The IMO has queried whether medical indemnity against swine flu vaccination extends to the cost of cases brought before the Medical Council.
Department of Health Chief Medical Officer Dr Tony Holohan has tried to allay its fears. “Normally providers of insurance cover would give such indemnity to medical practitioners. We expect the approach to be no different in respect to this vaccine, compared to other vaccines,” said Dr Holohan last week.
Under current arrangements, GPs may decline to provide H1N1 vaccines to their patients, according to the Department of Health. “We would regard it as good practice in that scenario for GPs to help the person presenting to get access to the vaccine, perhaps through another GP,” explained Dr Holohan. In such circumstances, the HSE will assist in sourcing GPs who will vaccinate, he added.
Medisec, one of the two insurers, which is owned by GPs, has issued advice to its members. The Medical Protection Society, another insurer, has also indicated on its website that it has received clarifications from the HSE and the Department of Health on the issue. In terms of timelines, many GPs will not be in a position to vaccinate against swine flu until the end of October. The HSE and Department of Health have announced that the swine flu vaccination programme will commence on November 2.
Vaccines are safe
Also speaking at a briefing last week at Government Buildings was the HSE’s Assistant National Director of Health Dr Kevin Kelleher, who stressed that all the information the Executive had to date from licensing agencies and test results indicated that these vaccines were as safe as the seasonal flu vaccine.
Correspondence between the HSE and the IMO, however, indicates that additional indemnity is being provided for manufacturers of the vaccine. This was a condition of the contract being put in place with the manufacturers.
In the event that an individual’s GP has opted not to participate in the vaccination programme, GPs may direct the person presenting to an alternative doctor. A total of 1,800 GPs have — according to the HSE — indicated that they will participate in the swine flu vaccination programme. A total of 200 GPs have asked for and received clarification, it added, while ‘a few’ have said they do not wish to participate, added Dr Kelleher. Out of the almost 2,000 GPs who responded, the ‘vast majority’ indicated their willingness to participate in the programme ‘in the way that we’ve set out’, said Dr Holohan.
Provide facilities
It has emerged that in the second or third week of the vaccination programme, the HSE will, ‘if necessary’, provide facilities around the country for people who wish to get access to the vaccine.
The vaccine began arriving at GPs’ surgeries last Monday, along with syringes, needles and information (for both vaccinators and the public). On the whole, people will need to contact their GP. Over a four-week period, it is expected that 410,000 doses of the vaccine will be delivered.
“We are advising GPs to give a single dose to people in the at-risk groups. We are hopeful that by the end of that four-week period, the evidence might show we don’t need to give a second dose to people in these categories,” stated Dr Holohan. Almost certainly, children under the age of 14 will be offered two doses.
Information for the medically at-risk groups has been provided, on why they should have the vaccine and what they need to expect as a consequence. GPs will have 24 hours to use up the vaccine vial.
The HSE wishes to offer vaccination to everybody in the population. There are 410,000 people in the at-risk category. Vaccines will be available for this group from November 2.
By that time, GPs should have approximately half of what they need to vaccinate their at-risk groups and the remaining half is scheduled to arrive over the following two weeks. Vaccination of the next priority group – children – is likely commence in mid-November.
Reduced immunity
It has been the HSE’s intention to see the young chronically ill immunised through general practice. This group includes those with long-term lung disease like asthma or cystic fibrosis, long-term heart, kidney, liver and neurological disease (MS and cerebral palsy, for example). The group also includes those who have reduced immunity — for example, as a result of cancer or cancer treatment – and their household contacts. It includes those with haemoglobinopathy blood disorders, diabetes and severe obesity.
There are two contracts to deliver vaccines to the HSE, neither of which is delivering vaccine at the rate the Executive hoped. Healthcare workers cannot as a consequence be given vaccine at the same rate as the distribution via general practice.
The two vaccines to be used in this country, Pandemrix (GSK) and Celvapan (Baxter), have been licensed by the EMEA. Children, other people over the age of 65 and health care workers will be the next groups to be vaccinated.
The HSE has stated that over the next four weeks, sufficient vaccine will be distributed to ensure that everybody in those groups will receive a dose through their GP. Ireland has put in place plans to double intensive care capacity at the peak of the pandemic. – Irish Medical Times
