General practitioners and state health departments are still in the dark as to how they should roll out third doses of Covid-19 vaccines, despite the commonwealth announcing that 500,000 severely immunocompromised Australians became eligible for a booster jab from this week.
Guardian Australia is aware of eligible third-dose recipients, including a cancer patient undergoing treatment, who have been turned away by GPs and state-run clinics that are yet to begin administering the third doses as they are still awaiting further instruction from the federal health department.
Separately, two sources involved in the coordination of the vaccine rollout in primary care also expressed frustration at the speed with which the third dose rollout for severely immunocompromised Australians was progressing, in the week that New South Wales reopens from lockdown.
In advice released last Friday, the Australian Technical Advisory Group on Immunisation (Atagi) recommended the third vaccine dose for all people aged above 12 who either have conditions that severely weaken their immune defences, as well as patients receiving cancer treatment and other therapies.
An interval of two to six months is recommended between second and third doses. Atagi recommends an mRNA vaccine for a third dose regardless of a patient’s first two doses, but AstraZeneca can also be given as a third dose if an adverse reaction was experienced to earlier mRNA doses.
When announcing the first phase of third doses, the federal health minister, Greg Hunt, said the third doses would be available from Monday for those who were eligible – estimated to be 500,000 Australians.
However, it is unclear if the majority of providers have been able to begin administering third doses this week. Commonwealth vaccination data for Monday, which was released on Tuesday afternoon, did not list any third doses as being administered.
A spokesman for Victoria’s Department of Health told Guardian Australia on Tuesday afternoon that the state’s vaccination centres were still “considering how best to implement Atagi’s advice, with further detail to be announced shortly, once it is available”.
The spokesman urged immunocompromised people eligible for third doses to instead seek information about a third dose from their GP.
The president of the Royal Australian College of General Practitioners, Dr Karen Price, said the third dose rollout “is a big update to the vaccine program and with each change, practices need time to update their processes”, noting the eligibility began only on Monday.
Price said immunocompromised patients should seek advice from their GPs and urged people to be respectful of GP receptionists because many practices were not yet ready to begin the third-dose rollout so soon after the commonwealth approved it.
Eligible recipients have reported difficulty booking appointments this week. One woman, who is undergoing cancer treatment and eligible for a third dose of vaccine, said she contacted her GP on Monday and that “neither her nor her colleagues ... had been advised on how to proceed with booking their severely immunocompromised patients in”.
“I [then] contacted the Victorian Covid vaccine hotline [on Tuesday] and the staff member I spoke to said neither her nor her colleagues had been given any information on how to book eligible patients in for their booster shot.”
The woman, who asked to remain anonymous, was eager to get her third vaccine due the risk of her cancer treatment diminishing the effectiveness of her first two Covid vaccine jabs.
“I think it’s so frustrating that the federal government announces something to be available and then does not deliver,” she said.
In a bulletin issued to providers of the Covid vaccine in primary care on 8 October – when the third doses were announced – the commonwealth health department explained Atagi’s advice.
The bulletin urged providers to “please proactively reach out to any of your patients with one of the identified conditions who are fully vaccinated to book them in for their third dose”. It also said clinics should begin accepting third-dose appointments from those eligible.
A spokesman for Hunt, citing that health advice, said the minister was confident that state-run vaccination clinics and GPs had received adequate instruction to begin administering third doses.
Prior to the health department releasing Atagi’s advice last Friday and following the federal government’s acceptance of this advice, the states and territories and peak primary care groups – including GP and pharmacy peak groups and Public Health Networks – were provided with an embargoed copy of the advice to ensure their visibility.
The spokesman said there was also “updated guidance available on the Department of Health website including updates to the consent form for Covid-19 vaccination, clinical guidance, updates to the provider and shared guides on immunocompromise and a new eligibility declaration form to assist individuals who may not be presenting to their usual provider to demonstrate they are eligible for a third dose”.
Government advice for severely immunocompromised people states “these third doses are provided as part of the primary course” and that “they are not boosters”.
Robert Booy, a University of Sydney professor of vaccinology, told Guardian Australia that vaccine data had suggested “at least half of severely immunocompromised people may not have had an immune response to either of their first two doses of vaccine”.
He stressed the need for this cohort to receive a third dose was far greater than for the rest of the population.
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