Despite PM’s AZ announcement, AMA urges under-60s to wait for Pfizer

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The Australian Medical Association is urging people under 60 to wait for the Pfizer vaccine if they can, despite a snap announcement by the Prime Minister that any adult who wants the AstraZeneca jab will be allowed to have it.

The AMA’s advice came as more than 12 million Australians faced days in lockdown as authorities in NSW, Western Australia, Queensland and the Northern Territory try to contain outbreaks of the highly infectious Delta variant of the coronavirus. Three Labor premiers have called for restrictions on international arrivals as the country deals with the latest phase of the COVID-19 crisis.

The AstraZeneca vaccine.Credit:Eddie Jim

“We are obviously on high alert,” federal Health Minister Greg Hunt said on Tuesday.

The announcement on Monday evening that any Australian over 18 will be able to access the AstraZeneca vaccine through their general practitioner came without warning, surprising even the Australian Technical Advisory Group on Immunisation, which provides expert advice to the government on vaccines.

Earlier this month, ATAGI changed its clinical guidance to limit the AstraZeneca vaccine to over 60s due to the severity of a number of non-fatal cases of a rare blood clotting condition in people in their 50s

“I think ATAGI was as surprised as the rest of Australia by the announcement last night,” Richard Kidd, one of the experts on the ATAGI working group and the chair of the Australian Medical Association Council of General Practice, said on Tuesday.

Health Minister Greg Hunt.Credit:Alex Ellinghausen

“If there are people who wish to access it, by informed consent, via the existing ATAGI rules, then that is simply being enabled,” he said.

On Tuesday, some general practitioners said they were so confused by conflicting advice, they were unwilling to administer the vaccine to younger patients until they received official guidance from the government.

Dr Khorshid said the AMA received no notice of the Prime Minister’s move, although the group had been consulting with the federal government on the planned indemnity program as well as extending the Medicare item covering COVID-19 vaccine consultations to under-50s.

The details of the indemnity scheme are still being worked on, but it will cover all pandemic vaccines and the period of the pandemic from February 22 this year.

Vaccine uptake expert Margie Danchin said the change allowed all adults the choice of getting vaccinated after carefully weighing up the risks and benefits.

“What the government is doing is making AstraZeneca available for those people who are prepared to take the risk and want to protect themselves against COVID,” said Associate Professor Danchin, who is a non-voting member of ATAGI.

ATAGI remained locked in meetings on Tuesday and Associate Professor Danchin said its advice could be overturned if there was a significant coronavirus outbreak.

“If we do suddenly see a rapid increase in the number and severity of COVID cases then the advice from ATAGI could change, but at the moment, this is really just opening up choice for people in the community who are not protected and want to have access to a vaccine,” she said.

Victorian GP advocate Dr Bernard Shiu said doctors across the country had been surprised by the Prime Minister’s evening announcement, which had confused advice only recently given by ATAGI.

“We are in a very interesting situation. Are we listening to the Prime Minister [for] the legal guidelines of what we are capable of, or should we listen to the TGA [Therapeutic Goods Administration] and ATAGI as our clinical fallback system?” he said.

By Tuesday morning he said he had already conducted two phone consults with teachers in their 40s who were interested in getting the AstraZeneca vaccine.

“And I strongly advised them that yes any vaccine is better than no vaccines, and they are both safe to have AstraZeneca. They are both booking in next Friday.”

Victorian Health Minister Martin Foley also appeared surprised by the news and told reporters it was not a decision of national cabinet, despite the Prime Minister and all state and territory premiers and chief ministers meeting last night.

He said the Victorian government was yet to receive any formal guidance from the federal government and there were still details being confirmed before the vaccine rollout could expand.

While applauding the Prime Minister for introducing the vaccine indemnity scheme, Dr Kidd said that young people who wished to have the AstraZeneca vaccine would not necessarily be able to get it immediately, as GPs were still working through those eligible under phase 1b of the rollout.

”But having said that, anyone who puts up their hand and identifies that they might be at some increased risk will I’m sure be considered by their doctors,” Dr Kidd said.

“And while there is ongoing good supply of AstraZeneca… it may well be for people now who would appear to have been at relatively lower risk will be able to access it a lot sooner than they would have thought.”

Melbourne GP Todd Cameron said he would need more information before he would be prepared to dispense the AstraZeneca vaccine to younger Australians, as he was yet to see any official change of the guidance provided to GPs.

“As recently as two weeks ago [the advice] was it’s not safe to use in the under 60s,” he said. “Why the complete change of tack? It’s important to articulate.”

GPs will be able to claim for vaccine consultations for under 50s by the end of the week.

“We will be extending our Medicare item for over 50s to have vaccine consultation to the under 50s and I think this will be important and that will be developed over the coming days,” Mr Hunt said.

“Significantly, we will update the eligibility checker and provide additional advice to all GPs during the course of the next 24 hours.”

With Rachel Clun

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