Rural patients and those living in lower socioeconomic areas are struggling to access Covid booster shots, experts are warning, amid concern the vaccine rollout is “falling behind” as the Omicron variant spreads.
General practitioners and pharmacies are reporting a sudden increase in demand for vaccines, after federal health advice changed to allow boosters five months after the second primary dose.
Representatives of the aged care sector said the rollout for residents and staff was improved from earlier this year, with more than 1,000 booster clinics conducted in aged care facilities already.
But rollout problems are emerging in other areas.
Some GPs caught off guard by the weekend’s announcement said they were left without enough supply to meet demand. Demand on pharmacies also increased suddenly and significantly.
The Australian Medical Association said it was “extremely concerned” at the lack of support for both GPs and pharmacists, and warned the booster rollout was already falling behind.
AMA president Dr Omar Khorshid also warned against scaling back state and territory vaccination hubs.
“Whilst we recognise that the state and territory vaccination hubs have taken nurses out of hospitals, aged care, and other health settings, it is critical that state and territory governments continue to run these clinics to ensure adequate access to vaccines for Australians needing their booster shot,” he said.
Figures from the Pharmacy Guild of Australia show in the week leading up to the announcement, just under 20,000 vaccinations a day were delivered. On Tuesday, that figure rose to 40,000.
At the same time, the guild has warned that vastly fewer pharmacies will be participating in the rollout of boosters, down from 3,400 pharmacies in the initial rollout to 1,900, due to the government’s low level of remuneration.
Victorian branch president, Anthony Tassone, said the rate of $16 per booster dose was seen as “not sufficient to cover the true costs of delivery of the program”.
Access issues are particularly pronounced in rural areas.
Megan Belot, the president of Rural Doctors Association of Australia, said the access to booster shots for rural patients has been disappointing.
“We are hearing stories that some state vaccination hubs in regional and rural areas are not getting access to the booster shot in a timely manner,” Belot said.
She said the issue was especially concerning for rural and remote frontline healthcare professionals, because booster shots are vital to avoid hospitalisation and putting increased strain on an already burdened system.
Belot said there was strain on rural and remote hospitals at the best of times even before the Covid-19 pandemic and that many rural and regional hospitals did not have intensive care units to treat severe Covid-19 cases.
Rebecca McGowan, a rural GP in Albury, says organising booster shots for her patients has been a “shambles.”
She said for GPs to only find out on a Sunday evening, at the same time as the public, that booster shots would be pushed forward meant that by Monday morning she was inundated with calls from patients asking to be booked in.
McGowan has had difficulty securing booster shot appointments for her patients, because she has had to prove that she has appointments booked for a full clinic two weeks in advance of being able to secure the supply.
“We keep being told GPs are partners, but we’re not being treated as equal partners, but more like an afterthought,” McGowan said.
She said there was added pressure for rural GPs because of the difficulty of staffing the clinics, especially as the booster shot program will now be running alongside vaccinating children.
GPs like McGowan in the Albury-Wodonga area also face the challenge of having patients who straddle two states.
Belot said another problem was programs that attempt to vaccinate remote populations in a two-day period often don’t accommodate those who are occupied with farming activities and can’t fit into the allocated window.
In Melbourne, Prof Mark Stoove from the Burnet Institute warned of a slower take-up in lower socioeconomic areas if the booster program was again run through pharmacies and GPs.
Until October, when there was a targeted campaign from state and local governments, Melbourne’s vaccine rollout ran along socioeconomic lines, with age, disadvantage and access to GPs mixing to create a perfect Covid cocktail.
In August, Delta was rapidly spreading through Melbourne’s northern suburbs as some of the state’s lowest socioeconomic LGAs lagged on vaccination rates.
“There will still be issues concerning the availability, according to the distribution of GPs and pharmacies,” Stoove said.
“Certain areas have a lower density of GPs and pharmacies, so if the booster rollout primarily occurs through those avenues we will come across those problems.”
In August the LGA of Hume had one of the lowest vaccination rates and highest daily case numbers. One of the key reasons was the low number of GP clinics per population.
As vaccination rates caught up, the state has peeled back its hubs in the area, but councillor Joseph Haweil, who was mayor during the outbreak, says the community can’t rely on a GP-driven model.
“Just how little supply and support there was through the GP system, I’m worried that is replicated again,” Haweil said.
“I don’t think we can afford to have that happen again.”
Cohealth is a not-for-profit on the frontline of the vaccine rollout in Victoria. It targets communities that have access issues and in the last six months, they’ve set up vaccination pop-up clinics in more than 50 separate locations.
Cohealth’s community engagement manager Emit Taylor said it was too early to tell what barriers would have to be addressed with the booster rollout.
“We’re still not quite in booster town,” Taylor, who uses they/them pronouns said. “We’re not quite sure what the hesitations will be.”
Cohealth is tailoring its approach to each community, making sure language and access barriers are broken down.
Taylor said there was a lot of work done to make strong community connections before the service will set up a pop-up – which will be essential when the need for boosters becomes more prominent.
