Thousands of general practices to receive COVID vaccine doses within weeks

General practices need to start gearing up for the coronavirus vaccine rollout.
 
That is the guidance of RACGP President Dr Karen Price, following a meeting with Deputy Chief Health Officer Professor Michael Kidd on Wednesday.
 
‘Practices will get a notification [Thursday], if not the next day, about which week they’re involved in,’ she told newsGP.
 
‘There’s an appetite to notify the practices before anyone else.’
 
While it was previously anticipated that only a few hundred practices would be involved in the initial stages of phase 1b, Dr Price said thousands will be quickly added as the rollout ramps up.
 
The new strategy will see fewer doses spread across more practices, and means almost all of the more than 4600 practices approved to take part in the COVID vaccination program will receive doses during the first weeks of the rollout.
 
The new strategy will allow more patients to receive their COVID vaccine at their local general practice, which Dr Price says makes sense from a logistical viewpoint and in terms of continuity of care.
 
‘The aged population has a propensity to want to be vaccinated by their own doctor in their own clinic, and there’s all sorts of transport and [other] issues,’ she said.
 
‘In phase 1b there’s also people with underlying medical conditions. Who decides that? That is a clinical decision, and the best person to make that clinical decision is the patient’s usual GP.
 
‘The smaller volumes of vaccines delivered will actually help with fridge space allocations, too, as that’s also been an issue.’
 
The Federal Government has secured 53.8 million doses of the Oxford University/AstraZeneca vaccine, and it has now been confirmed these will arrive in two different vials – containing either eight or 10 doses – depending on where they have been manufactured.
 
Practices will receive an information pack in coming days that will include a vaccination roadmap and the number of doses the practice has been allocated, as well as guidance on where and how to order stock.
 
‘The other thing to note is that with that onboarding will come some consumables in terms of needles, syringes, and sharps containers,’ Dr Price said.
 
‘The rest of it is likely to be asked to be provided by the practice. Or if that’s not possible, then there’ll be a Commonwealth supply.’
 
Dr Price confirmed the Federal Government has accepted the RACGP’s recommendation for the development of a GP-specific training module for the Oxford University/AstraZeneca vaccine; however, it is unclear when the new module will be ready and all GPs and other health practitioners participating in the rollout will need to have completed the current mandatory training before taking part.
 
‘I understanding there’ll be a lot of redundant material taken out [of the current training], but some of it will be kept in, of course, and the questions will made a little bit better in terms of being streamlined,’ she said.
 
‘But [Professor] Michael [Kidd] did say adult learning applies; so if you think you know everything, just quickly read it and move on, and if you get it wrong you’ll have to go back and do it again. Don’t be too worried about it.’
 
Almost 13,000 people have so far completed the AstraZeneca training, 9000 nurses and 2300 GPs among them.
 
‘So we really need those GPs who are going to be stepping up within a few weeks to be getting onto their modules and not waiting for the revamped one,’ Dr Price stressed.
 
‘They’re acting on it, but it might not be quick enough. So just get them done.’
 
Along with training, Dr Price advised that practices should be thinking about the logistics of the rollout, including staff rosters and contacting patients that classify under phase 1b.
 
‘Logistics and implementation – it’s always the hardest bit and will depend on what volume they are likely to be given and what their clinic structure is like,’ she said.
 
Phase 1b will commence with the people aged 70 and older, Aboriginal and Torres Strait Islander people aged 55 and older, adults with an underlying medical condition, including disability, and critical and high-risk workers.
 
But Dr Price says practices can expect to have some leeway to use clinical judgement when it comes to particularly vulnerable and hard-to-reach cohorts, such as Aboriginal and Torres Strait Islander patients.
 
‘A commonsense approach,’ she said. ‘GPs are used to applying this approach. That is, if they bring in an elderly family member with whom they live and the rest of the family are there, then it makes sense to vaccinate everybody.
 
‘If someone is homeless and they turn up and they’re 30, I would probably be vaccinating them. But if someone who is 40 says to me “I’m travelling around Australia” I would have to think about it and see how the doses were going.
 
‘You don’t necessarily want to be denying people a vaccination, but you also don’t want to be encouraging queue-jumping. This is again where the clinical decision-making is going to have to come in.’


Doses of the Oxford University/AstraZeneca vaccine will arrive in two different sized vials, depending on where they have been manufactured.
 
While there are a number of grey areas for which GPs need to prepare, Dr Price says it is not unlike the complexity they face in their day-to-day work.
 
‘To be honest, I can’t imagine another health professional group who knows their patients as well as we do, so we’re going to be able to make that kind of decision,’ she said.
 
‘If you’re going to [vaccinate] people quickly and efficiently, that level of knowledge shows just how close GPs are to their communities.
 
‘We should be proud of that.’
 
For practices that have the time and resources, Dr Price encourages they conduct a practice run-through to help staff anticipate any issues that may arise and iron out any creases.
 
‘It’s called simulation training and it’s a fantastic way to just check that everyone knows what they’re doing before the first patient rolls in the door,’ she said.
 
The RACGP is continuing talks this week with the Therapeutic Goods Administration to gain further clarity for practices around the parameters of vaccine advertising, and will also be seeking more guidance regarding COVID vaccine item numbers.  
 
‘There’s still some tidying up,’ Dr Price said.
 
‘We’re trying to take the heat out of the anxiety of this because everyone is tired – GPs are tired, the patients are tired, the public health department are tired.
 
‘But it is a constant dialogue, so members’ feedback is really helpful [and] welcomed. And people are acting upon it, their voices are heard.’
 
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coronavirus COVID-19 Oxford University/AstraZeneca vaccine rollout