AMA President - mass vaccination centres

15 Apr 2021

Transcript:   AMA President, Dr Omar Khorshid, ABC Radio Melbourne, Thursday, 15 April 2021

Subject:   Mass Vaccination Centres

HOST: Ali Moore   

ALI MOORE: Well, mass vaccination hubs, are they the answer to the slow vaccine rollout? Maybe not according to the AMA, or at least not yet. The President of the Australia Medical Association is Omar Khorshid. Good morning. 

OMAR KHORSHID: Morning Ali. 

ALI MOORE: The Prime Minister says the Government's looking at the potential for mass vaccination hubs for people in the 50 to 70-year-old bracket to get the AstraZeneca vaccine. A good idea? 

OMAR KHORSHID: Well, I think what the Prime Minister said was that was something that had been suggested by one of the State's premiers, and he was happy to consider that. And now our advice to the Prime Minister is that that's probably not the way to set up mass vaccination centres. The problem with a centre that focuses on the 50 to 70-year-old age group using the AstraZeneca vaccine is that you're using the same vaccines that we are currently rolling out through general practice. So, the only way to actually fill those centres will be to take the vaccines off general practice, which is quite capably administering those vaccines as we speak. 

ALI MOORE: So, the issue for you is more about the amount of supply? 

OMAR KHORSHID: Yes, the only handbrake on our GP rollout of AstraZeneca is the supply. The current 4500 odd practises that are participating have a lot more capacity to do more vaccination. We've heard that loud and clear from them. And also there are another almost 4000 practices available that could participate should they be permitted to do so by the Government. 

ALI MOORE: If there is more supply, though, don't mass centres make sense? They're efficient. Everyone's in one place. All the information can be in one place. All the experts can be in one place. You might have 4000 GP clinics, but they may only be vaccinating a tiny fraction of people. 

OMAR KHORSHID: The good thing about 4000 clinics is that's 4000 queues and 4000 carparks and 4000 sets of reception staff to admit people. I don't know if you've seen the queues that we've seen from other countries where they've set up mass vaccination centres, but they're enormous. They're huge logistic challenges. Of course, you need to find a workforce from somewhere. And we're not aware of large numbers of registered nurses and doctors who are available to man these centres. They do make sense for the Pfizer vaccine because it is the most logical way that we can see the rollout of the Pfizer vaccine. The mass vaccination centres are, you know, not a bad thing, but we shouldn't be robbing Peter to pay Paul and we should focus those centres on the vaccines that we can't roll out through general practice. 

ALI MOORE: You're listening to the federal President of the Australian Medical Association, Omar Khorshid. Omar Khorshid, I just heard you say it's a different situation with Pfizer. I assume that's because of the storage issues. 

OMAR KHORSHID: That's right. So even though we've heard recently that you can store the Pfizer vaccine for up to a couple of weeks at normal freezer temperatures, we just don't have the appropriate types of freezers in general practices or other community settings out there right now. And it would be extremely difficult and expensive to bring those into place. So it's not impossible, but it's unlikely that we could see widespread use of the Pfizer vaccine out in community settings and therefore, the best way to deliver that vaccine to our under 50s and in the short term to our healthcare workers and aged care workers will be through state run centres. 

ALI MOORE: At the same time, your concerns about who would staff a hub clearly would remain because you might be able to get more vaccine; in theory, you've got a static number of doctors and nurses. But is it- have we got to the point where we need to, for example, follow the US model, bring people out of retirement, bring in the military, think laterally, use pharmacists, do everything that we can if we've got greater supply of vaccine? 

OMAR KHORSHID: That's a very big if, Ali, and really that's why the answer to your question is no, we don't need to do that. We just don't have the vaccine. This is something that I think the public debate has not really realised time and time again over the last couple of months. You can criticise the rollout in different ways, and some of those are valid criticisms. But at the core of our problem is that we just don't have the vaccine supply and there is no mass increase in vaccine supply likely for several months. And if it does come, it's probably going to be in the form of the Pfizer vaccine, which, of course, has those logistic challenges when it comes to rolling them out. 

ALI MOORE: Are you a little questioning of the Government's confidence at this point? 

OMAR KHORSHID: There's no doubt that the government's confidence and in fact the public's confidence in the program has taken a hit since last Thursday when we got the advice from ATAGI about AstraZeneca. And we're hearing from GPs and also from Government that the number of people presenting to GPs for their vaccine has dipped when it was going up very nicely… 

ALI MOORE: Including the over 50s? 

OMAR KHORSHID: Including the over 50s, yes. So, there is a problem with confidence. And I think the biggest challenge right now for the Government is to project an aura of calm, that they're on top of this. And probably the best way to do it will be to partner better with the states so we don't have people firing hotshots over state borders or at Canberra over the rollout. And if we do work together as governments at different levels with the medical profession, with our hospital system and other community settings, I think we've got this. It's not beyond our capability. 

ALI MOORE: That said, though, an aura of calm. We have a national cabinet on a warlike footing. We have meetings now that are going to be held way more regularly than they were. We have everything on the table. It doesn't exactly inspire an aura of calm, does it? 

OMAR KHORSHID: It doesn't. And I think, though, that the Prime Minister is trying to demonstrate that they are listening to feedback from the community and from the media and that they are reacting. But at some point, they do need to just say, this is it. This is how the rollup is going to go. It's going to take some time. Let's be patient. We don't have COVID in this community. We're still living in the best country in the world when it comes to our management of COVID. Let's remember that and let's work together as a community to get this vaccination program back on track and get the job done, hopefully by the end of the year. 

ALI MOORE: Yeah. I suppose you've already made the point, though, that there are over 50s cancelling their appointments. That confidence has been dented. What do you make of the news overnight about Denmark's decision to withdraw AstraZeneca altogether until further notice, the first European country to do that? 

OMAR KHORSHID: I think the European countries are in exactly the same position as the Australian Government. I think we've seen the US react to the Johnson & Johnson vaccine as well. They are very, very sensitive to the criticism of these vaccines and to side effects that could undermine public confidence. They don't want to harm their communities, which is great. But each move like this does overall harm the health care of our population all over the world, because AstraZeneca remains, as far as we can see, an excellent vaccine with an excellent safety profile, way better than most medical treatments that we provide.  

ALI MOORE: So you- you feel confident about the ATAGI advice as we got last week, that it is safe for people over 50? Clearly, that's not the impression- the understanding of Denmark's regulatory authorities. 

OMAR KHORSHID: Each country has different access to vaccines. And if Denmark has good access to, say, the Pfizer vaccine and doesn't perceive a problem there, then they could move an abundance of caution to cease using AZ without harming their community.  

ALI MOORE: I suppose it goes to the risk benefit analysis again. 

OMAR KHORSHID: It does, and AZ comes out extremely well. If you look at the- there's some great graphs that came out from University of Cambridge that the UK used to explain their decision around AZ, and they showed the risk-benefit equation for different age groups. It's a no brainer for anybody over the age of 50, and you could argue over the age of 30, and that's [indistinct] very little COVID. 

ALI MOORE: But is it in a country which, as you and the Government keeps saying, doesn't have any COVID. 

OMAR KHORSHID: We don't have COVID now, but COVID is coming. We cannot keep this virus out of Australia forever unless we become a true island nation with no travel. The virus is going to keep mutating and keep changing. Vaccination is our only way out of this. So it is a priority. But we don't need to panic. We can roll out these vaccines. And if we get any data that casts safety questions around any age groups, the Government will act. We just saw that. The moment ATAGI made a recommendation that one vaccine was preferred, not saying it wasn't safe, just saying it was preferred over another, the Government immediately acted. Our state governments around the country immediately acted. And if there's any data that suggests any problems of safety for over 50s, the Government will do the same. But right now the data is extremely clear, and you only need to look at the UK's overall impact of both Pfizer and AZ in the elderly. The reduction in hospitalisation and ICU admission was 85 to 90 per cent after one dose of these vaccines in elderly populations during an outbreak. And that's a fantastic response to vaccine. That's why we need to get this program fully rolled out as soon as we can. 

ALI MOORE: So GP's across the board are confident and agree to the ATAGI advice that if I walked into my GP tomorrow and I said I'm just over 50, it's safe for me, the answer would be an unequivocal yes if there are no other outstanding issues. 

OMAR KHORSHID: The answer certainly should be an unequivocal yes. But the great thing about our general practitioners around the country, they are independent thinkers and they will, like with every other medical treatment, they will explain the data in their own way to their patients. But certainly, the view of the AMA, the view of every medical body, the Government, the view of all the experts is that AstraZeneca is an extremely safe vaccine with a rare side effect described mostly in young people. It is an excellent decision for anybody over the age of 50 to get vaccinated. And we would encourage all Australians as soon as they've got access to the vaccine to go and get it done. 

ALI MOORE: Well, that's the big question, as soon as they've got access. Dr Omar Khorshid, thank you very much for your time this morning. 

OMAR KHORSHID: No worries, Ali. Cheers.