Vaccine overdose cases raise questions over doctor training

Australia’s vaccine rollout suffered a major hiccup, with health minister Greg Hunt revealing on Wednesday that two elderly residents at an aged care home received four times the recommended dose of the Pfizer vaccine.

The two patients, an 88-year-old man and 94-year-old woman at the Holy Spirit Nursing Home in Carseldine, did not show any signs of an adverse reaction to the extra vaccine doses, but experts are questioning whether Australia’s training program for doctors may have been rushed.

The doctor responsible for giving the wrong doses has been stood down from the vaccine rollout program.

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Mr Hunt said a nurse discovered the mistake quickly and safeguards were immediately put in place to care for the two elderly Australians.

“Both patients are being monitored and both patients are showing no signs at all of an adverse reaction,” Mr Hunt said. “But it is a reminder of the importance of safeguards.”

Queensland Premier Annastacia Palaszczuk questioned the government training related to the vaccine rollout and said she would be requesting national cabinet be convened to deal with the issue.

The vaccination program in aged care homes is the responsibility of the federal government and Ms Palaszczuk said that Queensland authorities were notified quite late about the overdose situation.

“I will write to the prime minister asking him to convene national cabinet as soon as possible,” Ms Palaszczuk tweeted on Wednesday.

“I want to know what training is provided to the people the federal government is employing to administer the vaccines in our aged care facilities.

“I want to know about the communications strategies for the next phases of the vaccine rollout.”

Professor Peter Collignon, an infectious diseases expert from the Australian National University, told The Guardian that similar mistakes had been made overseas, and questioned whether training should have been done more thoroughly, given Australia’s privileged COVID position compared to the rest of the world.

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Prof. Collignon explained that the vial for the Pfizer vaccine is designed to contain enough doses for four people and if the health professional was not properly trained, they could assume that the whole vial was for one person.

“I have no idea if this is what happened here, but it has happened elsewhere,” Prof. Collignon said.

“I’m not aware of any adverse events from that occurring but you’d certainly get a more sore arm due to the larger volume of vaccine, and some more prominent side-effects.

“The mistake people sometimes can make if they are not well trained is they may give too much to one person or assume the whole vial is for one person.”

Lincoln Hopper, the chief executive of St Vincent’s Care Services, which manages the nursing home where the extra doses were administered, also questioned whether staff were appropriately trained.

“This incident has been very distressing to us and to their family and it is also very concerning,” Mr Hopper told a news conference. “It has caused us to question whether some of the clinicians given the job of administering the vaccine have received the appropriate training.

“Certainly, health authorities and contracted vaccination providers should be re-emphasising to their teams the need to exercise greater care so an error like this does not happen again.

“The families are doing okay in the context of the situation but certainly we need to continue to monitor the residents. They are not out of the woods in that sense and so we are very concerned for their welfare.”

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Australia’s chief health officer, Professor Paul Kelly, explained that while the dose given to the two patients was much higher than recommended there was evidence to suggest there would not be side-effects from the mistake.

“In the early clinical trials of the Pfizer and BioNTech vaccine, they did actually experiment with different doses of the product, including one three or four times higher than what have eventually been the prescribed doses,” Prof. Kelly explained. “During those trials, the side-effect data was not a higher problem.

“We are aware of several cases like this happening early in the phased rollout through residential aged care facilities in Germany and the UK.

“Again, the side-effect profile was minimal, particularly in older people, so that gives us hope.”

Professor Julie Leask, a social scientist from the University of Sydney, told The Guardian that the government had done the right thing by being upfront about the mistake and acting transparently when the situation arose.

“This is a large complex program, staff are being newly trained in giving multi-dose vials, and a good safety culture is one that is upfront about these things and addresses them proactively in a transparent way,” Prof. Leask said.

“These things will always make some people feel a bit more cautious about the vaccine, but it’s much better to be upfront rather than it getting leaked out some other way.

“Trust is the most precious resource when you have a big health program that needs public cooperation, and what must be prioritised is sustaining trust.”

Do you think that Australia rushed its vaccine training program for doctors? Are you more worried about getting the vaccine now or comforted that the government has been upfront about the mistake?

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Written by Ben



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