New ATAGI update: Changes for patients below 50 years of age cause some confusion

 In vaccination, COVID-19

Week 3 update: 50 years or younger? Your vaccine choices have changed.

We are now in week 3 of the HHMP COVID-19 and flu vaccine clinic. The clinic has been running very well however government changes and updates continue to cause havoc with patient bookings. The latest updates are the changes to the type of vaccine available to those below 50 years of age. These changes arose due to the occurrence of blood clots in some patients. This has received significant coverage in medical and non-medical media.

Basic summary of the changes 

Basically there are 2 vaccines in Australia at this stage. Lets call them A and B.

Before 08/04/2020: All phase 1b patients (those over 70, those over 18 with serious health conditions, etc) who got vaccinated in a general practice got vaccine A. Vaccine B was only available at specialised centres with specialist freezers to aged care patients and high risk workers eg: hospital staff and quarantine workers.

Now: All phase 1b patients who are over 50 years still get vaccine A from their local GP as before. Those over 50 years are not affected. Those under 50 years are preferred to have vaccine B but can choose to have vaccine A after discussion with their doctor and informed consent.

So, why the change?

The research found that blood clots occurred with vaccine A in about 1 patient of every 200,000.  This was more likely in women than men. It is thought that a clotting pathway might be activated in some susceptible patients to cause this.

A 1 in 200,000 chance of injury is a very low risk. Many things that we do in our lives have much higher risks; such as driving a car, climbing a ladder, crossing a road or having a colonoscopy. If someone got the clot they have a 1 in 4 chance of dying. So 1 in 200,000 get the clot and 1 in 800,000 die from it.

In a way Australia is a victim of it’s own success. The fact that there is little to no COVID-19 around makes the risk of getting COVID-19 very low, much lower than 1 in 200,000. So lets say at present the risk of getting COVID-19 in Australia might be 1 in 1,000,000 or 1 in 3,000,000 this makes the clot risk of 1 in 200,000 seems high. As a result we can afford to be cautious and have more targeted recommendations. In other countries where the risk of getting COVID-19 is much higher, say 1 in 100 or 1 in 1000, a risk of a blood clot of 1 in 200,000 is well worth taking.

How does this affect me?

If you are above 50 years of age, no changes are needed, please turn up to your appointment and get vaccine A as planned.

If you are under 50 years of age, you need to consider your options. The advice at present is that vaccine B is preferred for those below 50 years old. Please note the use of the word “preferred” rather than mandatory. This means that people under 50 years can still have vaccine A as long as they understand the risk and discussed this with their doctor.  For example if someone under 50 had to travel to an area where COVID-19 risk was high, then having vaccine A would still lead to more benefit than risk.

If you are eligible under Phase 1b and are under 50 years old, your options are:

  1. Cancel your Vaccine A appointment and await notification about vaccine B availability.
  2. Book an appointment with your doctor to discuss the risk and benefits of vaccine A and vaccine B to help you make an informed choice. This discussion needs to be had with your doctor and not at the vaccine clinic with the vaccinator.
  3. Keep your appointment for vaccine A, if you have a good understanding of the risks including the information noted above. If after reading and analysing the information you feel comfortable with a 1 in 200,000 chance of a clot, we can still give you vaccine A. The key is being informed of the risk, understanding the risk and making an informed decision that the level of risk is acceptable to you.

The issue of COVID-19 vaccine supply persists 

The supply of vaccine A was limited at best. We are only receiving 100 doses per week.  We hope this will improve in time. With less people needing this vaccine there will be more availability of vaccine A for those above 50. Please continue to check the BOOK NOW button or call us if you are unsure.

The Supply of vaccine B is even more limited and that’s before considering the difficulties of storage in freezers. Shifting those under 50 to vaccine B means it will take significantly longer to vaccinate them. The supply is just not there for everyone at this stage and vaccine B is not available at your GP, only at specific government run clinics.

We understand your frustration 

HHMP continues to manage appointments as best as we can despite dealing with very large volumes of calls and booking requests. We understand the anxiety about vaccine access and will continue to do our best to improve the supply.

Please be patient with our staff, they do not like to call and change your appointment, they would rather welcome you and ensure you have a safe vaccination. If you are unsure about what is right for you, please book an appointment with your doctor.

Please continue to check here, our vaccine clinic page and the online booking for further availabilities which will be opened as supply improves. In the meantime, please consider booking your Flu vaccine.

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