GPs ‘in the dark’ over aged care vaccination delays

Anastasia Tsirtsakis

1/04/2021 4:35:54 PM

Failure to reach vaccination targets and a lack of communication has left GPs concerned and unable to prepare for the influenza vaccine rollout.

Close up should of elderly man's hands.
To date, only around 99,000 residential aged care facility residents have been vaccinated.

Murrumbidgee GP Dr Alam Yoosuff has more than 50 aged care residents on his books.
Six weeks into the rollout, not one has received a COVID vaccine, nor has there been any indication of when they will.
‘I’m worried,’ he told newsGP. ‘They have not given a date … not even a sign to say it might be this week or this month.
‘I’ve already vaccinated almost 120 people in the community, and none of my aged care residents or aged care staff are able to have it because they’re waiting for a day to come – God only knows when – that it is going to happen.’
Dr Yoosuff is not alone in his frustration.
Phase 1a of the vaccine rollout commenced on 22 February, and the Federal Government had set a target to vaccinate all aged care and disability care residents and staff by the end of this week.
But to date, only around 99,000 residents have been vaccinated across 848 facilities; furthermore only 279 facilities have residents who have received their second dose. It also remains unclear how many aged care staff have received even their first dose.
To ramp efforts up, the Department of Health (DoH) has since expanded sites delivering vaccinations to aged care staff to include general practices, GP-led respiratory clinics and dedicated aged care worker clinics.
But Associate Professor Charlotte Hespe, Chair of RACGP NSW&ACT and member of the college’s COVID Working Group, told newsGP that practices – many of which are still facing delivery delays and inadequate supply – have not been informed of the change.
‘It begs the question: why weren’t the GPs told?’ she said.
Dr Khayyam Altaf, Chair of RACGP Specific Interests Aged Care, told newsGP he initially believed he would be vaccinated at the age care facility at which he works, but has instead had to seek out vaccination at his Primary Health Network.
Dr Altaf agrees communication from the DoH has been ‘very limited’, raising concerns over whether there is an adequate plan in place.  
‘I accept the logistical difficulties in providing the vaccinations to such a large number of people, but GPs have been doing this successfully for decades,’ he said.
Dr Altaf also says he is not sure explanations involving supply issues are accurate.
‘There’s different providers involved now, [and] I really feel this should have been left to the GPs from the start,’ he said. ‘We would just need the supply; we can arrange all of the organising logistics – that would not have been a problem at all.
‘We could have done a lot better.’
The Australian Technical Advisory Group on Immunisation (ATAGI) has advised that recipients of a COVID vaccine have a two-week window between the that and the flu vaccine.
But with the delay of phase 1a, Dr Altaf says facilities and GPs are not being given enough notice to facilitate this requirement, risking significantly delaying flu shots.
‘What I’m hearing from aged care facilities is that they’re getting less than 48 hours’ notice that the provider is going to attend to deliver the vaccinations,’ he said. ‘That’s causing the major problem at the moment.
‘We at least need an indication of roughly when the COVID vaccinations are going to be delivered. Even if we know it’s going to be beyond three weeks from today, it gives a little bit of time to plan.’

GP Dr Alam Yoosuff says the vaccine rollout across aged care facilities would have been faster and more efficient had GPs been given a leading role. (Image: Supplied)
According to Dr Altaf, the flu vaccination campaign should already be underway. In 2020, he says, anybody entering an aged care facility was required to be vaccinated by 1 May – a deadline that is unlikely to be met this year – and he fears the consequences of the flu are being overshadowed by COVID.
‘Elderly patients and residents of aged care facilities are at very high risk of complications from flu, and the evidence is there that the winter months is the time that flu strikes,’ he said.
‘Also, given that we’ve had very little flu last year, we’ve got a potential of a significant flu outbreak this year.
‘This is the perfect example of why it would have been better for residents’ own GPs to be giving the vaccinations because we could have incorporated it with the time of the influenza vaccination to ensure that we’ve got the correct timing.
‘But now we’re in the dark.
‘We’re getting the vaccination supplied now, so the supply’s there; we’re basically ready to go.’
Meanwhile, Dr Yoosuff has concerns that taking the role of vaccination away from GPs will have implications on continuity of care, as well as uptake.
‘It will be a lot quicker and more efficient if we do it because we know our patients well. We know their history, we know whether they’ve given consent or not, by heart,’ he said.
‘Usually I do all my patients’ flu vaccines. In the rural and remote setting, if a patient comes and sees somebody completely alien that they’ve never seen before coming to give a vaccine, it might not be taken very well.
‘That a person who is living in my town gets the opportunity to get the vaccine via their usual doctor should be the same for aged care residents.
‘I could have put up with it if … the aged care residents are all going to get it a lot quicker and a lot earlier than everybody else, or if they are being allotted to have the Pfizer vaccine and not the AstraZeneca – that’s a different story.’
Both Dr Altaf and Dr Yoosuff say there is an immediate need for a better communication pathway between government, residential aged care facilities and GPs.
‘I’d like to see the Federal Government give us a plan of how they’re going to roll out vaccines and use some definite, earmarked dates for us so that we know what’s going to happen with our residents and our staff,’ Dr Yoosuff said.
‘We have taken a lukewarm approach … because we haven’t got a burning platform of a pandemic [thinking] we have enough time to do this. But we’re actually letting down our most important priority group.’
The Government continues to maintain that the rollout is on track, and hopes to have all first doses administered by October.
The Department of Health was contacted for comment.
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Dr Stewart James Jackson   2/04/2021 7:00:54 AM

Our practice has administered 350 doses 1B . Two local aged care facilities have not had any and one had first dose 2 weeks ago. If doses are delivered we can administer them. No one to ring , aged care staff no info. Who is in charge? Who can we call? Not interested in blame.

Dr Devendra Kawol   2/04/2021 7:43:08 AM

Just plain ridiculous
Same thing

Dr Bram Singh   2/04/2021 7:54:41 AM

Chaotic planning of the launch.... Let the game begin.
Political football...blame game . Federal vs state.
Too many cooks.... with vested interests.
And add to this.. unqualified referees....
The right hand doesn't know what the left hand is doing.
What a game.
The best hope is to start praying and
Manage your disappointments by expecting the worst.

Dr Greg Hunter   2/04/2021 9:46:17 AM

I work in the Tweed Shire and southern Gold Coast and visit 15 RACF's. Tweed Shire has only 0.3% of Australia's population but 1% of Australia's RACF population and 0.7% of Australia's RACFs. Only 1 of my patients in RACFs have had a COVID-19 vaccine, 5 weeks into the rollout and with no notification to me other than by the patient. I have been told staff at some of these centres have been instructed to obtain their COVID-19 vaccination from their GP, many still without a supply, as the residents only will be vaccinated at the RACFs. It was my impression that the whole population at RACFs would be vaccinated en masse for optimal protection. As others have realised, we cannot plan our influenza vaccinations for our RACF patients since the timing of influenza immunisation is critically dependent on the COVID vaccination timing. Is there a government contact for RACF immunisation to discuss this?

Dr RSY   3/04/2021 9:30:23 PM

Dr Singh is spot on with his comments!
The Commonwealth Dept of Health (DoH) has bureaucrats who are totally incompetent, have no clue on what they are supposed to be doing, yet pretend to be experts!
The State Health authorities manage the National Immunisation Program - which is a well established and effectively delivers year after year. Thru this mechanism, last year approx 12 million doses of Flu Vax were delivered with no issues! Please take away this program from DoH and give it to the NIP to administer!

Rural GP   4/04/2021 2:42:44 PM

Thanks Dr Yousuff. I was feeling a little chuffed that we delivered all of the COVID vaccines received to our small rural practice. We were ready and are able to ramp up when supply comes. Only to be kicked in the teeth, again, and told NSW Health will step in and save the day ? I thought the problem was vaccine supplies.? If the vaccines are there please give them to Gp’s and give us a go. I do not believe distribution should the obstacle .
It feels like the captain has sent us back to the bench while the big players score the points. We didn’t even get good swing at owning it. Frustrated and dispirited.

Dr RSY   5/04/2021 10:42:36 PM

Just to clarify my earlier post - The National Immunisation Program has GPs as the cornerstone of immunisation. The 12 million doses (I may stand to be corrected - as I read today that it was 17 million doses) of flu vax delivered last year were mainly thru General Practices! The current issue (despite what the DoH) says, is not a supply issue. It is an inefficient supply chain system setup by the DoH. My point is that the DoH should handover the COVID vaccine program to the NIP, who then can have General Practices roll it out efficiently (as with flu vax).