Practices scramble to adapt to vaccine rollout changes

Jolyon Attwooll

29/06/2021 5:17:16 PM

General practices have had to adapt at speed once again following another significant shift in COVID-19 vaccination guidance.

AstraZeneca vial.
Anyone under the age of 40 can now request an AstraZeneca COVID vaccine from their GP. (Image: AAP)

Following the latest National Cabinet meeting, Prime Minister Scott Morrison said that anyone under the age of 40 could request a vaccine from their GP – at the same time as announcing mandatory vaccinations for all aged care staff and a no-fault indemnity insurance scheme.
But the timing of the announcement, clarity of the advice, and the difficulties in addressing community hesitancy – particularly over the AstraZeneca vaccine – have left GPs concerned.
‘The ability to rollout what it is [the Federal Government] announces, does not necessarily align with supplies, availability and how everything is set up,’ RACGP NSW&ACT Faculty Chair Associate Professor Charlotte Hespe told newsGP.
‘GPs can try and be flexible, but you can only be so flexible. We are still constrained by supplies, manpower and appointments.’
Associate Professor Hespe highlighted the challenge of vaccinating wider age groups, particularly with the perception of AstraZeneca as it is, although she did report interest in the vaccine had increased at her Sydney practice since the Prime Minister’s Monday night press conference.
‘It is realistically about increasing the uptake for AstraZeneca, which had looked a bit dead in the water,’ she said. ‘I think we really need to have a good media campaign.’
RACGP Vice-President Dr Bruce Willett echoed that call, telling newsGP there has been a ‘small’ increase in requests for AstraZeneca at his Queensland clinic.
‘I think the majority of people are confused about the changes,’ he said.
‘It’s going to be difficult to repair the damage to AstraZeneca, and I don’t think this [announcement] is particularly going to change that.
‘It’s unfair and it’s unfortunate that it’s been branded in this way, but that’s where we are now.’
At his Adelaide clinic, Dr Alvin Chua said almost twice the total daily number of calls had been received by 11.00 am on Tuesday morning, the majority of them from people requesting the Pfizer vaccination, with no noticeable rise in interest for AstraZeneca.
‘It’s getting very tiring,’ he told newsGP.
‘We’re supposedly getting 300 Pfizer doses on 5 July, and 85% of those [appointment] slots are already booked, and we only opened [them] this morning.’
He was also critical of ‘mixed messages’ coming from politicians.
‘It’s been extremely frustrating from our point of view,’ Dr Chua said. ‘We have also had to convince the people that have already had their first AstraZeneca that they should already be getting their second.’
Meanwhile, RACGP President Dr Karen Price has urgently advocated that the Government provide more detail following the Prime Minister’s announcement, saying that many practices have been left scrambling by the change.
‘It makes the job of GPs that much harder when we are trying to get as many of our patients vaccinated as quickly as we can,’ she said.
‘We are then left with the task of trying to explain to our patients what changes have taken place, as well as managing those who are taking their frustrations out on receptionists who are doing their best in very challenging circumstances.
‘This is a significant alteration to the COVID-19 vaccine rollout, and it is vital that general practice is given significant time and support from the Federal Government to implement these changes. That includes sufficient stock of the vaccine and guidance for GPs and general practice staff.’
In Victoria, GP Dr Nathan Pinskier also underlined the upheaval in general practices each time the advice changed.
‘We have had to make significant changes to our website, update doctors, protocols, consent forms, update the post in the waiting room. It’s a fairly significant logistical undertaking every time there is a change,’ he said.
‘[But] overall, the change is welcome I think. We look forward to being able to vaccinate a lot more people.’
However, he said the healthcare focus – and the extra administration caused by the changing advice on vaccinations – could come at a cost.
‘You end up diverting your nursing and medical staff into COVID vaccinations. From a long-term perspective that’s not necessarily a good outcome, because it means we are going to see an increase in morbidity and mortality in other areas,’ he said.

‘We need mechanisms that would give us additional capability to do what we normally do.’

Clearer details on state-run clinics were also needed, Dr Price said, following Victorian Premier Daniel Andrews’ comments that state clinics would not offer AstraZeneca to people under 60.
No GP reached by newsGP on Tuesday had received further detail about the no-fault indemnity insurance referenced by Prime Minister Scott Morrison, but all welcomed the announcement, with one calling it ‘long overdue’.
The Government’s new vaccine counselling MBS item number has also not yet been updated to include patients aged under 50, and the Department of Health (DoH) did not respond to requests for clarification prior to publication.
There are now a total of 4849 general practices actively administering the vaccines nationwide, as well as 830 state and territory vaccination clinics, 136 Commonwealth sites, 49 pharmacies, and 158 Aboriginal Community Controlled health services. Another 236 general practices are due to be added to those giving the AstraZeneca vaccine in the next week
For Associate Professor Hespe, the increased urgency surrounding vaccination is welcome, even if some of the details remain unclear.
‘There will be infection in the community – it’s just that we’ve managed to contain it up until now,’ she said.
‘That’s not going to be forever. What you’re doing is managing the risk that’s in front of you. Isn’t that what preventive medicine is all about?’
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Dr Noela Catherine Whitby, AM   30/06/2021 12:58:25 PM

Well said all of my colleagues. Hopefully more rational people who can weigh up risk, will book for the AZ vaccine and will protect themselves and others during the inevitable recurrent winter outbreaks. The supply and stress on practice teams diverted from usual activities will be limiting factors.