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President of the Medical Association of TT Dr Vishi Beharry is suggesting to the Ministry of Health that general practitioners who see children, as well as paediatricians who do vaccinations should get some Pfizer covid19 vaccines to give to their patients, even if they are not sentinel physicians.
TT received a donation of 300,000 doses of Pfizer vaccines from the US on Thursday morning. Previously, the Prime Minister said as Pfizer was the only vaccine approved by the World Health Organization for use in children, any of the vaccine received by TT would be reserved for students aged 12 to 18.
On July 3, Health Minister Terrence Deyalsingh announced that 64 sentinel physicians would receive 15,000 vaccines to administer to private patients free of charge. He later said the initiative would be expanded to a further 50 doctors.
However, many doctors did not get their supply until the last week of July. Beharry explained that, with the minister’s announcement, the initiative was piloted with only a few physicians so that any problems with the system could be solved. Now, the ministry is expanding.
“Because there are a small number of sentinel physicians, to help distribute the vaccines more efficiently, the ministry is trying to bring on board new physicians who would not have been sentinel physicians.
“But of course that process is taking some time because it requires getting the names, the locations, sending someone to inspect the site to ensure they meet the requirements, and so on. So, it is happening but it is taking some time.”
One doctor in central Trinidad said he hardly had any patients coming to him to be vaccinated.
“Before we got the vaccines, when the minister made the announcement and I put out the word that I would be getting them, a lot of patients expressed their interest in getting vaccinated. But it took a little while to get approval from the ministry and in that time there were all the mass vaccination sites and people being allowed to walk in.
“I contacted one or two who had called before and they decided to go. I believe a lot of people ended up doing that because since then I haven’t heard from many people.”
He said the few patients who were still calling him to get vaccinated were mostly those with allergies. He would do a subcutaneous test to see if there was a reaction and monitor them. If there was none, he would administer the full dose.
There were also those who felt more comfortable getting vaccinated by a doctor they trusted, who were able to get advice, who wanted to avoid any crowds at the mass vaccination sites, or who found it more convenient because he would open later than the sites.
One doctor in west Trinidad said the uptake was good when she first got the vaccines with about eight appointments a day. But, within a week, it slowed down to two per day or none at all.
She said vaccinations were made by appointment only because the vaccine came in a double dose vial. She did not want to open a vile, use one dose and have to throw away the other. Appointments also assisted in controlling the patient traffic so there was no overcrowding.
“Most who came to me to be vaccinated were vaccine hesitant and preferred to speak to a doctor they trusted to get their advice to help them make their decision. And some were needle-phobic and preferred to be in a comfortable environment.”
Patients were mostly concerned about blood clots and the different side effects associated with the vaccine, as well as the lack of years of study of the vaccines.
The only challenge, she said, was the amount of paperwork and checks associated with the process.
Time honoured tradition to vaccinate
Beharry explained, “For decades, every time a physician opens his or her office, the physician can choose to contact the County Medical Officer of Health (CMOH) Office and sign up to be a sentinel physician. When you sign up, your responsibility is to report any cases of a list of mostly infectious diseases through the surveillance unit every Monday morning.”
The National Surveillance Unit of the Public Health Department monitors how many cases of a particular disease is happening in the country so they could identify when an outbreak or epidemic occurs. It would give the Ministry of Health the relevant information in a timely manner to be able to decide how to treat with the situation.
[caption id="attachment_907314" align="alignnone" width="1024"] A volunteer administers the Sinopharm covid19 vaccine to a man at the Supermarket Association's vaccination site, Divali Nagar, Chaguanas on Saturday. - Photo by Marvin Hamilton[/caption]
Meanwhile, the Expanded Programme on Immunization (EPI) Unit was responsible for childhood and adult immunisation.
“That unit is responsible for distribution of the vaccines, tracking, monitoring, identifying if there are any adverse effects and so on. That unit has been heavily involved in covid19 vaccination but, for all these years, they have been involved in regular vaccination.”
When the ministry gets vaccines, it goes to the EPI which distributes vaccines to the different health centres. An EPI nurse from each CMOH office would manage vaccination in the region.
“The ministry would have offered physicians who want to administer vaccines the opportunity to sign up to be part of that sentinel physician practice. At the RHA level, the nurses would come down to the medical practitioner’s office to do some inspections, and make sure your space is safe to administer vaccines.”
Once inspectors confirm the space and storage, that the vaccine would not be compromised, and the doctor would be able to administer vaccines safely, the doctor would request a certain number of vaccines and collect them. Then, once a month, the doctors then have to report how many vaccines were used, what type of vaccine, if the first or second dose was administered, and other details.
“(The ministry is) using that same system of sentinel physicians to have them administer covid19 vaccines to their private patients. Those who can accommodate it will allow for persons who receive the vaccines through them, even if they are not one of their patients.”
However, he said most of the physicians would administer the vaccine to their patients so their medical history would be known and they could advise the patients whether or not they should take the shot.
 
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