Pressure on GPs as pharmacies drop out of COVID booster rollout

GPs have raised concerns about their role in the COVID-19 vaccine booster program, with access options set to narrow for the next phase of the rollout in Australia.
 
Nine Newspapers reported this week that around two-thirds of Victorian pharmacies involved in the primary course rollout have not signed up for supplies of Pfizer – the only vaccine approved for boosters so far – for the booster program.
 
As state vaccination hubs also begin to wind down, it could mean general practice has more responsibility for the booster program than anticipated, with some GPs unsure how they will make it work.
 
‘It’s not surprising to see people wanting to drop out of the booster program,’ Dr Michael Wright, Chair of the RACGP Expert Committee – Funding and Health System Reform, told newsGP.
 
‘As the state vaccine clinics shut down, this will put more pressure on primary care services, particularly general practices, and we need to shift those resources to the people who are giving the vaccines.’
 
Dr Wright said the booster program is set to be an important part of the vaccination efforts but said that more support is needed for general practice to make it work.
 
‘GPs have done the heavy lifting in the vaccine program and are keen to provide the care our patients need,’ he said.
 
‘However, we can’t keep doing it at the cost of either running our practice into the ground, because it’s unsustainable, or because we’re not resourced or equipped to do it safely.’
 
Earlier this week, Melbourne GP Dr Joe Garra also said he is unsure about how to manage the practicalities of administering the booster shots.
 
‘A lot of us are still trying to work out how we’re going to do the boosters,’ he told newsGP.
 
‘We’re probably going to do try to do them opportunistically as people come in. “Oh, look, by the way, it’s been seven months since your last vaccine. We’ve got some ready, do you want one now while you are you here?”
 
‘We’re hoping to do lots of people that way … because the booster dose is not going to be as time-critical [as the two primary care doses].’
 
Dr Wright acknowledged the dynamics of the booster program will be different to the primary course and said more needs to be done to ensure that vaccination is part of routine care, where possible.
 
‘As the levels of vaccine remuneration are so low, and because they have to be bulk billed and can’t be associated with normal billing practices, most practices can only do this in vaccine clinics,’ he said.
 
‘That’s not business as usual. It’s going to be a challenge for the program if GPs aren’t given more flexibility to roll it out as part of normal care.’
 
The launch of the national booster program was announced last month and officially got underway at the beginning of last week (8 November). 
 
The Federal Government kept in place the MBS item numbers used for second doses of COVID vaccines for the administering of booster shots.
 
Only a small proportion of the population, including healthcare workers, are currently eligible for a third dose of the vaccine. Many general practices did not start administering second doses until at least mid-June, meaning patients will not be eligible for a booster until shortly before Christmas at the earliest.
 
As such, there have been calls from some GPs to reduce the recommended gap between second doses and booster shots below six months to allow more of the existing vaccine stock to be used.
 
This week, UNSW epidemiologist Professor Mary-Louise McLaws also told newsGP she believes the Government should reduce the gap as the available vaccines often show a significant decline in protection against infection sooner than six months after a primary course.
 
According to the latest Government figures, almost 300,000 people have received a third dose of a COVID-19 vaccine in Australia so far.
 
However, the statistics do not distinguish between those who have received a third dose due to severe immunosuppression, which is categorised as part of the primary course, and those who have received a third dose as a booster.
 
The head of the Therapeutic Goods Administration (TGA), Professor John Skerritt, said last month that around 1.6 million people will be eligible for the booster by the beginning of 2022.
 
Dr Wright, in the meantime, highlighted the significant task still facing GPs in immunising the vaccine-hesitant and those who have been unable to receive a vaccine so far.
 
‘We still need to help the remainder of Australians to get immunised, as well as vulnerable people who need to get access to their third shot,’ he said.
 
‘There’s a lot of work for GPs to do, but they need to be resourced to do it properly and the current Medicare items are inadequate and inflexible.
 
‘It’s limiting the ability of GPs to do the job that’s needed.’
 
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