even then, the viability is not really there,’ he said.
 
Dr Colin Metz is another member of the REC–FHSR and also believes the process should be simpler for latter stages of the vaccine program.
 
‘This is just a personal opinion but when the Government designed the current COVID vaccine rollout it was overly engineered,’ he told newsGP.
 
‘They should just let it go through the normal GP channels. 
 
‘We’re good at vaccinating, at doing it in a way that best suits us. My sense really around the vaccination program is they should let the GPs decide how they are going to do it, and just make sure we have the ability to get the vaccines.’
 
Dr Metz believes the way the rollout has gone so far means any booster program will naturally be staggered.
 
He also hopes there will be opportunities to streamline the process – for example by combining any booster shots with flu vaccines – and awaits the results of further research that may indicate whether that can be recommended.
 
‘You should have a system that should be easy on the patient, easy on the doctor,’ he said.
 
For Dr Metz the biggest obstacle to overcome is likely to be the same as at the onset of the rollout: the consistency of supply. 
 
‘You just know [flu vaccines are] going to be there and you are going to get it from your GP,’ he said.
 
‘Why should COVID vaccines be any different? The only trouble is the Government this time overcomplicated things – they put brakes on the system.
 
‘Let us do what we know works.’
 
Dr Djakic, in the meantime, acknowledges booster clinics are likely to be factored into the system for the long haul.
 
‘That’s how we understand the science at the moment,’ he said.
 
‘[Vaccination] is a patch we do very well already, and most of our membership and GP cohort and nursing cohort who work with us would see it as core business.’
 
The RACGP’s information page has more information about the COVID vaccine items, including descriptors and rebate details.
 
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