Queensland and NSW clinics won’t administer AstraZeneca to young people as new rules throw doctors into turmoil

Two states say they will not provide the AstraZeneca vaccine to young people, despite what the PM says. No wonder Aussies are confused.

State authorities are rebelling against new rules allowing AstraZeneca to be given to young people despite a surprise change announced by Prime Minister Scott Morrison.

Both Queensland and NSW have indicated they don’t want to administer AstraZeneca (AZ) to young people in their state vaccination clinics despite the PM’s unexpected decision to open up these jabs to those under 60 years old.

Previously AZ was only available to those aged over 60, following advice from the Australian Technical Advisory Group on Immunisation (ATAGI) over the risk of rare but serious blood clots.

The health advice has not changed, but on Monday night Mr Morrison said younger people who still wanted the AZ vaccine would now be able to speak to their general practitioners (GPs) about getting the jab. A no-fault indemnity scheme will be introduced to cover GPs.

The move has been welcomed by many young Australians, especially those aged under 40 as they have not had access to any vaccine yet. Those aged between 40 and 59 are eligible for the Pfizer vaccine.

But the decision came as a surprise to doctors and to state authorities, with Queensland Premier Annastacia Palaszczuk telling reporters on Wednesday the rule change was not a decision of the National Cabinet.

“I do not think this is the time to risk the safety of our young Australians when … the UK will not even allow their under-40s to get the AstraZeneca vaccine,” she said.

Queensland chief health officer Dr Jeannette Young was very clear in her message: “I do not want under-40s to get AstraZeneca,” she told reporters.

“I don’t want an 18-year-old in Queensland dying from a clotting illness who, if they got covid probably wouldn’t die,” she said.

Queensland deputy premier Steven Miles said the Government would only provide the vaccine that is medically recommended.

“We will not ignore the health advice,” he said.

“For the Prime Minister to attempt to overrule the medical advice and provide a vaccine that is not recommended for people under 60 puts Queenslanders at risk.

“There is some discussion that the Commonwealth might even provide their own vaccination hubs so they can get AstraZeneca vaccine out to younger people despite the vaccine not being recommended and that would be very risky.”

NSW Premier Gladys Berejiklian also appeared to rule out vaccinating under 60s with AstraZeneca in NSW health clinics.

She said clinics would accept those aged over 60 wanting AZ and anyone getting their second shot, “beyond that, you should talk to your GP”.

RELATED: Why under-40s should consider AstraZeneca vaccine

Young Australians are now able to get the AstraZeneca vaccine but the health advice has not changed. Picture: Darrian Traynor/Getty Images

“If you’re under 60 and you want the AstraZeneca, you should have a conversation with your GP,” Ms Berejiklian said.

Asked whether under 40s should get AstraZeneca or wait for Pfizer or Moderna, Ms Berejiklian said: “the important thing is to follow the health advice and the health advice in NSW says if you’re over 60, get the AstraZeneca vaccine.

“If you are under 40, we welcome you to get the Pfizer vaccine.

“Beyond that, you need to go to your GP.”

Ms Berejiklian said National Cabinet had agreed only that GPs would not face any legal consequences if they administered the vaccine to anyone.

NSW chief health officer Dr Kerry Chant said ATAGI had said people could make personal choices but they needed to be informed.

She said mass vaccination clinics were not the right place to have detailed discussions about risk and it was best to discuss this with GPs.

“For younger people we really encourage you to go to your GP and just discuss your particular circumstances and have that discussion,” she said.

Western Australian Premier Mark McGowan said the health advice was that under 40s shouldn’t have AstraZeneca.

Doctors in turmoil over AZ change

The Royal Australian College of General Practitioners (RACGP) is also calling on the Federal Government to urgently clarify details concerning the changes.

“The nation’s general practices had no warning of the announcements made last night and are now scrambling to figure out what this means for our patients,” RACGP President Dr Karen Price said in a statement on Tuesday.

“Phones are ringing off the hook at general practices across the country with people trying to book in, but general practices are not yet armed with the advice needed to implement this change in eligibility.”

There also seems to be reluctance among some GPs to recommend the jab to young people.

RACGP vice president Bruce Willett said he would urge patients to wait for Pfizer.

“The AstraZeneca vaccination is a safe vaccine … and if it was the only vaccination we had available, we would be rolling it out to everyone,” he told the Australian Financial Review.

“But my advice to young people is that they wait for the Pfizer unless there’s an issue that means they need or want to get the Astra earlier, then it’s a perfectly reasonable and rational thing for them to do as well.”

He suggested people have a discussion with their GP.

“The risks are still very low and there’s no right or wrong answer, it’s very reasonable to do either,” he said.

Australian Medical Association (AMA) president Dr Omar Khorshid said advice from the AMA and doctors would also remain the same.

“The experts have said that the preferred vaccine under the age of 60 is the Pfizer vaccine and that is still the health advice,” Dr Khorshid said.

“However, the PM’s announcement does mean that for those who really want their vaccine now or who think that they are happy to take the risks associated with AZ, that’s actually an option now for all Australians.”

He said the AMA recognised there was a desire among some in the community for access to AZ.

“People have been saying, ‘I want it, I’m happy to make that call’,” he told reporters on Tuesday.

“So, whilst the AMA does support ATAGI’s advice and says you should get Pfizer, this change is something that will free the vaccine up.

“It is an approved vaccine for anybody over the age of 18 and Australians in conjunction with their GPs can make that decision.”

How can young people get the AstraZeneca jab?

Due to the quick change to the AstraZeneca rules, the Federal Government’s vaccine eligibility tracker has not yet been updated to allow young people to book an appointment through its website.

Some people were simply ringing their GPs to check if they are part of the vaccine rollout and to make an appointment. Online appointment booking systems, such as HotDoc, also allow patients to make vaccine appointments with other doctors in its system.

Dr Khorshid said GPs were reporting they were already getting lots of calls from people interested in getting the vaccine but urged them to be patient.

“Hopefully, maybe even by as early as next week, we’ll be ready to roll AZ out to those who are interested under the age of 60,” he said.

He said the Health Minister had said an item number would be created to allow GPs to have conversations with younger Australians.

“They are still waiting for advice from the Government. So please give GPs a bit of time to get used to this really big change,” he said.

Dr Khorshid said the AMA had first proposed an indemnity scheme in January.

“For such a scheme to be effective and fair, we knew it needed to cover all vaccines, administered to all age groups and be applied retrospectively, so we are really pleased the Government has taken this on board,” he said.

RELATED: Why Covid recovery in Australia could take a long time

The health advice says AstraZeneca is only recommended for people over 60. Picture: Nikki Davis-Jones

“It means in the very rare circumstances where patients believe they have been injured by vaccine, they can access support or compensation if required without the need to include their doctor or nurse in legal action,” Dr Khorshid said.

He said nearly all patients and doctors would never need to use the indemnity scheme but having it in place would give peace of mind to patients and doctors.

The AMA will now work with the Government to extend Medicare support to cover Covid-19 vaccine consultations to Australians under the age of 50, which would support GPs to provide information to patients around the risks and benefits of the vaccines and help patients to make an informed decision.

Risks versus benefits for young people

Infectious diseases expert Professor Peter Collignon of Australian National University said it was also important that those older than 70 were vaccinated as a priority – ahead of younger age groups – as they were more likely to die if they got Covid-19.

“I think it’s good that people can have access [to AstraZeneca], it is approved for anyone over 18 anyway, but they need to provide informed consent because the risk is higher,” Prof Collignon told news.com.au.

He pointed out Australia did not have uncontrolled transmission of coronavirus in the country and was not expected to experience this, even in NSW, which is grappling with a serious Delta variant outbreak.

Prof Collignon said for young people, getting the AstraZeneca vaccine was riskier than getting other vaccines, even though there were potential adverse events associated with every type of medication.

“The risk young people are taking is a bit higher [than older people] and the benefit is lower but if they are informed about it and are willing to take it, I wouldn’t say don’t get vaccinated, I just wouldn’t push it strongly.”

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