"The GPs of Australia are confused". A doctor's perspective on the COVID-19 vaccine rollout.

It's been mere days since Aussies were told that anyone under the age 40 can get the AstraZeneca vaccine. And it's fair to say, many of us are confused.

On Monday night, after an emergency meeting of the National Cabinet, Prime Minister Scott Morrison announced that younger people, who were previously told Pfizer is the preferred vaccine for their age group, can receive the AstraZeneca vaccine if they want to and are fully accepting of the rare health risks associated with it. 

Following the announcement, state premiers and chief health officers have criticised the government's mixed messaging and warned against ignoring advice from the Australian Technical Advisory Group on Immunisation (ATAGI), leaving many of us with questions and concerns. 

And we're not the only ones. 

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According to Dr Preeya Alexander, even "the GPs of Australia are confused". 

So she wants to clear a few things up. 

Earlier today, the General Practitioner, author and mum-of-two shared a video on Instagram, clarifying what the Therapeutic Good Administration of Australia (TGA) and Australian Technical Advisory Group on Immunisation (ATAGI) have said about the vaccines, and what we can do to make an informed decision. 

"To the people of Australia, it is okay if you are feeling confused and bombarded. And [thinking] 'who they heck am I meant to be listening to?' because the GPs on the group feel the same way," she says.

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Here's what we learnt from the video.

First off, who is the TGA and what are they saying?

"The TGA is Therapeutic Good Administration of Australia. They are the people who review medications before they are allowed to be used in Australia," Dr Alexander explains. 

The TGA have approved the use of AstraZeneca for over 18-year-olds. 

"It is approved," she stressed. 

The other group we're hearing about in the news is the ATAGI. 

"That is the Australian advisory group on immunisation. They are a board of people who advise, they look at data coming in, they look at potential side effects, they look at risks of things and they give recommendations," she says. 

"And these are the people that with data evolving and coming in, made the recommendation that anyone over 50 could have AstraZeneca... and anyone under, ideally, the preferred vaccine was Pfizer."

However, Dr Alexander says it's important to remember that this is "a recommendation". 

"If you read the language, it actually says for individuals who are under 60, Pfizer is the preferred vaccine if it is available. But other vaccines can be considered if benefit outweighs risk and the individual has an informed decision."

So what do we know about the risks associated with AstraZeneca?

Dr Alexander wants to make clear that "it's not that one vaccine is banned". 

Instead, Pfizer is more ideal for people under 60 because of the rare risk of a blood clotting condition called thrombocytopenia syndrome or TTS.  

"AstraZeneca is approved for use in over 18-year-olds. The recommendations suggest that, yes, Pfizer is ideal because of the risk of that rare immune-mediated clotting disorder, TTS, is higher in the under 40 age group. Is it radically high? No. Is it two to three in a hundred thousand? It varies depending on age group, even those figures are not sent to GPs. We go hunting for them." 

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So far Australia has recorded only 64 cases of confirmed or suspected TTS from approximately 4.2 million doses of the AstraZeneca vaccine. Of those confirmed cases, tragically, two have died.

However, for those over 60 who are concerned about getting their second dose of AstraZeneca, Dr Alexander has some advice. 

"Please, anyone over 60 you are higher risk for death and complications from COVID-19. You should really, ideally be getting your second dose.

"The risk of that TTS of that really immune-mediated clotting disorder is actually one in a million with the second dose. It's extremely low. And don't forget we are so much better at identifying this rare immune-mediated clotting disorder. We know what to look for, we know when to send you to hospital... we know what to do and how to treat it, we're all over it."

"But what this messaging has done is it has stopped the people who are actually eligible for AstraZeneca form getting it. They're scared, they're frightened, everyone's confused."

Why it's so important to have a conversation with your GP.

In these times of confusion, Dr Alexander says it's incredibly important to talk to your GP about the risks and benefits associated with each vaccine to choose the one that is right for you. 

"Here's what I would like to say, there is a risk of COVID-19 and you need to personally decide where you are, what you do, who you live with, how big that risk is. And if you are under 60... you need to decide if those risks of COVID-19 and passing it onto other people, if those risks outweigh the potential risks of the vaccine."

"You do need to have that conversation with your GP and you need to hear the figures specific to your age group, and you need to hear the risk-benefit ratio."

While she says doctors are swamped right now, individual counselling is key.

"I want to be clear here, talk to your GPs if they're available."

"We can't say this is a one-size fits all approach. We can't say to everybody you're going to get a Pfizer dose."

Instead what GPs need, what we all need, is clear united messaging from the government. 

"Lets use language here which is not going to scare and confuse people. And I'm a GP and I'm scared and confused."

"Give people information and let people think for themselves and talk to the right qualified people."

For more about the AstraZeneca vaccine, read our explainer here.

Feature Image: Instagram @thewholesomedoctor