[Australia] Swine flu vaccine program in jeopardy:

http://www.theage.com.au/national/swine-flu-vaccine-program-in-jeopardy-20090827-f16m.html
Julie Robotham
August 28, 2009

THE Federal Government's plan to immunise the population against swine flu is in chaos because doctors' insurers may not cover them to administer the jab, saying inadequate testing and the possibility of spreading other infections mean there is too high a risk that patients will sue them later.

Despite weeks of crisis talks, the Government has refused to underwrite doctors' liability for the vaccinations, and medical groups say the program - due to start as early as mid-September - cannot proceed unless doctors are insured.

Andrew Pesce, president of the Australian Medical Association, said ''the indemnity issue needs to be sorted out or else the vaccination program won't go ahead''.

''In the environment we're in, someone has to be held accountable for rare vaccine reactions that may occur … if the Government decides there is a priority need to roll out the vaccine, then it has a duty to indemnify the doctors who provide it,'' he said.

Ronald McCoy, a spokesman for the Royal Australian College of General Practitioners, said the wrangling could undermine community confidence in the vaccine's safety. ''It's the public's health that's at risk here,'' he said.

In May, Health Minister Nicola Roxon announced an order with vaccine supplier CSL Ltd for 21 million doses - enough to protect at least half Australia's population from the flu strain.

But insurers believe the distribution of the vaccine in multiple-dose vials exposes people to an unnecessary risk of blood-borne infection from other recipients. As well, they believe the possibility of rare side effects has been inadequately explored. These issues, they say, will make it hard for doctors to advise people whether or not to have the injections, exposing them to patient complaints that they were not properly informed.

Ellen Edmonds-Wilson, chief executive of the Medical Indemnity Industry Association of Australia, said it was up to individual insurers ''to make an assessment of the risk [from] the drug'', which she noted had not yet been approved by the Government's Therapeutic Goods Administration.
Medical defence organisations MDA National Insurance Pty Ltd and Avant Mutual Group said they were still considering whether to indemnify members who gave patients the vaccinations.

Lisa Clarke, Avant's general manager of claims, said the industry was ''in ongoing discussions with the [health department] on the proposed roll-out''.

Elda Rebechi, a spokeswoman for the insurer Medical Indemnity Protection Society Ltd, said the company would cover doctors, but warned them to ''appropriately advise patients that the vaccine is untested and may have [currently] unknown consequences''.

But the head of clinical research at the National Centre for Immunisation Research and Surveillance at the University of Sydney, Robert Booy, said the insurers' arguments were superficial and ''unnecessarily inflammatory'' and proper training of clinicians would virtually eliminate the risk of infection.