Pharmacist travel vaccines pose ‘Russian roulette risk’, says AMA

Pharmacy organisations have hit back at the AMA’s claims that pharmacist-administered travel vaccinations could be deadly

Holidaymakers could be “dicing with death” under proposals to allow pharmacists to deliver live travel vaccines, the Australian Medical Association (AMA) has announced in a statement on Friday.

Findings from the Queensland Pharmacy Inquiry, released in October, recommended that the Health Department develop options for pharmacists to provide low-risk vaccinations, including low-risk travel vaccinations, subject to a risk-minimisation framework.

AMA Queensland doctor and Australian Travel Medicine Alliance medical spokesperson Dr Deb Mills said she was “horrified and appalled” the proposal was being considered.

“This is not a trivial issue. Death or serious illness can be the result if a live vaccine is inadvertently given to someone who has a weakened immune system,” she warned.

Dr Mills said live vaccines were not the same as a tetanus or flu shot and had special risks that required a comprehensive overview of the patient’s medication and health status.

“It is a live product, which means it contains specially prepared organisms that can multiply in the person vaccinated,” she said.

“If that person has a compromised immune system – and they may not be aware if they do – the vaccine strain can run amok in the body and cause a great deal of damage, even death.”

Dr Mills said pharmacists were not trained to assess the health of a person’s overall immune system.

“Drugs people have taken in the past can place them at serious risk from live vaccines so it’s not a matter of assessing current medications and making a decision on the spot,” she said.

AMA Queensland President Dr Dilip Dhupelia said the proposed legislation was premature and unsafe.

“I am sure that no pharmacist wants to be inadvertently responsible for causing serious illness or worse to patients,” he said.

“It is absolutely critical that live vaccines are managed by GPs or specialised travel vaccine providers who are extensively trained to assess the risk benefit of such a product.’’

Pharmacy Guild Victoria branch president Anthony Tassone labelled the AMA statement as “scaremongering”.

“The AMA’s scaremongering and constant sense of outrage at any prospect of another health professional practising to the top of their scope is hopelessly out of touch with the preferences and needs of patients and the broader public,” he told AJP.

“The scope of practice of pharmacists, or any autonomous health profession is not determined by the AMA or any other reticent doctor’s group but by regulators, policy makers and – just as importantly – the public.”

Mr Tassone pointed out that the recommendations from the Queensland parliamentary inquiry follow what has already been legislated in Victoria, where pharmacists can administer live vaccines such as measles-mumps-rubella.

“It is important that states and territories have a harmonised approach to immunisation, including what pharmacists are authorised to administer,” he said.

“Jurisdictions that are not as advanced as others should become consistent with more progressed states and territories for benefits to patients and the broader health system.”

PSA national president Chris Freeman agreed that the AMA’s comments were “alarmist”.

“These comments directed at the ability of pharmacists to administer vaccinations again will undermine the communities support and understanding of the rationale for vaccinations,” he told AJP.

“It really is causing mixed messages and is putting the safety of patients at risk by suggesting that a pharmacist-administered vaccination is any less safe than one administered by another health professional who is authorised to do the same vaccination.”

He said the PSA maintains that a wider range of vaccinations can and should be administered by pharmacists and recognises that some vaccinations will require additional recognition and training programs to ensure the practitioner is fully competent to administer them.

“In patients with more complex health needs who require a travel vaccination, it would be appropriate for the pharmacist to refer them to their general practitioner. However, this would be a relatively small proportion of the population seeking such a service,” said Dr Freeman.

“The PSA acknowledges the central role general practitioners play in the primary care sector. However, this type of messaging is alarmist and unfortunately seeks to undermine the opportunity for pharmacists and doctors to better work together.

“As an organisation, PSA would prefer to have discussions directly with the AMA and other stakeholders around health system challenges, than continually needing to respond to media releases. This approach to health policy debate is not in the best interests of patients.”

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