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Doctors are urging Victorians not to wait for the Pfizer vaccine, warning that many people who have had blood clots or strokes still wrongly believe the AstraZeneca vaccine is unsafe for them.

On a day when Victoria recorded 246 new coronavirus cases, the highest number since August last year, Health Minister Martin Foley revealed that most people who are sick with COVID-19 in Victorian hospitals had not received any vaccine, despite being eligible.

People queue at the Royal Exhibition Building vaccination centre in Carlton on Saturday.Credit:Joe Armao

General practitioners say there is still a lot of misinformation about who cannot get the AstraZeneca vaccine, meaning vulnerable people with underlying conditions that put them at much higher risk of dying of coronavirus were unnecessarily waiting for the Pfizer vaccine.

They say the number of people who could not have the locally manufactured AstraZeneca jab for medical reasons was actually “very small”.

Royal Australian College of General Practitioners president Karen Price said “people are getting the wrong idea that because they’ve got a chronic health condition that they shouldn’t have AstraZeneca – but they’re precisely the people who need to get vaccinated because COVID is such a risk to them”.

The push to get more people immunised comes as health authorities continue to warn that Victoria is facing a “pandemic of the unvaccinated” with many of those who have tested positive for coronavirus being children, who are not eligible for a vaccination, or adults who have not yet received their first dose. About 60.8 per cent of Victorians have received at least one dose of vaccine, short of the national average of 63.2 per cent.

Victorian COVID-19 response commander Jeroen Weimar said that the increasing number of people being hospitalised – including the growing cohort of young, unvaccinated people – was a “real and present danger”.

“This week we’re bringing on more COVID-dedicated wards at a number of our health services. We have a plan going forward over the weeks and months ahead. Should these numbers have not started to turn around, then we will continue to provide more capacity in our health services to look after people who’ve become seriously ill.”

Mr Foley said only one of the 92 people in Victorian hospitals with coronavirus at the start of this week was fully vaccinated, and that person was now well enough to be discharged.

Meanwhile, 67 of those still battling the illness in hospital had not received any vaccine despite being eligible at the time they were hospitalised. Another 13 were unvaccinated and were not eligible because they were under 16 at the time they were diagnosed.

The rare side effect linked to the AstraZeneca vaccine is called thrombosis (blood clots) with thrombocytopenia (low platelets), but despite the name, there is no evidence that people are at additional risk simply because they have a family history of blood clots or strokes, for example.

Dr Price said Pfizer was recommended for pregnant women and children, but, overall, “there are only a few limitations on getting the AstraZeneca, and blood clots is not one of them – unless it’s a very particular type of blood clot”.

Nevertheless, Melbourne GP Magdalena Simonis said some of her patients, including those with bruising, had been unnecessarily concerned about this issue.

“The majority of people who have previously had a stroke, deep-vein thrombosis, pulmonary embolism, are on blood thinners, take aspirin to prevent a stroke are all candidates for AstraZeneca,” Dr Simonis said.

Asked if anyone should be waiting to get Pfizer, Melbourne GP Ines Rio said this would require an “individual discussion, but “overall my recommendation is to get vaccinated ASAP – with whatever you can get”.

A few weeks ago when the interval between jabs was vastly different, and coronavirus cases were lower, Dr Rio was largely recommending younger people wait a few weeks as she felt they would probably finish their Pfizer before their AstraZeneca doses, even if they had to wait a while for Pfizer.

“That’s not the case now as they are both six-week intervals.” she said. “There will be more Pfizer around soon, but the COVID cases will also go up. The death rate from clotting with AZ is very low at about one in a million and the vaccine is very effective.”

Coronavirus is now being detected across Victoria, although the largest clusters are still located in Melbourne, including 129 new cases in the city’s northern suburbs and 71 in the west.

Dr Simon Benson, a GP at The Clinic Footscray in Melbourne’s west, believes “hardly anyone should be waiting for Pfizer”.

“We get people coming in for flu vaccines, and they don’t say: oh I want Seqirus, or I want flu vaccine x. Nobody asks for the flu vaccine they want, but with COVID there’s been so much publicity about the side effects, which are all rare, that you get people coming in saying: I only want this one.”

The Australian Technical Advisory Group on Immunisation strongly recommends AstraZeneca for those aged 60 and over, and also says it should be considered by all adult Australians in communities such as Melbourne affected by outbreaks if they do not have immediate access to Pfizer.

The advisory group said the Pfizer vaccine is preferred for people with a history of idiopathic splanchnic (mesenteric, portal, splenic) vein thrombosis and antiphospholipid syndrome with thrombosis.

However, it said the risk of thrombosis with thrombocytopenia isn’t increased for those with a history of blood clots in typical sites, increased clotting tendency that is not immune mediated, family history of blood clots, history of ischaemic heart disease or stroke, current or past thrombocytopenia (low platelet count) or those receiving anticoagulation therapy. This means this group can receive the AstraZeneca vaccine.

For those among the highest risk of dying from COVID if unvaccinated – those in their 60s and above – there has been one death in Australia from the rare vaccine side effect, compared with 995 deaths from COVID.

With Rachel Eddie

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