Patient safety cited in vaccine turf war


vaccine vaccination

Ongoing debate over community pharmacy involvement in COVID-19 vaccine rollout is “a waste of everybody’s time”, says leading community pharmacist

Lobbying by GP groups against the proposed role of community pharmacists in Australia’s COVID-19 vaccine program has continued into the new year, while other countries are already utilising their pharmacy networks to bolster immunisation efforts.

With the impending rollout of a vaccine – scheduled for mid-to-late February according to an announcement by Prime Minister Scott Morrison on Thursday – doctor groups are ramping up criticism against community pharmacy’s potential role.

RACGP Vice-President and Chair of RACGP Queensland, Dr Bruce Willett told newsGP last week that it is a safety issue.

“Patients should really consider having these COVID vaccinations in general practice if possible,” he said.

“It’s a new vaccine, it’s come out quite quickly and so general practice is a far safer environment.

“Pharmacies are retail spaces, they’re essentially shops,” Dr Willett added.

“The pharmacist is at the back of the pharmacy always for a reason, because they want you to walk through and buy things. They’re not really clinical spaces for administering vaccines.”

AMA Queensland President Professor Chris Perry also recently said the new COVID-19 vaccine is likely to involve a two-dose regimen over a few weeks, and use multi-dose vials, “which requires more skill and training than is available at a shopping centre pharmacy”.

Dr Willett cited additional concerns about the ability of pharmacies to follow up patients for second doses, or appropriately record the vaccinations.

Melbourne community pharmacist Anthony Tassone, president of the Pharmacy Guild of Australia’s Victorian branch, told AJP the ongoing debate is “a waste of everybody’s time”.

“Another year, another swathe of disparaging remarks from the medical profession of the important role that community pharmacy and pharmacist immunisers can play in the accessibility of the COVID-19 vaccine for the Australian public,” he said.

“It is simply a waste of everybody’s time debating whether ‘if’ community pharmacy should be involved, as the only matter needing to be clarified is ‘when’ and ‘to whom’ pharmacist immunisers will deliver the vaccine – as stated in the Australian government’s COVID-19 vaccination policy.

The implementation of the Australian COVID-19 vaccination program is a mammoth task that will need all immuniser hands on deck to deliver to all those Australians who not only wish to receive this vaccine, but to also ensure other vaccination programs including seasonal influenza do not suffer in uptake.

A Pharmacy Guild spokesperson told AJP that the exact role community pharmacies will be undertaking in COVID-19 vaccination in coming months is “actively under discussion”.

Health Minister Greg Hunt confirmed at a media doorstop on Tuesday that community pharmacies will be enlisted into the COVID-19 vaccination program in its second phase, following discussions with the head of the Pharmacy Guild.

Phases 2A and 2B involve a population of over 13 million Australians (up to 31.8 million doses), including adults aged 50-69, Aboriginal and Torres Strait Islander people aged 18- 54, other critical and high risk workers, and any unvaccinated people from previous phases.

General practices join the program in phase 1B to cover elderly adults, Aboriginal and Torres Strait Islander people aged >55, younger adults with an underlying medical condition, and critical and high-risk workers.

“We have the existing vaccination network of general practices and subsequently pharmacies,” said Minister Hunt.

“We have the state-based vaccination clinics, the Commonwealth vaccination clinics, the Aboriginal community controlled health organisations and the hospitals, all of which will deliver that.”

In terms of the total number, we’d like to see as many Australians as possible be vaccinated, said Minister Hunt.

Queensland’s Chief Health Officer Dr Jeannette Young also asserted that the Government would use the state’s network of community pharmacies when a COVID-19 vaccine becomes available in Australia.

“It’s very important that when we do get a vaccine that everyone has access as quickly as possible, and it would be great for them to go to their community pharmacy. We’ll continue to work with the Pharmacy Guild to roll out a program in future,” she said.

Mr Tassone cited overseas examples such as in West Virginia, US, where the state’s network of local pharmacies has played a big role in swiftly administering the new vaccine across the community.

West Virginia is reportedly outpacing the rest of the country, having already delivered vaccines to health workers and completed a first round of shots at all its long-term care facilities. The state is now administering second doses and moving on to other populations.

All other US states have also partnered with pharmacy chains to vaccinate people in long-term care and assisted living facilities.

Community pharmacies are being utilised in the UK’s COVID-19 vaccination strategy as well. According to the Pharmaceutical Journal, the first wave of 200 sites run by community pharmacies started administering vaccines this week.

And while NHS England has yet to confirm the total number of pharmacy-led vaccination centres, UK Prime Minister Boris Johnson told Parliament on 6 January 2021 that “hundreds” had been commissioned to provide vaccinations.

The PM added that community pharmacies will play a “potentially vital role” in the vaccination program, reported the Journal.

Pharmacies in Australia have played a significant role in the past few years in boosting rates of influenza vaccination.

Mr Tassone said: “It’s laughable that the RACGP would put out these statements criticising pharmacies being in ‘crowded environments such as shopping centres… less than ideal in especially in a pandemic’ when during the first and second waves of the COVID-19 pandemic, where GPs had transitioned to telehealth, they were more than happy to refer their patients to the local pharmacy to receive services such as blood pressure and other health checks when the general practice wasn’t available for face-to-face consultations.

“General practice wants pharmacy there when it suits it seems – but we will always be there for the Australian public.”

In response to a May 2020 report, which found pharmacist vaccination underreporting to the Australian Immunisation Register (AIR), Mr Tassone said the Pharmacy Guild and its members support legislative amendments passed in parliament late last year to mandate the recording of vaccinations to AIR in certain instances.

Mr Tassone called on GP groups to collaborate and work together with community pharmacists to make the vaccine accessible to the Australian public.

“Stop the public sniping and start doing what’s right for patient access and care,” he said.

This article was updated on 13 January to include new details on the Australian COVID-19 vaccination strategy.

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2 Comments

  1. Michael Ortiz
    22/01/2021

    I find it interesting that the RACGP and the AMA leadership continue to attack Pharmacy’s commercial business operations, while AMA fee is around double the Government scheduled fee.

    The real issue is about payment. How much will “underpaid” GPs charge for immunising patients? compared with the more accessible pharmacists.

    What the RACGP and the AMA are really worried about is that Government has a policy of paying up to the level of the lowest price for goods and services (minimum pricing policy). This would mean that Government could pay up to the lowest fee (Pharmacists) for the same service and the GPs could lose income. I await Dr Eckerman’s comments on differential payments for vaccinations.

    We need to immunise 20 million people twice because we can’t open the borders until we have 70% of the population immunised. Do the maths – if all 30,000 GPs vaccinate 20 patients a day this would take around 14 weeks. If we add 5000 pharmacies immunising an additional 40 patients a day, then the number will drop to around 10 weeks.

    I doubt the RACGP or AMA want to discuss which venue is easier to access. The Government has an immunisation database that both Pharmacists and GPs can complete. Pharmacists have been safely vaccinating all around the world for the last decade, so safety is no longer an issue.

    The other issues will be vaccine availability and uptake rates. The country can’t afford for a battle over turf to delay the rollout of the COVID19 Vaccinations. More importantly, it is essential that Pharmacists and GPs work together to ensure as many people as possible are immunised as soon as possible.

  2. rose DJOUDI
    28/01/2021

    Pharmacies were in the last year the place were patients came to discuss health concerns when practices were shut and doing Telehealth , we have been open at all times and accessible despite the risks , it is a national emergency that requires cooperation , good logistics and all competent hands on deck , NOW IS NOT THE TIME TO TRY AND SCORE POINTS !!! after the stressful year we have been through , I for one have had enough of these attacks , I have been trying to call my own GP for 2 days no answer !!!! they are too busy dealing with the backlog !!! how are they going to take on that extra load ??

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