Een AstraZeneca-vaccin. (Foto: Orange Pictures Nieuws)

Rotterdam GPs are raising the alarm about vaccination with AstraZeneca: “This tour is the last, we can’t do it again”

Friday, April 2, one day after general practitioners in our district started injections, vaccination with AstraZeneca has been temporarily stopped for people under the age of 60. The reason: Eight reports in our country of women who, after getting vaccinated with the now controversial vaccine, got a rare combination of a stroke and a low platelet count. A woman died from him.

The European Medicines Agency (EMA) decided last Wednesday that this is indeed a negative reaction. Very rare, with a chance of less than 1 in 100,000. Because of this small chance, the Medicines Agency said the benefits of the vaccine outweigh the risks. However, the Health Council recommended in emergency advice that people under the age of 60 be given a different vaccine. The Cabinet adopted this advice on Thursday.

Thus, GPs in our region cannot vaccinate children under the age of 60 at the present time, and not only this. A large number of people over the age of 60 are canceling their injection appointment, fearing AstraZeneca. As a result, many vaccines remain, says Martin Oil. She is a general practitioner in Karnes (Rotterdam-Charlieu). “We are located in one building with three clinics, so we had 330 injections available. We invited 350 people for that, because we thought: There are always a few that don’t come. These messages arrived to our patients last Thursday and then Friday became Friday. After that. They decided to stop injecting 60-year-olds with AstraZeneca. As a result, we’ve had all 60-year-olds cancellations this week, and I think half of that. “

Hours spent with vaccinations

And that’s while Owl did everything in her practice of injecting 330 injections last Thursday. “We rented an entire room, got everything set up and organized the normal care very differently on the day of the injection. So we thought: Let’s do our best to pump as much as possible that day. Then we are only people between the ages of 65 and 70. There are actually a few hundred. We spent hours with our vaccinations. In the end we got 227 rounds out of 330. “

Chakib Sana, a general practitioner in Delfshavn and a board member of the Rotterdam-District General Practitioners Association, introduces himself, in the words of his colleague Aweil. “We had hoped that the participation rate would be 80 to 90 percent, but it would drop to between 30 and 40 percent. This is also in deprived areas, where diabetes, diabetes, lung disease and obesity are more prevalent. Information gap, and difficulty in obtaining information. “Determined correctly, and doubts about vaccinations. By pressing the stop button twice in this way, confidence in these people will be completely destroyed.”

“For a week, all the numbers related to thrombosis, no matter how low, were moved around people’s ears. This makes people anxious. They think: I might be the one. It’s disastrous that it’s not just people under the age of 60. The vaccine isn’t allowed,” But people over the age of 60 have now been canceled as well. They don’t trust it. The elderly also have questions: Why are we still allowed to receive this vaccine? The decision to take the AstraZeneca vaccine is really a week’s decision. People left. The government has not launched a media campaign To explain it to people, so that they can make an independent decision based on good information. As a result, people have now based their choice on fear. “

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Mattis van der Bolle, general practitioner at Heemraadssingel in West Rotterdam, cites a concrete example of this fear: “I have a family in this practice, as the man has been severely affected by the coronavirus. He has been in intensive care and is now walking. With a walker, but fortunately I just survived. I have a relative of this man in practice, a woman at the same time, who suffers from breathing problems, rheumatism … you name it. She will not do it because she is too anxious. “

No more in this way

What do all these cancellations and doubts do to prepare to continue vaccination as a general practitioner? Shakeeb Sana does not have to think long about his answer. “Catastrophic, really catastrophic. I have no motive to carry on like this. I’m not alone in that.”

All practitioners are already working to get the balls out of their pants. Then this puppet theater is around AstraZeneca, it’s impossible dude.

General Physician Matthijs van der Paul

Martin Aoyle and Mattis van der Bolle are aware of this feeling. The latter is now close to despair. “When my stock runs out, I don’t really want anything vaccination-related. On Saturday I’m going to make one last attempt to sell the vaccine to people a little over 60 who want that. Then I really want to finish it. I don’t want to order again at all, it’s too heavy.” All practitioners are already working to get the balls out of their pants. And then the puppet theater around AstraZeneca, it’s impossible, dude. “

The owl adds: “We planned a full day on Thursday for the injection. That’s why we spoke on our phone line: We are now in the process of being vaccinated, so call tomorrow unless it’s urgent. So you have all the people who are regularly there and we were there, in front of a lot of people who didn’t attend In addition, the phone was ringing in previous days with questions about the AstraZeneca vaccine.

After Uil contacted people over the age of 65 with her exercise for hours on end, 227 of the 330 vaccines from AstraZeneca were finally placed on Thursday. “It was really such an excessive effort on our part, which we think is disproportionate, it’s too much work for what it comes out of. We’re not going to do that anymore.”

Van der Paul: “It’s really stressful. We provide day, night and weekend care for all conditions: from appendicitis to heart attacks to Covid-19 patients who are collapsing. Regular care continues. We can’t do it that way, yes with art. And the flying business. But this is a process, practitioners are cracking at the seams. I am a 39-year-old young doctor, I have a lot of adrenaline and pull everything, but I notice to myself: This round is finally, we can’t do it again. ”

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Sana, Auel and Van der Paul believe their views are shared by many colleagues in Rotterdam. Owl Martin at Matthijs van der Paul They previously expressed on LinkedIn that they do not want to impregnate another round of their practices. There, their calls were supported by a number of fellow physicians.

Tingling in the GGD?

It has nothing to do with doctors’ unwillingness, says Aoyle. “It’s not that we don’t want help, we are all eager to dedicate ourselves to vaccinations. But in an effective way. I hope we, as GPs, can simply work on the injection sites of GGD. If they have very few doctors then let us help there.” They have all the logistics, we don’t. “

“We said ten months ago that we would like to intervene in the current way, if it is similar to the flu vaccine. It turns out that is not the case. With the flu vaccine, I inoculate 600 patients within four hours. I set up five tables and put the flu vaccines in this way. Those ampoules are ready to use. . An injection on it, you put the injection on it, it gives a smile and a pat on your patient’s head and it disappears. AstraZeneca vaccines are logistically like this dragon, our entire team and the care we provide is usually suffering from this. We’d like to help with GGD. Prepare two hundred syringes and I’ll inject them. But don’t cancel this, Cancel it, create the sites and cancel it again. We can do it systematically. “

Sana: “As a general practitioner, we would like to hand over the staff and as far as I’m concerned, we will be injecting GGDs 24/7, no problem at all. But don’t let us do all the logistical work, this is not our job. I’m not there. For training.”

Kristel Frigg, a general practitioner in West Rotterdam, also sees an important role for practicing clinicians in injection sites in GGDs. “We have people under the age of 60 who are at higher risk and therefore need a piercing early, we can contact them to have GGDs. We can make patient selections. We will all do it if they ask us to. We GPs must also do our homework.” But the turmoil that has arisen now is where the greatest concern lies. “

Vaccines in the freezer

For now, the time is not yet ripe and Rotterdam doctors still have to sell AstraZeneca vaccines to people over the age of 60. Owl: What I find the worst: I now have over a hundred vaccines in the freezer and I have a 60-year-old who are coming in and asking, “Can I have one, please?” We should say no because the government is not allowed to do this. We are being cared for. There are a lot of AstraZeneca vaccines in the Netherlands so hopefully the government gives space for people who say: I’ve heard everything, I get it, but I think the risk of getting vaccinated is so small that I still want to get an AstraZeneca vaccine, because it’s my turn soon. Now we are waiting for vaccines from other brands while we only have them here. “

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Van der Poel also sees this trend: “I already have fifteen patients under the age of 60 who have emailed me in the past week and a half: If no one else wants, we will get vaccinated. I don’t think you could ban such a thing, but that’s legal. A little bit of things … Instinctively, there are a lot of doctors who still want to vaccinate 60-year-olds .. Soon there will be ampoules left and there will be 60- miners who want that … I’m not convinced they’re They will be somewhere for the next five months. Otherwise, you will get a vaccine. If someone is eligible and can oversee the risks, why should I not get the vaccine? ”

“We think AstraZeneca can really be offered. If people want it, it should be possible, even under the age of 60. Following the same advice from the EMA, for example, England decided to set the maximum age at 30. But in the Netherlands, it is We keep it at 60. For example, I now have to tell a 50-year-old cardiologist who is sick with me: Yes, sorry, you want that, but you don’t want to like me. It doesn’t look good in the storm we’re in right now. ”

No vaccine rejecters

Kristel Frigg is also concerned about the group refusing to take the AstraZeneca vaccine. “These people should not be portrayed as vaccine refusers. They may want a different vaccine. What will happen to that group of people? How will they be registered with RIVM? Can they use a different vaccine? A lot of questions that patients ask that we, as GPs, cannot answer.”

“Our assistants are called throughout the day to answer these questions. They cannot spend the time they spend answering“ normal ”questions, many people wait for a long time. This puts extra pressure on practice, making it easier to reach them. Less. During a phone consultation, Half of the calls are about the vaccine. There are massive disruptions between patients. Then it would be a good idea to organize this more centrally. “

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