[ad_1]
Will you take it yourself?
As a GP, this is one of the questions I am asked the most. Here in the Midwest, we are waiting for the vaccine with a mixture of hope and fear. Scientists and the World Health Organization (WHO) tell us that Covid-19 vaccines have been produced in an unprecedented spirit of global cooperation. Scientists from many disciplines have shared information, and these vaccines arrived long before it was thought possible a year ago. But the logistics are formidable.
Was it all too fast?
Scientists say no and that they have spared no effort. Older patients are avid radio listeners and often have the latest information before I do. They realize that they will be among the first to receive the vaccine and are very interested in the progress.
Will GPs give it and will it be given to them in their surgeries?
I do not know. There are many logistical difficulties. We know that the Pfizer vaccine must be kept at a very low temperature, much lower than what we have in our office vaccine refrigerator. for up to five days. Each injection has to be reconstituted before delivery, which is painstaking work, with up to five doses administered at a time. There are 975 doses if we open a package, which must be administered in one work week. The flu vaccine comes in individual syringes and has minimal side effects. Giving the Covid-19 vaccine will be a slower task. The recipient will have to enter the building, we will have to have separate exits and entrances so that people do not mix, monitor them for 15 minutes after the injection for side effects. Then we have to disinfect the room and make the computer inputs. We will have to keep unused vaccines to a minimum. And, a small but important point, our vaccine coolers are small and usually full before the new vaccines arrive.
GPs are excellent at identifying patient groups and administering vaccines, but vaccinating the adult population is a huge task. If we have to collate which patient ranks first in the 15 categories and who gets the Pfizer, Astra Zeneca or Moderna vaccine, as some may work better than others for different types of patients, very careful planning will be required.
What about allergies?
A surprisingly large number of patients have an allergy marked on their notes. It may be that an antibiotic has caused gastric upset, or that they do not remember what type of reaction occurred or even the name of the medicine. The last tip is not to give the Pfizer vaccine to anyone who has had anaphylaxis.
Have the vaccines been tested in all groups?
Covid-19 infection is dangerous for people in the late stages of pregnancy. The vaccine has not been tested in pregnant women. The R number is expected to decrease as herd immunity increases and they will benefit from the lower level of circulating virus, but only if enough people are vaccinated. And even vaccinated people, even if they stay well, could be contagious. It is simply too early to tell.
How many will need to get the vaccine?
Current evidence suggests that 60 percent of the population achieve herd immunity. There were long delays in the flu vaccine supply chain this year. GPs had to explain to their vulnerable groups that we were waiting for the flu vaccine to arrive while the HSE was loudly advertising it. Nobody wants that to be repeated.
How long will the vaccination last?
The vaccine can confer immunity for a year, five years or for life, nobody knows.
What vaccine will we get?
Some may be different and given to different age groups. Family doctors have learned what to do with Covid-19: falling oxygen levels, wearing PPE, etc. Now we will have to learn the ways of a new vaccine, in a rapidly evolving situation.
What level of uptake can we expect?
The clearer the message and the more fluid the delivery, the sooner the crisis will pass. The WHO has identified disinformation as one of the main difficulties of this pandemic. Government information must be honest, consistent and clear.
In my office, people in the oldest age group and anyone I have met with a serious medical condition are eager to receive the vaccine. People dealing with the public, especially hospitality workers, worry that it will take months to reach them. Many of the fit and the younger are wary, saying they will wait to see how the vaccinated do, and it will be a while before they are called anyway.
I volunteered to receive the vaccine live on the Tipp Today radio show. It will be a relief to finally get vaccinated and banish the troublesome virus to the rare diseases section of textbooks.
Pat Harrold is General Practitioner at Nenagh, Co Tipperary and ICGP Tutor
