21 April 2022

RACGP and AMA warning on immunisation program decision for Western Australia

The Royal Australian College of General Practitioners (RACGP) and Australian Medical Association (AMA) Western Australia have warned that expanding the community pharmacy vaccination program in Western Australia is a step in the wrong direction.

Under changes announced today the community pharmacy vaccination program will be substantially expanded with influenza vaccines for patients aged five and above and measles-mumps-rubella vaccinations for those 20 and above subsidised by the Government. Pharmacies will be able to administer the flu vaccine to persons aged five years and above and human papillomavirus and diphtheria-tetanus-pertussis vaccines for persons aged 11 years and above as part of the expanded program.

RACGP President Adj. Professor Karen Price said the decision could have unintended consequences.

“Patients are better off receiving their vaccines from their usual GP,” she said.  

“Extending the community pharmacy vaccination program in Western Australia is not a sound decision and takes the state in the wrong direction when it comes to vaccinations. Pharmacists may claim that GPs require support as we manage patients who have delayed or avoided screenings and consultations during the pandemic; however, this is not a valid reason to extend the community pharmacy vaccination program as it leads to fragmentation of care during this critical period as pandemic-life returns to normalcy.

“Where is the modelling? Is this an evidence-based policy or is this the result of political lobbying? Are we providing a solution to a problem that does not exist? There is evidence of the benefits of embedding non-dispensing pharmacists within practices and the RACGP is always keen to explore collaborative solutions; however, these changes are not something we support.

“As our previous RACGP President the late Dr Harry Nespolon said on many occasions - the safest place to get vaccinated is at your local practice. We draw on a detailed and comprehensive patient history and, not only that, we are also well-equipped with the training and facilities to respond promptly in the very rare case that a patient responds adversely to a vaccination and needs urgent medical attention.

“Receiving your vaccines at your local practice provides your GP with an opportunity to detect other chronic health issues. Human papillomavirus or HPV vaccinations for example provide an opportunity for GPs to discuss broader sexual health matters and conduct preventive screening activities; and childhood vaccinations allow us to screen for ‘red flags’ such as problems with speech, motor and cognition skills and problems with social or emotional skills.”

AMA (WA) President Mark Duncan-Smith said that the changes would be detrimental to patients.

“Such a change in the way vaccinations are delivered in Western Australia has the real potential to fragment patient care by doctors, and result in worse outcomes for patients,” he said. 

“In a WA Government report in 2021, it was found that 50 per cent of flu vaccines were wasted by pharmacies during the period of 2018-2020, or not registered with the federal immunisation registry.”

RACGP WA Chair Dr Ramya Raman said that GP practices are best equipped to deliver vaccines.

“Patients must wait for a period of 20 minutes after being immunised and at a pharmacy that often means milling around a crowded retail store because there is no separate consulting or waiting area,” she said.

“This is particularly problematic at a time when there is increased risk of transmission of respiratory illnesses including COVID-19. Pharmacists also may not have the appropriate environment to respond to rare risks such as anaphylaxis so if something goes wrong - that is a real problem.”

Dr Raman also urged the community to ensure they receive their annual influenza vaccine and to use that opportunity to talk to their GP about their preventative health, especially if they haven’t had a health check in the last 12 months.

“This year’s flu season could be a particularly severe one,” she said.

“Many people don’t realise that influenza needs to be taken very seriously. Just before the pandemic in 2019 there were 953 influenza related deaths nation-wide and cases are already emerging across Australia. Catching the flu can be life threatening for some and even for young, healthy people it can be a serious illness.

“So please do the right thing by contacting your local practice and asking when you can book in to receive a flu vaccine. You can help protect not only yourself, but vulnerable members of the community including older people and those with serious underlying health conditions”

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