COVID-19 Vaccine Rollout: At the coalface

For many, Australia’s COVID-19 vaccine rollout has felt like a game where the rules change as you go. While we can all see the prize of vaccinating our population against this potentially deadly and easily transmissible disease, getting to that point has been equal parts challenging and frustrating.

Despite these obstacles, GPs across the country have been active and willing participants in the program. 

Hunters Hill Medical Practice

For Dr Charbel Badr, who runs Hunters Hill Medical Practice, there was never any question about the practice being involved in the rollout.

“Our practice ethos is to provide multidisciplinary care to patients in the community, so we were always going to provide the vaccine. It shouldn’t be just about the money. Even if the rebate was lower we would do it anyway, because we want our patients to be able to access it. Especially our patients who are older and can’t drive to somewhere like Chatswood or Homebush.”

When the Government put the call out for EOIs, Dr Badr and his team spent more than 100 hours preparing the clinic. Preparations included:

• Converting an upstairs education area to be used as a vaccine hub;

• Creating appropriate signage;

• Establishing a pre-vaccination waiting area with social distancing;

• Creating a post-vaccination waiting area, with social distancing and a staff member to monitor patients;

• Placing timers in the post vaccine area to alert patients when 15 minutes is up;

• Printing Government resources such as consent forms and post vaccination materials;

• Printing vaccination cards for patients to use as a physical record and to keep track of their next appointment;

• A four-hour staff education workshop and dry run of their vaccine clinic;

• Flowcharts for reception, with pathways depending on whether the patient was new or a current, and retrieving medical records from their usual GP if needed;

• Running vaccination information on their waiting room TVs;

• Creating a website specific to their vaccine clinic, which allows patients to download the consent form and/or new patient forms prior to their appointment.

Dr Badr says feedback from patients has been positive.

“I think it also gives patients confidence when they see a process and a protocol in place – they don’t feel like this is something new.”

Initially the clinic received only 50 doses of AstraZeneca a week, which was disappointing, given their readiness to vaccinate more patients.

“The first few weeks we had lots of staff capacity, lots of room capacity, lots of patient demand, but no vaccine.”

The early days of the vaccine rollout were a bit chaotic, with many patients calling, some getting upset and staff struggling to find them appointments.”

“We tried to control it in those first few weeks by concentrating on our most vulnerable people, but as soon as we opened up the appointments online, they would fill in automatically and some of them would fill in with patients from far and wide.”

He adds, “From a continuity of care perspective that created a bit of a mess. Because somebody from Ashfield could come and get their vaccine here, and some of my patients could be going to the Northern Beaches – so just in terms of continuity and medical records – that was a bit difficult.”

The system is working quite smoothly now, but his main criticisms of the rollout is poor supply at the beginning, the Government’s decision to develop a COVID vaccine specific ordering and delivery system (as opposed to using the system already established for flu vaccines), poor education and messaging. 

“All in all, it’s a new program and it’s going to have some teething issues.”

Bridgeview Medical Practice

Drs Thava Seelan and Shanthini Seelan are the principals of Bridgeview Medical Practice, located in Toongabbie. The Western Sydney practice caters to a large multicultural community and has a mixed patient base with a significant number of older patients and vulnerable patients with chronic disease.

“We have been eating, breathing and living COVID vaccinations for the last couple of months,” says Dr Shanthini Seelan.

Bridgeview started vaccinating its patients in April and initially received 50 doses per week, but they began planning for the rollout months before. 

Dr Thava Seelan says the practice held collaborative planning sessions with the practice’s doctors, as well as administration and nursing staff, completed training modules and created a ‘COVID team’ which meets regularly to discuss updated COVID vaccine information and guidance. 

The practice utilises two buildings and has converted an adjacent auditorium to be used as its vaccine clinic. The clinic has been modified to meet the specifications outlined by Government and includes multiple cubicles to allow vaccination of five patients at a time. Whilst they are currently administering 300 doses per week, they have capacity to ramp up to 500 doses per week.

Thava says demand for the vaccine was initially very high but noted increased vaccine hesitancy after media reports of patients experiencing the rare side effect of thrombosis with thrombocytopenia syndrome surfaced.

“However, many of our patients showed delayed acceptance following our positive approach and messaging around the importance of vaccination,” he says.

According to Shanthini, the Government’s decision to use general practitioners to roll out the vaccine was a “master stroke of genius”.

“You cannot do something like this without getting the GPs involved – you need the relationship we have with our patients,” she says. 

“We are not dealing with the mainstream Australian public here – we are dealing with people with varied experiences of the healthcare system … it’s a very unique relationship that we have with them.”

In addition to the supply issues that plagued the rollout at the beginning, the doctors’ other concerns included the loopholes that have allowed people who were not eligible for Pfizer to receive that vaccine at the state hubs, and lack of communication and transparency.

“GPs have been called the protagonists, we’ve been lauded as the saviours, but we would really appreciate some strong support, because we have really invested a lot in this – time, energy, and money,” Shanthini says.