Pharmacists should be allowed access to NIP flu vaccines to boost the number of people vaccinated and increase herd immunity, writes Anthony Tassone
Warnings that this year will see another severe flu season should be the catalyst for a major expansion of the National Immunisation Program (NIP) nationwide, to ensure that the impact of the flu is contained as much as possible.
From 1 April, the Commonwealth Government acknowledged the start of the flu vaccination season by making flu vaccines available under the NIP. This recognises the need to vaccinate as soon as possible to reduce the risk of getting the flu.
The need to vaccinate and develop herd immunity has never been clearer, with the annual death toll from the flu and flu-related conditions reaching 3,000 in Australia.
But there remains some complacency amongst the public. A Pharmacy Guild survey this year has shown that some 50% of Australian adults do not plan to vaccinate against the flu this year despite last year’s record flu season which saw more than 249,000 laboratory confirmed infections.
The survey found also that 43% of Australian adults fail to understand that annual flu vaccination is required for optimal protection against the virus, and 57% mistakenly consider themselves to be at low risk of contracting the flu.
From last year, appropriately trained pharmacists across all States and Territories of Australia have been able to administer adult flu vaccinations but, despite this, in all jurisdictions besides Victoria they are prevented from accessing the free vaccines available under the NIP for eligible patients.
The NIP was set up by the Commonwealth and State and Territory governments in 1997 with the stated aim “to increase national immunisation coverage to reduce the number of cases of diseases that are preventable by vaccination in Australia”.
Under the program, those eligible for free vaccines include children under the age of six months and others with medical risk factors, Aboriginal and Torres Strait Islander children six months to less than five years, Aboriginal and Torres Strait Islander peoples 15 years and over, people aged 65 years and over, and pregnant women.
But as of now only one State, Victoria, enables pharmacies to access flu vaccine stocks under the NIP.
All other States and Territories need to allow pharmacists access to NIP flu vaccines to boost the number of people vaccinated and increase the desired herd immunity. The fact that Victoria has effectively and seamlessly moved to increase the protection for its communities by giving pharmacies NIP vaccine access is a benchmark for other jurisdictions to follow.
Striving for achieving herd immunity is a team effort across the health profession team delivering vaccinations – doctors, nurses, pharmacists and those within the community agreeing to be vaccinated.
Policymakers must not blindsided by spurious arguments by some doctors’ groups that pharmacies delivering vaccinations poses a ‘health risk’ for patients. It’s exactly the opposite. Pharmacists not having access to the NIP across the country is an anomaly which at best is short-sighted and at worst a public health risk.
It is a contradiction in health policy that some of the most vulnerable in our community – such as those aged 65 and over – can’t get NIP vaccines through the most accessible health professionals at their community pharmacy. Not all patients have ease of access to a GP or even have a regular GP at all.
Perceived fears of ‘fragmentation of care’ in receiving health services (from a competent health professional within their scope of practice) other than a doctor does not justify a delay in care or potentially no care.
Compare that with the often walk-in service provided by pharmacists and you have a copper-plate argument for expanding full NIP access to all pharmacies across the country.
NIP access would also address another troubling issue over the provision of relevant information about vaccines to pharmacists. Many pharmacies report they are not fully informed by their respective departments of health about the specific vaccine for the over 65-year-old age group (e.g. high dose trivalent vaccine/Fluzone, and trivalent adjuvant/Fluad) that are on the NIP.
Access would also remove the disparity of community pharmacy not having access to high-strength trivalent for over 65 year olds which is only available through the NIP.
The other contradiction in the limited NIP access is that pharmacists are being trained in vaccination in some States for certain scope of service – such as in Victoria where training includes vaccinating for measles, mumps rubella, DTP, Hepatitis A and B – yet are not allowed to immunise against these conditions.
Access by community pharmacies to NIP vaccines is good health policy which will produce very positive outcomes. We need to act now.
Anthony Tassone is President of the Victorian Branch of the Pharmacy Guild of Australia and a National Councillor of the Guild.