Leaving GPs out of aged care vaccination a ‘decision-making error’

‘To be honest, it’s quite astonishing that we’re in this position. There was ample time to get the vaccinations done.’
 
Dr Khayyam Altaf, Chair of RACGP Specific Interests Aged Care, was very clear in his assessment of the current situation in Victoria when speaking to newsGP.
 
The state’s COVID outbreak has seen four cases linked to aged care, including two workers, a resident and the son of a worker, forcing multiple facilities into lockdown.
 
The scene unfolding has many in the community on edge, given that 685 of 910 COVID deaths in Australia have occurred in aged care settings, 655 in Victoria alone.
 
Dr Altaf, who has more than 100 patients in aged care across Melbourne, is among the GPs sidelined from the vaccine rollout and believes the current predicament could have been avoided.
 
‘There’s been over reliance on a private vaccination provider that’s led to restrictions with delays and their availability to get the vaccinations done,’ he said.
 
‘GPs have been left out … and I would say that’s a decision-making error. And it’s now clearly evident.’
 
A Senate Estimates session on Tuesday revealed that 44,333 aged care residents in Victoria have received at least one dose of COVID vaccine, and just 25,319 are fully vaccinated. Nationally, 153,641 out of approximately 183,000 aged care residents have received at least one dose.   
 
Dr Sachin Patel, who is the founder of an aged care GP service that cares for patients in 100 Melbourne facilities, says GPs predicted the shortfalls of the proposed model, but their concerns ‘were ignored’.
 
‘It was foretold that this would happen, and GPs were dismissed in the whole process,’ he told newsGP.
 
‘At the outset, there was this huge fanfare – “We’ve got this private service that’s going to do aged care” – it was as if the GPs didn’t exist.
 
‘Why would you sideline the people who are fundamental in providing medical care and vaccination to this population at the time when you need vaccination for this population? It doesn’t make sense.’
 
Senate Estimates also revealed that less than 10% of the 366,000 aged care workers nationally are fully vaccinated, with just 32,833 having received both doses.
 
Exact figures remain unknown, however, as it has not been mandatory for aged care providers to supply governments with information about staff immunisation.
 
Dr Altaf says many who work in aged care have been left out of in-reach programs.
 
‘Aged care staff have essentially been left to see if there were any leftover vaccinations at the end of the day, as opposed to having a designated supply,’ he said.
 
‘So many just didn’t have any access at all, even after waiting for the allotted date.’
 
Others who were able to secure their first dose were left waiting their second.
 
‘We’ve got this promise of, “All staff and all facilities are going to be done”. Within a couple of weeks, it changes to, “Oh we’re not doing staff now”,’ Dr Patel said.
 
‘So you had situations where staff were half vaccinated [and] they were then stuck.
 
‘That damaged confidence of the aged care staff, which I’m sure affected uptake. It is really shocking.
 
‘General practice would have done this within 10 weeks … just with a little bit of support, and some trust.’


Dr Khayyam Altaf has ‘no doubt’ the current situation could have been avoided if GPs were more involved in aged care vaccinations.

Delays in the rollout have also affected the administration of influenza vaccinations.

Dr Patel said many GPs were forced to hold off until aged care homes could supply a date for COVID vaccinations, in order to ensure they could adhere to the initial recommendation of a two-week wait between the flu and COVID vaccines, a challenging feat that was further affected when residents started to be offered AstraZeneca instead of Pfizer.
 
‘This wasn’t very well communicated at all to general practitioners,’ Dr Patel said.
 
‘The reality is that this is policy that’s just been made up as they go, without any clear strategic thinking, and the most valuable piece of the jigsaw in terms of ensuring a good outcome – the GP – has been completely left on the side.
 
‘And so the people who are suffering are going to be residents and staff. It’s just not acceptable, and someone needs to be accountable for that.’
 
To help ensure residents and staff are protected, the Australian Health Protection Principal Committee is now considering whether to make COVID vaccinations compulsory for workers in the sector.
 
Meanwhile, it was announced on Tuesday that Victoria will undertake a five-day vaccination blitz for workers in private aged care facilities, as well as those in the residential disability sector. Commencing on Wednesday 2 June, workers will be given priority access to walk-in vaccination hubs around Victoria between 9.00 am – 4.00 pm.
 
But Aged and Community Services Australia (ACSA) is calling for vaccines to be administered in workplaces to help ensure easy access.
 
Despite growing anxieties over the outbreak, Federal Aged Care Services Minister Richard Colbeck told the Senate Estimates Committee the Government is ‘comfortable’ with the pace of the rollout.
 
‘Everybody would have liked to do it faster but logistically we have done it as quickly as we possibly could. Except for a few in a couple of states, all of the facilities have received their first dose,’ he said.
 
Dr Altaf disagrees, maintaining it could have been done a lot quicker.
 
‘It’s mind-boggling. If GPs were involved, we would have been able to get the most important staff and residents of aged care facilities vaccinated at the start,’ he said.
 
‘We would have been able to avert this crisis, I’ve got no doubt about that.’
 
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