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WA Government expands community pharmacy vaccination


Matt Woodley


21/04/2022 2:32:32 PM

The RACGP has questioned whether there is evidence to support the policy shift, warning the decision could have unintended consequences.

Young child waiting for vaccination.
Children as young as five years old could soon start receiving their influenza vaccinations at West Australian pharmacies.

Western Australia has further expanded its community pharmacy vaccination program, in what the RACGP has described as a step in the wrong direction.
 
The decision means that from Monday 26 April, pharmacists will be able to administer Government-subsidised influenza vaccines to children aged five years and above, having previously been restricted to private vaccinations for those aged 10 years and older.
 
A statement released by WA Health Minister Amber-Jade Sanderson also revealed that the following vaccinations are due to be extended ‘later in 2022’, although a specific date was not provided:

  • Human papillomavirus (HPV) and diphtheria-tetanus-pertussis vaccines for persons aged 11 years and older (previously not available in pharmacies)
  • Meningococcal ACWY for persons aged 15 years and above (previously 16 and older)
Meanwhile, measles-mumps-rubella vaccines will continue to only be available for people aged 16 and above, but will be subsidised for recipients over 20 years old.
 
RACGP President Adjunct Professor Karen Price responded to the move by warning that the changes could have unintended consequences.
 
‘Patients are better off receiving their vaccines from their usual GP,’ she said.
 
‘Extending the community pharmacy vaccination program in Western Australia is not a sound decision and takes the state in the wrong direction when it comes to vaccinations.’
 
Professor Price said while pharmacists may claim that general practice requires support as GPs manage patients who have delayed or avoided screenings and consultations during the pandemic, it is not a valid reason to expand pharmacy vaccination.
 
‘It [will lead] to fragmentation of care during this critical period as pandemic-life returns to normalcy,’ she said.  
 
‘Where is the modelling? Is this an evidence-based policy or is this the result of political lobbying? Are we providing a solution to a problem that doesn’t exist?
 
‘There is evidence of the benefits of embedding non-dispensing pharmacists within practices and the RACGP is always keen to explore collaborative solutions; however, these changes are not something we support.’
 
RACGP WA Chair Dr Ramya Raman shares Professor Price’s concerns, saying that pharmacies are not as well equipped as general practices to deliver vaccines.
 
‘Patients must wait for a period of 20 minutes after being immunised, and at a pharmacy that often means milling around a crowded retail store because there is no separate consulting or waiting area,’ she said.
 
‘This is particularly problematic at a time when there is increased risk of transmission of respiratory illnesses, including COVID-19.
 
‘Pharmacists also may not have the appropriate environment to respond to rare risks such as anaphylaxis.
 
‘So, if something goes wrong, that is a real problem.’
 
In May 2019, Tasmania became the first state or territory in Australia to reduce the age of patients who could receive influenza vaccinations to 10 years old, with the previous cut off being 18.
 
It was followed by WA a few months later – in a move also criticised by the RACGP – before a wave of regulatory changes in 2020 subsequently reduced the cut off to 10 years old in all other Australian jurisdictions.
 
Regardless of these decisions, Professor Price said general practices remain ‘the safest place’ for patients to receive vaccinations.
 
‘We draw on a detailed and comprehensive patient history and, not only that, we are well-equipped with the training and facilities to respond promptly in the very rare case that a patient responds adversely to a vaccination and needs urgent medical attention,’ she said.
 
‘Receiving your vaccines at your local practice provides your GP with an opportunity to detect other chronic health issues.
 
‘[For example], HPV vaccinations provide an opportunity for GPs to discuss broader sexual health matters and conduct preventive screening activities, and childhood vaccinations allow us to screen for “red flags” such as problems with speech, motor and cognition skills and problems with social or emotional skills.’
 
AMA WA President Mark Duncan-Smith also spoke out about the decision following the State Government announcement.
 
‘Such a change in the way vaccinations are delivered in Western Australia has the real potential to fragment patient care by doctors, and result in worse outcomes for patients,’ he said.
 
In a WA Government report in 2021, it was found that 50% of flu vaccines were wasted by pharmacies during the period of 2018–20, or not registered with the federal immunisation registry.
 
‘Any potential deal with the Pharmacy Guild on this matter represents only a small proportion of WA pharmacists and does not demonstrate true consultation with relevant stakeholders.’
 
WA Health did not answer questions prior to publication as to why it had added pharmacies to the NIP, nor whether it had evidence or modelling to support the policy change.
 
Pharmacy-administered flu vaccine age limits by state and territory: 
 
  • ACT: 10 (since 2020)
  • NSW: 10 (since 2020)
  • NT: 10 (since 2020)
  • Qld: 10 (since 2020)
  • SA: 10 (since 2020)
  • Vic: 10 (since 2020)
  • Tas: 10 (since 2019)
  • WA: Five (since 2022)
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