Flu jabs no place for turf war: Guild


Pharmacist administers a vaccine. Source: PSA.
Pharmacist administers a vaccine. Source: PSA.

Not all doctor stakeholders share the belief that pharmacist vaccination may put patients at risk, says the Guild’s David Quilty

Writing in this week’s edition of Pharmacy Guild newsletter Forefront, Mr Quilty recounts a conversation he had in 2017 with a senior executive of a doctor organisation.

“This senior executive, who will remain nameless, made clear that their organisation thinks that flu vaccinations in community pharmacies are a good idea because they provide enhanced access for patients who are unlikely to visit a doctor,” Mr Quilty writes.

“While their organisation could not publicly support pharmacist vaccinations for political reasons, there was no valid reason why pharmacists who have received the requisite training should not be able to vaccinate.”

Mr Quilty says he is talking about this conversation because of concerns he has about recent claims by doctor groups about pharmacist vaccination.

“First, pharmacies were criticised for putting patients at risk by encouraging them to get their flu vaccination too early,” he writes.

“Then we were told there was no reason why patients who are eligible for the National Immunisation Program (NIP) should be vaccinated in a pharmacy (in spite of the fact pharmacies are NIP registered in Victoria) and if they did they should not be charged for the service.  

“Then it was grudgingly acknowledged that pharmacies do have a role as a second-best alternative to visiting a doctor.

“Throw into the mix the hoary old chestnuts that pharmacies are not an appropriate location to get vaccinated because of a lack of privacy and the claim that pharmacies (unlike doctors) only vaccinate to make money, and the playbook is complete.

“Little matter that none of these claims are valid; that the doctor organisations themselves probably don’t believe them; and that such comments might actually discourage Australians who otherwise would not get vaccinated from visiting their pharmacy to get their flu shot.”

It’s time for some “pertinent facts” in the debate, he says.

“First and foremost, it is an accepted fact that the best protection against the flu is to get as many Australians as possible vaccinated.  

“The public health benefits of maximising herd immunity dictate that pharmacies play a vital role in vaccinating as many of the millions of Australians who do not visit their GP for a flu shot as possible.  

“Last year, some 69% of Australians did not get a flu shot and everyone in the health system should be working together to reduce the size of the unacceptably high, unvaccinated population cohort, rather than taking pot shots at one another.”

These comments echo the words of PSA national president Dr Shane Jackson, who told the AJP during the debate that arguing over the timing of flu vaccination missed a key point.

“The priority is to immunise as many people as possible – as close to 100% as we can. That should be the priority, and the timing should be the next consideration,” Dr Jackson said at the time.

Mr Quilty points out in Forefront that last year there were nearly 250,000 cases of laboratory confirmed flu reported – and those who it kills are not always those who are eligible for the NIP.

“The flu can be contracted and carried regardless of your age and your overall state of health, making it imperative that as many Australians as possible are vaccinated,” he says.

“Pharmacists are qualified and authorised to vaccinate adults against the flu, just like the GPs and nurse immunisers who often administer flu vaccinations in doctors’ surgeries.

“Over the past three years, as pharmacist-administered vaccinations have been trialled and then rolled out on a national basis, there has been no evidence of any increased risk to patients.

“Infectious disease experts have made it clear that pharmacists did not risk the efficacy of the immunisation program by offering flu vaccinations to healthy adults from late March.”

Indeed Immunisation Coalition director Robert Booy told the AJP in March that people who are well could be vaccinated “now”.

Mr Quilty also highlights advice from the Federal Health Department’s Australian Technical Advisory Group on Immunisation (ATAGI) which states that “the period of peak influenza circulation is typically June to September for most parts of Australia” and “while protection is generally expected to last for the whole flu season, optimal protection against influenza occurs within the first 3 to 4 months following vaccination”.  

“The Guild has passed on the ATAGI advice to member pharmacies and there is no doubt that pharmacists, as trusted health professionals, will pay heed to it when they are having clinical conversations with patients,” Mr Quilty writes.

“In those States and Territories where pharmacists are not registered for the NIP, they will be encouraging older patients to visit their GP to access the new higher immunogenicity, NIP subsidised, trivalent vaccines.

“Influenza is a serious health issue and should not be the subject of turf wars or political game-playing.

“Doctor organisations, which regularly put themselves on a high pedestal when it comes to proffering advice on health and social issues, should be acknowledging publicly that pharmacies have a vital role in maximising community access to flu vaccinations.  

“Imagine the power of a united doctor-pharmacist campaign to get the nation vaccinated for this coming flu season.”

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