Family physicians: We could administer more vaccinations

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COVID-19 vaccinations at East Tallinn Central Hospital. Source: Raigo Pajula/ITK

Family physicians around Estonia are worried about coronavirus vaccine shipment uncertainties and risk group lists that are often not in accordance. ETV's weekly news show "AK.Nädal" took a look at two family health centers to see what stands in the way of faster vaccinations.

On Friday, Dr. Anne Kaldoja in Räpina was awaiting 24 patients for vaccinations. Three of them notified the doctor in the morning that they could not make it to their designated slot, but replacements were found quickly.

The family health center in Räpina received its first COVID-19 vaccine doses meant for risk group vaccinations on Wednesday. To find 36 people to vaccinate, the center had to contact nearly three times as many people.

"Who said they could not make it now, who said they did not want to. A big problem is also that people do not pick up unknown numbers. Unfortunately, there is only one phone in our practice that they know of and it was problematic that they did not pick up any other phones. So we had to use one phone number," Kaldoja said.

Although she did not receive any doses of the AstraZeneca vaccine, there are patients who have already stated they do not wish to get the controversial vaccine. "Many who we are planning to vaccinate say they do not want AstraZeneca. Those people could not specifically explain why," Kaldoja noted.

In addition to doses of the Pfizer vaccine, the family health center in Nõmme, Tallinn, also received 100 doses of AstraZeneca, aimed at people aged 70 and under. Although more explanation is needed when it comes to AstraZeneca, patients in Nõmme were mostly glad to get vaccinated. Ten people were called in the span of 30 minutes and six signed up for vaccinations. Three did not pick up.

Family physicians use a list sent to them by the Health Insurance Fund. While creating the lists, the person's age and health conditions are considered.

Külli Friedemann, head of first-level services at the Health Insurance Fund, said there are many kinds of comorbidities. "Asthma for example, high blood pressure. Those have been given to us by the immunoprophylaxis committee. A completely healthy man may have gone to his family physician, they have high blood pressure or another health issue, perhaps their body mass index is too high. That alone is enough to get into the risk group," Friedemann explained.

The risk group lists drawn up by the fund also include those who have already received an injection. The lists often clash, making it more complicated for family doctors. "The lists family physicians have now are as of January 11. One possibility is that if physicians want to draw up a new list, which we are doing now - we separate people who have been vaccinated and any other events," Friedemann noted.

Eero Merilind, a family physician at the Nõmme family health center, said the most important changes should already have been done by now. "We are speaking about two or three things that should be done. Of course, having vaccination time slots in the digital registry would be good, people could book their times. Then there are the lists - Latvia has an information system where people can queue up individually and if someone has extra doses, people can be called right away. And third - integrating information and databases," Merilind said.

Family physicians are still worried about uncertainties when it comes to vaccine shipments. "I called the Health Board repeatedly on February 22 and pressed them for a confirmation for me getting these vaccines," Anne Kaldoja said.

Both family physicians and Külli Friedemann of the Health Insurance Fund confirmed that the capabilities of family health centers are much greater than shipments allow for.

"The family doctor's team can administer ten doses an hour. Simple math shows that there are some 450 family health centers in Estonia, that is 4,500 injections. If we were to have a 'Teeme ära' kind of initiative, we could vaccinate 45,000 people purely off family health resources. We do not have a lack of space, the problem is rather that shipments have not held up and the chain is very long with many nuances," Friedemann said.

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Editor: Kristjan Kallaste

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