The Royal Australian College of General Practitioners (RACGP) is calling on state and federal governments to clarify vaccine eligibility criteria, promote consistency between states and territories, and consider expanding access to groups more likely to contract the Covid-19 virus or suffer severe effects.
It comes following several changes to eligibility for Covid-19 vaccines and different criteria applying depending on where a person lives and how they will access a vaccine. Whilst Doctors understand the shared decision making necessary to tailor these messages, some patients appear to be confused regarding the regular change and updates.
For example, in Western Australia, anyone over the age of 30 is eligible to receive a Pfizer vaccine, while anyone over the age of 16 can get that same vaccine in the Northern Territory and some rural areas of South Australia. In Greater Sydney, patients who have had their first dose of the AstraZeneca vaccine are now being encouraged to consider having their second dose at six weeks rather than 12 weeks.
In addition, the Government announced on 28 June this year that any Australian aged under 60 can receive the AstraZeneca vaccine after talking through their options with their GP. This is only applicable to Commonwealth sites such as general practices, not state-based vaccine hubs, creating even more confusion about where people can get their vaccine.
RACGP President Dr Karen Price says it is time for consistent messages from governments across Australia.
“The RACGP is calling on the federal, state, and territory governments to make it crystal clear who currently has access to which vaccine and where they can get them,” she says.
“Patients across Australia are suffering from ‘information overload’ and confused about their eligibility status and what next steps they should take. The goalposts seem to be shifting every other day and I am concerned that some patients will find it all too difficult and delay or avoid getting vaccinated altogether.
“Different states and territories might need different eligibility settings for perfectly good reasons to suit the local context and needs, such as what we are currently seeing in Greater Sydney. However, practices administering vaccines in locations where the state eligibility requirements differ from the federal eligibility requirements are shouldering an unnecessary burden.
“Many patients don’t realise that different rules apply to state government-run vaccine clinics and GP-run clinics, with general practices following federal rules because the Commonwealth is responsible for the rollout to general practice.
“Compounding this problem is the fact that GPs, nurses, receptionists and administrative staff are relying on updates from the Prime Minister, Premiers, Chief Ministers, Chief Health Officers and other public figures on their TV screens. Sometimes new information is being delivered in the middle of a working day when they are busy delivering vaccines to patients whose eligibility may be subject to change.
“Due to this, our hard-working general practice staff are spending valuable time comprehending and explaining the new rules. They are bearing the frustrations and sometimes aggressive behaviour from patients who don’t understand why they can get a particular jab at one place and not another.
“It is wasting time and causing unnecessary pain for practice teams at a time when they are busier than ever doing the job of rolling out Covid-19 vaccines as quickly as possible, while also continuing regular care for their patients.
“Governments need to work together through national cabinet to ensure that each jurisdiction’s eligibility criteria are clearly available to all vaccine providers and patients, and information needs to be updated immediately as changes occur and reach the people who need it.
Dr Price says there needs to be a national conversation regarding local vaccine eligibility criteria for new groups of people, particularly considering the Delta variant is spreading in New South Wales.
“The environment has changed the risk, and this can be communicated clearly,” she says.
“The federal Government should seek ATAGI advice regarding opening up vaccine eligibility to teachers, pregnant women and people living with healthcare workers, older people or Aboriginal and Torres Strait Islander people, who are currently not eligible to receive a Pfizer vaccine,” she says.
“Teachers work closely alongside children who are understandably ill-equipped to practice social distancing and are at times super-spreaders of this virus. As reported recently, health experts have said that pregnant women should be offered the Pfizer vaccine at any stage of their pregnancy. This is because the risk of severe outcomes from Covid-19 is significantly higher for pregnant women and their unborn baby.
“People living together in households are far more likely to spread the virus to each other, so it makes sense to expand access to people living with healthcare workers, other frontline workers and vulnerable groups who currently don’t qualify for a vaccine.
“It is true these people can potentially receive the AstraZeneca vaccine after a discussion with their GP but we are seeing that many Australians are reluctant to take up this option given the constantly changing advice on who should receive the vaccine has eroded patient confidence.
“AstraZeneca is a sound option when compared to the risks of the Covid-19 virus, especially for more vulnerable patients including older people. The second dose in particular is essential to protect against severe hospitalisation, severe illness and death.
“However, making vaccines more available for at-risk groups that don’t currently fit within the current Pfizer eligibility criteria will help stop the spread of this virus when outbreaks occur. This should include not only general practices but the state-run vaccine hubs.”
