H1N1 vaccine rollout arrangements - Further advice from AMA President
25 September 2009 - 3:00pm
Colleagues,
This email is to provide you with a further update on the rollout of the H1N1 vaccine program. The following information is to assist those of you who are preparing to provide H1N1 vaccinations in your practice.
We understand that a major government communication campaign will commence prior to the official commencement of the vaccine program on the 30th September i.e. in the next few days. I note that Minister Roxon has been interviewed in the last 48 hours and is advising people to “ring their GP as of next Wednesday to see when you can go to your GP to talk to them and have the vaccine provided”. While this may lead to an increase in enquiries to GPs about the vaccine from next week, it will allow you to provide advice to patients about the specific arrangements that you are putting in place in your practice to manage any demand for vaccinations.
1. Government guidance, advice and proformas
I would like to draw attention to the following guidance and advice from the Commonwealth Department of Health and Ageing:
These documents are available to be viewed, copied and printed as required from the healthemergency website.
2. Advice on adherence to the priority group recommendations
We have had inquiries from several doctors asking how strictly they are required to adhere to the priority group recommendations, given that they are also trying to ensure that vaccine arrangements in their practice avoid wastage.
We have confirmed with the Commonwealth Department of Health and Ageing that the Government's priority list is simply there to help target the roll out of the vaccine in the early days, particularly targeting the early communication messages to high risk individuals. While significant supplies of the vaccine will be available when the roll out first commences, it will not be enough for everyone. However, as more supplies become available the priority list will become less relevant.
The Government has confirmed that, while the initial focus in on priority groups, this needs to be balanced with ensuring that we minimize wastage and maximize the number of Australians who are vaccinated. Accordingly, the priority list does not preclude medical practitioners from vaccinating other groups. Indeed, the Government guidelines say:
While emphasis will be on targeting these priority groups, the opportunistic vaccination of friends, family, and carers of vulnerable people or anyone who wishes to protect themselves from pandemic influenza is also encouraged
The vaccine program information sheet for health professionals reinforces this message:
The aim of the program is to provide free vaccine against pandemic (h1N1)2009 influenza for all members of the community who wish to be vaccinated…In the initial stages of the rollout of the Panvax H1N1 vaccine, the focus will be on ensuring that people in the specified priority groups are offered the vaccine first as they are the groups who have been identified as being at the highest risk…However, vaccination will not be restricted to those identified as being in the priority group. There will be flexibility to vaccinate other people…if they wish to be vaccinated.
Throughout our consultations with the Government, there has been an emphasis on the need to minimise vaccine wastage. If practical reality means that this is best achieved by offering vaccinations to priority and non-priority groups alike, then it is acceptable for medical practices to organise flu clinics accordingly. The Government understands that each general practice will approach things differently and will organise themselves in order to best meet community need.
3. Reporting adverse events
Departmental officials have asked us to remind those medical practices providing H1N1 vaccinations that the normal adverse event reporting arrangements are in place to allow Government to monitor the rollout of the vaccine. More information on how medical practices can report adverse events is set out in the Government’s information sheet: vaccine program information for health professionals.
4. Advice on MBS claims for vaccination services
The Department of Health and Ageing has confirmed that GPs can bill the existing relevant items in the MBS schedule for services associated with providing this vaccination to patients.
In relation to the use of practice nurses, this vaccination rollout is no different to the administration of any other registered vaccine. GPs can bill the relevant consultation item for any clinically relevant service they provide in addition to the practice nurse item if a practice nurse administers the vaccination.
We are expecting the Department of Health and Ageing to formally confirm the above shortly on their website.
I trust this information is of assistance to AMA members. In the context of the current political debate in which many of us feel that the role of general practice is being unfairly questioned, I believe that this is an opportunity to demonstrate what general practice does best in expediently and professionally providing holistic care for the Australian community.
Yours sincerely
Dr Andrew Pesce
President
This email is to provide you with a further update on the rollout of the H1N1 vaccine program. The following information is to assist those of you who are preparing to provide H1N1 vaccinations in your practice.
We understand that a major government communication campaign will commence prior to the official commencement of the vaccine program on the 30th September i.e. in the next few days. I note that Minister Roxon has been interviewed in the last 48 hours and is advising people to “ring their GP as of next Wednesday to see when you can go to your GP to talk to them and have the vaccine provided”. While this may lead to an increase in enquiries to GPs about the vaccine from next week, it will allow you to provide advice to patients about the specific arrangements that you are putting in place in your practice to manage any demand for vaccinations.
1. Government guidance, advice and proformas
I would like to draw attention to the following guidance and advice from the Commonwealth Department of Health and Ageing:
- Chief Medical Officer’s letter to GPs of September 2009 – setting out the clinical and epidemiological rationale for rolling out the vaccine at this time;
- Vaccine program information for health professionals – an information sheet for vaccine providers summarising the latest advice about the vaccine program, including the priority groups for vaccination, latest advice about vaccination of children, contraindications, precautions and dosage information, information about possible adverse events including how to report, information about how to order the vaccine, details about how the vaccine is packaged and State and territory contact details for vaccine related information.
- Guideline for the administration of pandemic (H1N1) influenza vaccine from multi-dose vials (MDV) – prepared by the Australian Technical Advisory Group on Immunisation (ATAGI)
- ATAGI advice regarding the use of influenza vaccines containing thiomersal – containing advice that could be useful in answering questions or dealing with concerns from patients on this issue
The documents listed above are now available on the AMA website and also on the Federal Government’s health emergency website in the area containing information for health professionals
For your further information, there are two other important documents that are now available, copies of which will be distributed to medical practices with each order of the vaccine: - Vaccination consent form – note that the use of this consent form is not mandatory and can be replaced by your normal consent processes given that the vaccine is fully TGA registered.
- Vaccine recipient information sheet – this is an important information sheet to support patient consent. The Government is encouraging medical practices to give a copy of this sheet to all vaccinated patients so that they are aware of possible side effects and have information about how to report more serious adverse events.
2. Advice on adherence to the priority group recommendations
We have had inquiries from several doctors asking how strictly they are required to adhere to the priority group recommendations, given that they are also trying to ensure that vaccine arrangements in their practice avoid wastage.
We have confirmed with the Commonwealth Department of Health and Ageing that the Government's priority list is simply there to help target the roll out of the vaccine in the early days, particularly targeting the early communication messages to high risk individuals. While significant supplies of the vaccine will be available when the roll out first commences, it will not be enough for everyone. However, as more supplies become available the priority list will become less relevant.
The Government has confirmed that, while the initial focus in on priority groups, this needs to be balanced with ensuring that we minimize wastage and maximize the number of Australians who are vaccinated. Accordingly, the priority list does not preclude medical practitioners from vaccinating other groups. Indeed, the Government guidelines say:
While emphasis will be on targeting these priority groups, the opportunistic vaccination of friends, family, and carers of vulnerable people or anyone who wishes to protect themselves from pandemic influenza is also encouraged
The vaccine program information sheet for health professionals reinforces this message:
The aim of the program is to provide free vaccine against pandemic (h1N1)2009 influenza for all members of the community who wish to be vaccinated…In the initial stages of the rollout of the Panvax H1N1 vaccine, the focus will be on ensuring that people in the specified priority groups are offered the vaccine first as they are the groups who have been identified as being at the highest risk…However, vaccination will not be restricted to those identified as being in the priority group. There will be flexibility to vaccinate other people…if they wish to be vaccinated.
Throughout our consultations with the Government, there has been an emphasis on the need to minimise vaccine wastage. If practical reality means that this is best achieved by offering vaccinations to priority and non-priority groups alike, then it is acceptable for medical practices to organise flu clinics accordingly. The Government understands that each general practice will approach things differently and will organise themselves in order to best meet community need.
3. Reporting adverse events
Departmental officials have asked us to remind those medical practices providing H1N1 vaccinations that the normal adverse event reporting arrangements are in place to allow Government to monitor the rollout of the vaccine. More information on how medical practices can report adverse events is set out in the Government’s information sheet: vaccine program information for health professionals.
4. Advice on MBS claims for vaccination services
The Department of Health and Ageing has confirmed that GPs can bill the existing relevant items in the MBS schedule for services associated with providing this vaccination to patients.
In relation to the use of practice nurses, this vaccination rollout is no different to the administration of any other registered vaccine. GPs can bill the relevant consultation item for any clinically relevant service they provide in addition to the practice nurse item if a practice nurse administers the vaccination.
We are expecting the Department of Health and Ageing to formally confirm the above shortly on their website.
I trust this information is of assistance to AMA members. In the context of the current political debate in which many of us feel that the role of general practice is being unfairly questioned, I believe that this is an opportunity to demonstrate what general practice does best in expediently and professionally providing holistic care for the Australian community.
Yours sincerely
Dr Andrew Pesce
President
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