Last week a colleague was treating Sharon*, who had just had a brain injury, in a major teaching hospital in New South Wales. Her rehabilitation was progressing well, when her family announced that she had to leave the hospital for her booked vaccination with her GP. She needed transport, and a public bus was out of the question. Already confused from the injury, staff tried to explain that she wasn’t going home and that her dinner at the hospital would be kept warm, but she left perplexed.
Vaccines were in the building, at the hospital that was treating her. But Sharon was not able to have that vaccine administered by the professionals that know her and her condition well. The vaccinations on site were only available for hospital staff.
To date fewer than 7% of all people living with a disability in care homes have been vaccinated (despite them being classed as 1a and 1b priority).
They are a priority because many are uniquely vulnerable to the ravages of Covid and need to be protected. People living with disabilities will often have chronic respiratory difficulties and many can’t mount a strong cough or easily fight off a chest infection. Those with trouble swallowing, hearing, sight or speech may have more difficulty communicating their needs or clearing their throats while those with problems with thinking, memory and/or controlling impulses might simply change in their behaviour if unwell. When they get ill, they are likely to present late to doctors who might not used to managing people with disability.
So it’s complicated and critical that these people are vaccinated early. However, vaccinating these vulnerable Australians is not straightforward. Many won’t just roll up their sleeves for a shot.
But we have the specialised infrastructure ready and waiting to do it.
All Australian states have active rehabilitation medicine departments in their major hospitals that tend to the medical needs of those living with a disability. At any given moment NDIS-supported people living with disabilities are in hospitals around the country. Why these people, already in hospital, have not had their vaccine given or at least organised, remains a point of consternation for rehabilitation medicine physicians and the disability community.
Departments of rehabilitation medicine are staffed by consultant specialist physicians, nurses and allied health professionals who are expert in treating and caring for those with disabilities. Most people living with disability know where these departments are or have been treated in them. They are purpose-built to manage people living with all types of disabilities.
In NSW these departments stand ready to serve as vaccination centres. We have indicated to government that we are willing. But still, we are not being used and do not know if and when we will be.
Planning to vaccinate people living with disability will be nothing like other populations. Not just in administering the jabs, but support after.
Many of those living with disabilities that impact their thinking, memory and behaviour are unlikely to be able to give consent, and will have to have experienced staff to communicate why the needle needs to be given twice. Most of those living with disabilities are under 50 and will require the difficult to store and transport Pfizer vaccine. According to a study published in the Lancet a significant proportion of vaccine recipients may suffer mild side effects, which for people with disabilities may mean they could require extra home-based care for 48 hours after the vaccine.
You see, if you can’t walk and you need your arms to propel a wheelchair or move from bed to chair, then having a painful or weakened arm for 48 hours might lead you to be bed-ridden. Without the care you need, getting out of bed to go to the toilet will become a complex issue.
To date there has been a lack of communication on the preparations being made federally for this herculean logistical undertaking. Nor has there been any meaningful communication of the details of the vaccination process to people living with disabilities, their parents and families or their doctors.
At the moment only those with carers or those with disabilities that don’t prevent them from using public transport might be able to get to the GP to be vaccinated with the AstraZeneca. However, for many where transport is difficult or where vaccinating is a challenge due to consent, behaviour or hesitancy issues, trained expert medical teams in our taxpayer-funded hospitals and rehabilitation medicine departments stand committed to help. But right now we are unable to contribute or help even our current inpatients, people like Sharon.
Show us your planning or let us help. Or both.
*Name has been changed.
This content first appear on the guardian