Some GPs have opted not to sign up to vaccinate high risk groups due to the pressure and stress of the programme to date.
GPS HAVE SAID continued shortfalls in vaccine supplies in the country mean they will not be able to ensure all over 70s receive their first jab by mid-April, as promised by Taoiseach Micheál Martin just over a week ago.
In his speech to the nation on 30 March, the Taoiseach said supply is to “dramatically increase” in April, May and June.
“By the middle of April, all over 70s will have had their first dose, and mid to late May all over 70s will be fully vaccinated,” he said.
But GPs have continued to report supply issues hampering their ability to move fully through their over 70s list, with some still working through their 75-79 or 80-84 cohorts.
Some are now reluctant to get involved in the roll-out to at risk groups as they and their staff are experiencing burnout from months of juggling vaccine clinics and their normal practice work.
HSE Chief Clinical Officer Dr Colm Henry confirmed to The Journal that this mid-April timeline will not be met but said significant progress has been made and he is confident all over 70s will have their first doses by the end of the month.
“We were always aiming to get certainly all first doses for this over 70 age group by mid or the second half of April. I expect we’ll have covered all those first doses certainly within the month of April.
“Our experience is there’s always something that happens, there are always – stragglers is the wrong word, but there are reasons we have to revisit it and pick people up.”
Dr Denis McCauley, GP in Donegal and head of the Irish Medical Organisation’s GP committee, told The Journal that his practice should have been moving on to the 70-74 cohort this week but “due to Pfizer [delivery]constraints” they are only just finishing first doses for the 75-79 group.
“We get a delivery every two weeks, we’ve to finish giving second doses to the 80-84s, finish first doses for 75-79s and begin to vaccinate some of the over 70s. There has been a shortfall but we have an expectation that the next deliveries will be larger.”
He said delivery is now well streamlined in the majority of cases, with GPs given five to seven days’ notice on the exact quantities they are to receive. However he acknowledged there have been a small number of cases in which GPs’ deliveries were delayed, disrupting patients’ appointments.
“We would usually schedule vaccines for the day after the delivery is planned because there can be some delay on the day,” he explained.
On Monday, GP Dr Adrian McGoldrick reported he had to delay his vaccination clinic because of a late delivery, stating he had no way to to confirm the doses were definitely en route on that day. The doses did arrive later that day and patients received their jabs.
Scheduled to vaccinate 50+ patients this afternoon. Staff here since 9am preparing. Vaccines due to be delivered 12-1 but no delivery and no contact number available. Currently 5 staff in surgery and 15 patients waiting. Starting to cancel clinic. Utterly frustrating for all.
— Adrian McGoldrick (@AdrianAmcgold) April 5, 2021
Dr Nicola Stapleton also recently reported delivery shortfalls to her practice that would have delayed second doses for a number of elderly patients. The HSE later arranged for an additional unscheduled delivery of vaccines to the practice to address the issue.
We need 150 vaccines for our next Covid vaccination clinic
Found out yesterday we are due to receive 30
This means 32 vulnerable elderly patients will not receive their 2nd vaccine on time.(plus no 1st doses)
These 2nd vaccines were guaranteed by the [email protected]
— Nicola Stapleton (@dr_stapleton) March 27, 2021
Speaking at today’s HSE briefing, CEO Paul Reid acknowledged that some GPs did not receive the full delivery they needed but said it is “clearly communicated out in advance”.
Reid denied that this was a delivery issue on the part of manufacturers or a problem with Ireland’s own cold-chain delivery processes.
“The committed delivery that they [GPs] will get based on the volume that we have, sometimes they have more patients than we have volume for that given week,” he said. “It’s a scheduling issue then to schedule the patients for the following week.”
Monaghan GP Dr Illona Duffy will just meet the mid-April timeline in her practice, but only by holding a weekend clinic.
Speaking to The Journal said she will receive her last delivery of first doses on 16 April and will administer those jabs the following day during a Saturday vaccination clinic at the surgery.
However she said she knows colleagues who were left weeks behind in their roll-outs due to delivery shortfalls.
“It’s not even just about location. Here in Monaghan, two practices got their vaccines on the first week of the roll-out, we didn’t get ours until two weeks after that and another practice didn’t get theirs until another two weeks later again,” she said.
“That put them a month behind. It has caused a lot of angst, people saying we’re incompetent and can’t manage the roll-out or that we have them and we’re just not giving them for some reason.
“It didn’t help that they [the HSE]had their ads out saying everyone over 80 should be getting a call when we still hadn’t got vaccines for all of our over 85s.”
She said her practice has been “lucky” that deliveries have arrived on time, but she is aware of other GP colleagues who had delayed deliveries or shortfalls in expected supplies that forced them to rearrange patient appointments.
“It’s not helping patients to have confidence in the system, it’s also not helping GPs who are considering getting involved in vaccinating the at-risk groups. They don’t want to have to continue worrying about vaccines not arriving.”
I am happy to get involved identifying & vaccinating Cohort 4 vulnerable patients <70yrs old in our practice population. But far better communication is required from HSE to GPs. Finding out 2 days in advance re significant vaccine shortfall for example is totally unacceptable.
— Iver Hanrahan (@IverHanrahanGP) March 22, 2021
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Dr Duffy’s practice is aiming to have all first and second doses administered to over 70s by the middle of May and, after that, she said they will not be doing any further vaccination clinics.
“It’s too difficult to try to do it and keep normal surgery going. Staff have been working their weekends and taking work home with them in the evening because the time it takes to book the clinics is phenomenal. They just can’t get it all done during the day.”
Limerick GP Dr Kieran Murphy told RTÉ’s Liveline this week that he had decided not to participate in the vaccination roll-out any longer due to pressure and in some cases abuse from patients demanding a vaccine.
He said worry about the vaccination programme and the intimidating calls they received from some patients had kept staff awake at night. The main issue, he said, was supply.
“We were warned that there would be less than adequate quantities of the vaccine in our second and third deliveries and the problem with that was that we had arranged that we were going to vaccinate all of a particular age group and it meant that only some of that age group were vaccinated,” he explained.
“We live in a very small community so the word got out that some people, particularly in the age range 75 to 80, had been vaccinated while others hadn’t, and we then began getting intimidating phone calls as to why particular people had been vaccinated and others hadn’t.”
He said his practice will not sign up to administer vaccines to the very high risk and high risk cohorts.
Dr Duffy said staff at her practice have also experienced abuse on the phone from patients.
“I understand people are stressed, I get that, but some are thinking they should be getting it when they aren’t even meeting the criteria for it,” she said. “We won’t be finished our over 70s until the middle of May and there’s no way we’d consider doing other vaccines.”
It is expected that the majority of GPs will opt to assist with the roll-out to at risk groups, administering the AztraZeneca vaccine, with around 1,000 practices already signed up with the HSE.
Dr Nuala O’Conor Covid lead for the Irish College of General Practitioners (ICGP) said GP teams all over the country are doing their best to administer vaccines, in addition to normal non-Covid work and treatment of those with symptoms of Covid.
She said most are vaccinating at weekends and bank holidays to manage the workload.
“What happened to Dr Kieran’s team is happening to GP teams all over the country and is neither right, fair or deserved. Please respect your GP team,” she said.