KUALA LUMPUR, May 3 — Some general practitioners (GPs) have complained about complications registering as Covid-19 vaccinators, saying that administering coronavirus shots is no different than other vaccines as a simple outpatient service.
The government has allowed private GPs to carry out Covid-19 vaccination in Phase Two of the National Covid-19 Immunisation Programme (PICK) from May onwards. GPs who are interested in joining the programme will have to register through the ProtectHealth portal by ProtectHealth Corporation, a fully-owned company by the Ministry of Health (MOH).
However, certain conditions have been set in place in order for GPs to conduct the Covid-19 vaccination programme.
Federation of Private Medical Practitioners’ Associations Malaysia (FPMPAM) Dr Shanmuganathan Ganeson honorary secretary told CodeBlue that one of the requirements to conduct the vaccination is that the clinics will need two separate computers to enter patient information at the same time.
“First of all, you need two computers at the same time. We have a clinic computer but you also need another PC because of two different registrations. You can’t use the same computer for both the steps,” Dr Shanmuganathan said.
The medical practitioner said that one computer is for patients to register and the other is for entering patients information into another portal called MyVAS.
Another issue that the FPMPAM secretary brought up was that all GPs will have to simultaneously collect the Covid-19 vaccine from one vaccine storage centre every Tuesday at 9am at a designated place.
“You got to go and collect on one fixed Tuesday in the morning in one place.”
Besides that, GPs who do not have a fridge to store Covid-19 vaccines at between two and six degrees Celsius will have to purchase one at about RM4,000.
“I have a fridge for normal vaccines. So, if it can maintain two to six degrees Celsius, they are quite okay with that. Fridge is RM4,000 and above. Not all GPs will have, mostly won’t have,” the FPMPAM secretary added.
ProtectHealth: 45 GPs To Start Covid-19 Vaccinations May 4
ProtectHealth CEO Anas Alam Faizli said 45 GPs across the country will start rolling out Covid-19 vaccines from May 4. ProtectHealth has previously piloted the coronavirus vaccination programme at two GP clinics in Negeri Sembilan and another four in Selangor.
He said more than 2,500 private medical practitioners have registered with ProtectHealth to administer Covid-19 vaccines in PICK to date. The second GP Covid-19 vaccine rollout will take place on May 18, when ProtectHealth hopes to recruit 200 to 300 more GPs by then. ProtectHealth targets 3,000 GPs to join PICK as vaccinators.
It takes about two to three weeks to complete registration of GPs as Covid-19 vaccinators, including training.
“We’re doing the best to facilitate. We want to ensure zero wastage policy. We want to ensure the quality of vaccination that the public gets from private facilities is similar or better than the government,” Anas told CodeBlue in an interview, when asked about GPs’ complaints that the government is treating Covid-19 vaccines differently from other vaccines.
Dr Gan Siaw Chien, project manager for Covid-19 vaccines at ProtectHealth, said two computers are needed for GPs administering coronavirus vaccines because vaccine recipients’ identities must first be verified. After vaccination, GPs must record which batch of vaccines was given to the recipient so that any rare side effects can be traced.
“I would have to say, not every health care practitioner is familiar with vaccination,” Dr Gan told CodeBlue at the joint interview with Anas.
“Vaccinations have different types, some have more stringent requirements, Covid is one of the more difficult ones.
“Some GPs, if by government standards, they might not be ready to do that. That’s why we come in to do training. That’s why training is compulsory. We’re upskilling GPs’ skill sets and competency.”
He said best practice was a pharmaceutical top loading refrigerator that can easily maintain temperatures at two to eight degrees Celsius, but ProtectHealth is willing to facilitate GPs by allowing them to use lower-spec fridges with temperature data loggers to monitor temperatures at two to eight degrees Celsius.
Dr Gan also explained that there are 600 Covid-19 vaccine storage sites (PSV) nationwide. GPs will be directed to the nearest one, usually within 5km from their clinic. Pfizer-BioNTech’s coronavirus vaccine is stored in 55 ultra-cold temperature freezers across the country.
“We don’t allow staggered collection because of best practice in cold chain management. A fridge that is storing all the vaccines is not supposed to be opened frequently. Some standards only allow to open two to four times a day,” he said.
“Cold chain management is something we have to do very, very carefully. Any excursion of temperature will bring doubts on the potency of the vaccine.”
Pfizer-BioNTech’s coronavirus vaccine may be stored in an ultra-cold freezer at between minus 80 and minus 60 degrees Celsius until expiration date. Before mixing, the vaccine can be stored in a refrigerator at between two and eight degrees Celsius for up to 120 hours (five days). Thawed vaccines cannot be refrozen.
Unlike Pfizer, Sinovac and AstraZeneca vaccines can be stored in standard refrigerators at two to eight degrees Celsius.
Random Checks On GPs’ Covid-19 Vaccination
Dr Shanmuganathan said that the other requirements for GPs to conduct Covid-19 vaccination were nothing out of the ordinary.
GPs can choose to collect 32, 73, or 90 doses of the Covid-19 vaccine, which has to be administered by Thursday, in which six patients will be allotted per hour.
Dr Shamuganathan explained that the government also has a zero vaccine wastage policy hence, if anyone misses their appointments, the GPs will have a backup vaccination list.
“Somebody missed their dose (previously) you can call them. Own patients you can call them. So you keep a list there.”
Although the Covid-19 vaccination programme is conducted in GP clinics, these clinics will still be opened to treat patients.
“Our patients have to keep coming, otherwise, I can’t pay the rental,” Dr Shamuganathan added.
GPs will get a reimbursement of RM14 for every Covid-19 vaccine dose administered.
Dr Shanmuganathan also said that MOH’s Private Medical Practice Control Section (CKAPS) will be conducting random checks on GPs during their Covid-19 vaccination programme.
Former Malaysian Medical Association (MMA) president Dr Milton Lum pointed out that the Covid-19 vaccination programme is just like any other inoculation programme, hence there is no need for checks by CKAPS.
GP clinics routinely administer common adult and childhood vaccines, such as for the flu, HPV, MMR, hepatitis, among others.
“What is so special about this vaccination. Why do you need to check when you don’t check other vaccinations?” Dr Lum said.
“Except for the Pfizer vaccine which requires specific requirements with regards to the cold chain, the other vaccines have no such requirements. To make sure that mass vaccination is successful, there should be involvement of GPs.
“To involve the participants of GPs, they should not put too many conditions in their participation,” the former MMA president added.