Saturday , June 19 2021

Australia has hospital wards ready to vaccinate people with a disability. Why are we not used? | Steven Faux



Lfor a week treated a colleague Sharon *, who had just suffered a brain injury, in a large learning hospital in New South Wales. Her rehabilitation went well when her family announced that she had to leave the hospital for her booked vaccination with her GP. She needed transportation, and a public bus was out of demand. Already in the throes of the injury, the staff tried to explain that she would not go home and that her dinner would be kept warm in the hospital, but she remained stunned.

Faxes were in the building, in the hospital treating her. But Sharon could not have that vaccine administered by the professionals who know her and her condition well. The vaccinations on the site were only available to hospital staff.

To date less than 7% of all people living with a disability in care homes are vaccinated (despite being classified as priority 1a and 1b).

They are a priority because many are uniquely vulnerable to Covid’s injuries and need to be protected. People living with a disability will often have chronic respiratory problems and many will not be able to catch a strong cough or easily fight a breast infection. Those who have difficulty swallowing, listening, sight or speech may have more difficulty communicating their needs or clearing their throats, while those with thinking, memory and / or controlling impulses may simply change their behavior when they are not good. If they become ill, they are likely to present late to doctors who may not have been accustomed to managing people with a disability.

It is therefore complicated and critical that these people be vaccinated early. However, vaccinating these vulnerable Australians is not immediate. Many will not just roll up their sleeves for a shot.

But we have the specialized infrastructure ready and waiting to do it.

All Australian states have active departments for rehabilitation medicines in their large hospitals that cater to the medical needs of those living with a disability. At any given time, NDIS-supported people with a disability are in hospitals around the country. Why these people, even in the hospital, have not given or at least organized their vaccines remains a point of consternation for doctors for rehabilitation medicine and the disability community.

Rehabilitation medicine departments are staffed by consulting physicians, nurses, and affiliated health professionals who are expert in treating and caring for those with a disability. Most people living with a disability know where these departments are or have been treated. They are purpose-built to manage people living with all kinds of limitations.

In NSW, these departments are ready to serve as vaccination centers. We have indicated to government that we want to. Yet we are not used to it and do not know when and when we will be.

Plans to vaccinate people with a disability will be nothing more than other populations. Not only when administering the jabs, but support after.

Many of those living with a disability affect their thinking, memory and behavior will probably not be able to give permission, and will need experienced staff to communicate why the needle should be given twice. Most of those living with a disability are under 50 and will need to store and transport the troublesome Pfizer vaccine. According to a study published in the Lancet, a significant proportion of recipients of vaccines may suffer side effects, which may mean that people with a disability may need an extra home base 48 hours after receiving the vaccine.

You see, if you are unable to walk and need your arms to propel a wheelchair or move from bed to chair, then having a sore or weakened arm for 48 hours may lead you to get up in bed. Without the care you need, getting out of bed to go to the toilet will become a complex problem.

To date, there is a lack of communication about the preparations being made federally for this herculean logistics venture. There has also been no meaning communicating the details of the vaccination process to people living with a disability, their parents and families as well as their doctors.

Currently, only those with mantle caregivers or people with disabilities who are unable to use public transport can come to the GP to get vaccinated with the AstraZeneca. For many where transportation is difficult or where vaccination is a challenge due to consent, behaviors or hesitation issues, trained specialist medical teams in our hospitals and rehabilitation medicine departments with taxpayers are committed to helping. But now we can not even contribute or help our current patients, people like Sharon.

Let us see your planning or let us help. Or both.

* Name changed.

Prof Steven Faux is a Physician for Rehabilitation and Pain, Director of the St Vincent Hospital Department of Rehabilitation Medicine and Pain Medicine, and Cohesive Professor UNSW


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