Many of the nation’s GPs are refusing to offer AstraZeneca’s vaccine to people under 50 until the federal government urgently clarifies legal liability if patients suffer serious or fatal side effects.
Australia’s switch to the Pfizer vaccine for people under 50 to minimise blood clot risks has also raised concerns for unvaccinated front-line healthcare workers, who face a potentially long wait for the preferred vaccine.
The Morrison government last week accepted medical advice to “prefer” Pfizer’s vaccine over AstraZeneca’s for under-50s, although people in that age group could still have the AstraZeneca jab if the benefits outweighed the risks.
Professor Allen Cheng, left, co-chair of the federal government’s immunisation advisory body, received the Pfizer vaccine at The Alfred hospital in March.
But GPs are warning they could face expensive lawsuits if they advised a patient under 50 to have AstraZeneca’s vaccine and there was a severe side effect.
Victorian president of the Australian Medical Association Julian Rait said doctors should be guided by advice from the federal government’s Australian Technical Advisory Group on Immunisation to give AstraZeneca to under-50s when the benefits outweighed the risks.
But the president of the AMA’s NSW branch, Danielle McMullen, advised doctors in that state not to administer the AstraZeneca vaccine to anyone under 50 unless there were exceptional circumstances.
“At the moment, the guidelines are a little bit confusing,” Dr McMullen said. “Certainly in the next few days, quite quickly, we will be trying to get more clarity on making sure: is this a ban or not a ban and what level of exceptional circumstance do you need.
“Obviously protecting patients is our number one goal, but also making sure that the doctors aren’t putting themselves at risk.”
President of the Royal Australian College of GPs Karen Price said she was considering stopping offering AstraZeneca’s vaccine to people under 50.
“[AstraZeneca is] preferred not to give it in that age group, but it’s not a contra-indication,” she said.
“Can you imagine how a lawyer might feel if someone did have a catastrophic reaction? The uncertainty and litigation risk warrants pause.
“Right now in Australia, we don’t have an alternative vaccine. What would happen if we had an outbreak? What would happen if someone could not get their vaccine – and they suffered a severe consequence of COVID?”
Dr McMullen said the AMA had been trying to negotiate with the federal government about indemnity insurance for the vaccination rollout for some time.
“We all have professional indemnity insurance, but also the indemnity insurers are worried if there is a large issue with a vaccine and the possible insurance risk there,” she said.
Jared Dart, a Queensland GP and director of the Australian General Practice Alliance, which represents practice owners, said he would stop all AstraZeneca vaccines for under 50s for the next two weeks.
“I need to get a clearer understanding of the medico-legal risks for me as a doctor and our practice, to work out the best course of action,” he said. “I’m aware of many GPs who have called and told patients that for now, they are not proceeding with the under 50s for AstraZeneca.
“We’ve got essentially a tidal wave of patients coming to us asking advice when the science is not settled.”
A federal Department of Health spokeswoman said the government would continue to provide comprehensive information to GPs “as we have done right through the GP vaccination program” and they should contact their insurers.
“The Department of Health has been discussing with insurers and the medical profession whether additional indemnity protection may be required for the COVID vaccination process. Those discussions are ongoing,” the spokeswoman said.
“Given insurance products differ in both their scope and application, we would encourage GPs to contact their insurers if they have concerns about the scope of their medical indemnity insurance arrangements.”
The move last week to prefer Pfizer’s vaccine over AstraZeneca’s for those under 50 has complicated Australia’s already delayed vaccine rollout.
People under 50 are not banned from getting AstraZeneca’s vaccine but must weigh the risks and benefits with their doctor.
Only about 130,000 to 150,000 doses of Pfizer’s jab arrive on our shores every week, meaning some patients under 50 could opt for AstraZeneca’s more-available jab to get immediate protection.
This is a particular issue for unvaccinated healthcare workers who could be on the front line of a new outbreak.
The federal government said it would prioritise Pfizer’s vaccine for healthcare workers under 50, but much of that vaccine continues to flow to aged-care, which is still weeks away from being fully vaccinated. Some healthcare workers simply cannot access a Pfizer vaccine at all at this stage.
“It feels like they have basically left our members out hanging.”
Andrew Hewat, Victorian Allied Health Professionals
In Victoria, about 25 per cent of frontline healthcare workers in phase 1a – the highest risk group of the vaccine roll-out – still have not received their first vaccine dose. Federal figures are not available.
Victorian Allied Health Professionals Association assistant secretary Andrew Hewat said many members of the union were now caught “almost in no-man’s land”.
“They don’t know how long it’s going to take to get them vaccinated if they wait for Pfizer. And especially in Victoria, they are highly sensitive to the implications of an outbreak, having lived through 2020. It’s a real worry for them,” he said.
“It feels like they have basically left our members out hanging.”
NSW regional GP Alam Yoosuff said healthcare workers had been left in limbo.
“For my healthcare workers, they have no option other than AstraZeneca if they want to have one, to be honest, because there is no such place to get a Pfizer vaccine,” Dr Yoosuff said.
“Murrumbidgee has 50 to 60 private aged care homes. They all have healthcare workers. Nobody knows when those healthcare workers can be vaccinated.”
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Liam is The Age and The Sydney Morning Herald's science reporter
Lisa Visentin is a federal political reporter at The Sydney Morning Herald and The Age, covering education and communications.
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