Last Monday, Prime Minister Scott Morrison caused a bit of a ruckus amongst state leaders and the general public by announcing that under 60s could get the AstraZeneca vaccine.
The vaccine had initially been identified as our primary vaccine in the fight against COVID. However, not long after the TGA gave clearance for the vaccine to be used across the population, complications arose when it was discovered that it had been linked to very rare instances of blood clots in some people.
Subsequently, the vaccine was restricted to those over the age of 50. When this proved to be too young an age bracket to get the vaccine without risk of these, again, incredibly rare side effects, the recommended age was upped to 60.
When Morrison announced, almost without warning, that anyone could get the vaccine if they choose to after a consultation with their GP, phones in healthcare departments and governing bodies started ringing off the hook as people sought clarity over whether or not they should, could, or would be getting the AstraZeneca vaccine.
We put all the questions you might have about getting AstraZeneca to Dr Cathryn Hester, GP at Colleges Crossing Family Practice in Karana Downs, South-West of Brisbane.
She’s the Deputy Chair of the Royal Australian College of General Practitioners Queensland and a board member of West Moreton Hospital and Health Service.
Here’s what she had to say.
The Latch: Hi Dr Hester, thanks for taking the time to speak with us. What has it been like for GPs since the announcement?
Dr Hester: Well, it has been a bit of an anxious and confusing time for a lot of people, including GPs who are all just trying do the right thing by their patients. As a GP, I find it best to go back to basics and try to follow the ATAGI guidelines and recommendations as closely as possible.
Where it gets this gets confusing for people is that anything in medicine doesn’t usually have one set of hard and fast rules but a set of guidelines that need to be appropriately managed and considered for individual patients.
At the moment, during the COVID pandemic, this can change week-to-week, and even day-to-day, so assessing somebodies risk factors can change very quickly.
I would say to people generally that the best thing to do is actually have a chat to your GP, who will be familiar with the ATAGI guidelines but will also be familiar with your health and your particular situation and the risk factors that you might find yourself in.
TL: ATAGI is now saying, contrary to the government, that they wouldn’t recommend AstraZeneca to those under the age of 60. Why would the government, therefore, say it’s fine?
DrH: I think it’s fine in some situations.
So, where a patient understands the options that are available to them, and also their individual risk factors for COVID and the potential side effects of vaccination, and they’ve had a good conversation with their GP about consenting to be vaccinated with the AstraZeneca if they’re under 60.
That’s something that has to be assessed on a case by case basis and speaking to your GP should be the first step in understanding your situation.
TL: Are you personally getting a lot of calls asking for clarity around the situation?
DrH: Yeah, absolutely. It feels like I’m having about 100 consults a day with people asking the same questions.
I can really understand that because people are both scared of catching COVID and the complications from that and they’re very anxious to do the right thing and also to protect their communities and they don’t quite know what to do.
So, I’m having a lot of conversations with patients about if you’re between the ages of 14 to 60, what is the best path.
For some people, they probably will be thinking of getting vaccinated with AstraZeneca because that’s what’s available at the moment.
But we know that is something that does have to be carefully considered, because we know that the Pfizer shot will be available later in the year.
TL: Does it seem strange that something as significant as getting vaccinated against a viral pandemic is being put in the hands of the individual and their GP?
DrH: In Australia, fortunately, we’re actually relatively low risk from COVID infection – currently.
It’s difficult because we also have to assess our future risk of exposure to COVID and we’re all trying to make the best guess in a rapidly moving environment.
How much risk do we tolerate for the vaccination versus how much risk do we tolerate for people actually being exposed to, and potentially contracting, COVID?
In the areas of Australia experiencing lockdown at the moment, we’ve seen surges in people getting to be vaccinated because their risk assessment of their current situation has escalated, which to be honest I think is actually an appropriate response.
TL: So it’s not so much vaccine complacency but people re-evaluating their risk based on the changing environment as to why more people are getting vaccinated now?
DrH: Absolutely. It’s fantastic that we’ve been able to be complacent, to be honest, because we’ve been so safe.
I guess it’s up to the health professionals to keep encouraging people to seek vaccination for diseases that are preventable, when appropriate, because they know it’s very easy to be exposed to COVID and I imagine this will actually increase in the coming months as our borders restrictions ease up.
I think this is something very important to be mindful of. We do actually want people to be protected against COVID, and vaccination is kind of the best way to do that.
TL: How rational is it to be worried about the side effects of AstraZeneca, given that countries like the UK have used it extensively?
DrH: I think it comes back to the fact that there was very low levels of COVID circulating in the community.
As a health professional, the risk-tolerance for choosing an intervention that of course has some side effects was low. Obviously in the UK, where there were thousands of people passing away from COVID every day, is a very different sort of risk level.
So, we find ourselves in this tricky position of trying to balance finding the safest means to prevent people from catching COVID against maybe accessibility and availability of vaccines. We know that the Pfizer stocks are much less than the AstraZeneca stocks.
We do have to be mindful that, at some point, being protected, whether it’s from AstraZeneca or Pfizer, is going to be really crucial and really important in terms of moving towards a future where we’re allowed to travel interstate and internationally again and conduct our business as usual again.
TL: What advice are you personally giving to patients who are looking to get the AstraZeneca shot?
DrH: My position remains that vaccines are the most powerful tools that we have in healthcare to prevent people from getting sick.
We know that both AstraZeneca and Pfizer are actually really safe in terms of a medical intervention.
I’m encouraging all of my patients to come forward to be vaccinated in accordance with their risk stratification, and also with the ATAGI guidelines.
We do have to play by the rules, we do have to follow the medical guidelines, but as soon as the vaccines become available, as soon as they’re available to your eligibility criteria, I’m encouraging all my patients to get vaccinated.
That’s the best tool we have to protect our communities looking forward.
TL: How hard has it been for you so far to get hold of vaccines?
Well, clinics are starting to take deliveries of Pfizer shots this week, so it will actually become much easier for the general population to access that vaccine.
We’ll be trying to prioritise really important members of the community, like people who work in nursing homes, and then work stepwise from there.
We’re confident, as a professional body. As GPs, vaccinating people is part of our core business and we’re very happy to be part of the process whereby the community becomes protected from COVID.
We’ve had very little trouble getting hold of AstraZeneca. We’ve been able to get enough AstraZeneca vaccines to meet our communities demand for them. So that’s a very good thing.
There’s obviously a delay with the Pfizer shot, and that’s a national thing but also a logistics thing. Of course, you’ve got the very stringent temperature and transportation factors that you have to consider when you’re using the Pfizer vaccine.
Our clinic will shortly be receiving Pfizer vaccines so we can start to protect younger members of our community.
I’m not sure what the supply will be like but I think there are some good plans around Australia producing the Modena vaccine as well next year.
I’m pretty confident that everybody who wants to be able to have a Pfizer vaccine will be able to have that over the coming months.
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