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General practitioners say they have been blindsided by a decision overnight regarding their administration of the AstraZeneca to under-60s. Some doctors say they are so confused by conflicting advice they are unwilling to administer the vaccine to younger cohorts until they receive official guidance.
Prime Minister Scott Morrison announced a new indemnity scheme on Monday night after a national cabinet meeting, which will allow GPs to administer the AstraZeneca vaccine to any adult who wants it regardless of their age.
From today, all Australians can walk into their general practices and request an AstraZeneca vaccine.
Victorian GP advocate Dr Bernard Shiu said doctors across the country had been surprised by the Prime Minister’s evening announcement, which has confused advice only recently given by the Australian Technical Advisory Group on Immunisation, the expert panel that advises the government on vaccines.
Dr Bernard Shiu prepares to deliver the AstraZeneca COVID-19 vaccine for the first time at the Banksia Medical Centre in Newcomb.Credit:Wayne Taylor
“We are in a very interesting position. Are we listening to the Prime Minister [for] the legal guidelines of what we are capable of, or should we listen to the TGA (Therapeutic Goods Administration) and ATAGI as our clinical fallback system?” he said.
Mr Morrison said the Commonwealth would introduce a new no-fault vaccine injury indemnity scheme for GPs.
“If you wish to get the AstraZeneca vaccine, then we would encourage you to go and have that discussion with your GP,” Mr Morrison said, noting the expert medical advice was that the Pfizer vaccine was the preferred vaccine for people aged under 60.
The change will allow those who want an AstraZeneca vaccine to have that conversation with their doctor, including those under-40 not yet eligible for the Pfizer vaccine.
But, on Tuesday morning, Dr Shiu said GPs did not yet have a billing number that allowed them to charge younger people for that service.
In the meantime, he had already conducted two phone consultants with teachers in their 40s who were interested in getting the AstraZeneca vaccine.
“I actually gave a free service for them,” the Geelong doctor said.
“And I strongly advised them that yes any vaccine is better than no vaccines, and they are both are safe to have AstraZeneca. They are both booking in next Friday.”
Earlier this month, the federal Health Minister’s top immunisation advisers decided to limit the AstraZeneca vaccine to over-60s due to a concerning number and severity of non-fatal cases of a blood clotting condition in people in their 50s and came after weeks of difficult deliberations.
Experts on the Australian Technical Advisory Group on Immunisation told The Age on June 18 that the move to change the clinical advice, another major disruption to the nation’s lagging vaccine rollout, came after analysing months of local and international data.
Melbourne GP Todd Cameron said he would need more information before he would be prepared to dispense the AstraZeneca vaccine to younger Australians, as he was yet to see any official change of the guidance provided to GPs.
“As recently as two-weeks ago [the advice] was it’s not safe to use in the under 60s,” he said.
“Why the complete change of tack? It’s important to articulate.”
However, the president of the Royal Australian College of General Practitioners, Dr Karen Price, said doctors will feel empowered by the Government’s decision to allow people under the age of 40 to request the AstraZeneca vaccine from their GP given there will be a no-fault indemnity scheme.
“Up until now, I think doctors have been reluctant to have that conversation [about AstraZeneca] with those people who are under 60,” Dr Price told ABC’s radio national.
“There was a general fear and reluctance given the uncertain nature of the way that the advice had been communicated and it certainly became a bit of a media storm … about the good versus bad vaccine.
“It became a very difficult proposition for doctors to feel safe going down that path.”
Dr Price said doctors will talk to their patients individually about the risks associated with the AstraZeneca vaccine and what that means for them. (The Pfizer shot is the recommended jab for those under 60, however, people aged under 40 are not yet eligible under Australia’s staged rollout.)
Dr Price said she wouldn’t hesitate to dispense the AstraZeneca vaccine to a person under 40 as long as they consented and were fully informed about the risks, including the extremely rare side effect of blood clots.
General practitioner Nathan Pinskier, who runs six medical clinics across said while there had initially been interest from younger people to get vaccinated with AstraZeneca last month when outbreaks were unfolding across Melbourne, that had dropped off significantly following changing ATAGI advice that the vaccine was recommended for people over 60.
Dr Pinskier, who had his first dose of AstraZeneca this month, said the vaccine’s reputation had taken a battering and a public health campaign was urgently needed to reverse the damage.
“It is a really sensible and pragmatic decision by the government,” he said. “But whether there is an appetite for people under 40 now given all the negative publicity associated with AstraZeneca, a lot of which is unwarranted, remains to be seen.”
Dr Pinskier said his clinics had thousands of AstraZeneca doses in the fridge as demand for the vaccine plummeted in recent weeks.
He was hopeful a push for the younger population to get vaccinated with AstraZeneca would compel national health authorities to consider cutting the interval between doses of the vaccine by up to four weeks.
“We are very concerned by these highly infectious variants of coronavirus we now have in Australia and the only way out of this is vaccination,” he said.
The UK made the move to speed up the second dose seven weeks ago as it sought to combat the highly infectious new variant.
In Australia, advice from the ATAGI and the Therapeutic Goods Administration remains that the second dose can only be brought forward in the case of imminent travel, cancer treatment, major elective surgery, or an anticipated risk of COVID-19 exposure.
With Cassandra Morgan
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