Vaccination at GPs’ surgeries

Since March 2021, it has also been possible to get vaccinated against Covid-19 at general practitioners’ surgeries in addition to being vaccinated at vaccination centres. The rollout has been gradual and based on the amounts and types of vaccines available.

Who do general practitioners vaccinate?

1

Criterion

patients according to the age criteria announced by the Ministry of Health of the Czech Republic; from 16 years of age and upwards as of 4.6.2021, from 30 years of age and upwards as of 26.5.2021

patients whom the GP considers to be at risk of a serious case of Covid-19 that is similar to the risk of vaccinated people in the given period, especially in the case of patients with diagnoses and medical conditions with a high risk of suffering a serious case of Covid-19*

TIP

If a patient has registered for vaccination via the Central Reservation System, i.e. using the registrace.mzcr.cz website, they cannot be registered for vaccination with their general practitioner at the same time!

2

Criterion If the patient meets the conditions according to Criterion 1

Primarily patients registered with a general practitioner (GP) as their primary care provider, a GP’s registered patients.

As of 1 May 2021, GPs are allowed to vaccinate patients for whom they are not the registering providers. This option makes vaccination more efficient – general practitioners may, based on mutual agreement, arrange for vaccination of patients (e.g. those in older age categories waiting to see their general practitioners, who do not yet have the vaccine and/or do not vaccinate). At the same time, it is possible to arrange for the use of vaccines that are available to a general practitioner whose patients are no longer interested in getting the vaccine.

Patients who fall into the category of currently vaccinated persons according to age and health status. Patients belonging to a higher risk group, i.e. older age groups and those evaluated by the GP to be at high risk of serious covid-19 should be vaccinated primarily. Only then can the general practitioner proceed to vaccinate the younger age groups.

Patients who have not yet been vaccinated elsewhere.

Patients who are not registered to get the vaccine in the Central Booking System at another vaccination centre.

Bedridden patients who cannot go to a vaccination centre, as part of the visiting service.

What vaccines do general practitioners use??

General practitioners (GPs) can use three vaccines in their practices – Vaxzevria (formerly AstraZeneca), Janssen and Moderna.

For the second dose vaccination (for Vaxzevria and Moderna vaccines), GPs will receive the same amount of vaccines as they were supplied for the first dose. They will be supplied so that GP can give the second dose at the interval resulting from new emergency measure of the Ministry of Health of 7 June 2021 which comes into force on 11 June 2021.

The interval for administration of the second dose has been changed from the previous 38-42 days to 25-35 days after the first dose of Moderna. The new interval of 25-35 days for administration of the second dose of Moderna is valid as of 11 June for newly vaccinated candidates. The interval should not be shortened before 11 June. and in vaccinated persons the interval of 38-42 days should be observed, unless it is a shortening for medical reasons.

The 84-91 day interval for the second dose of Vaxzevria remains unchanged. The delivery system of these vaccines for the second dose vaccination has also been adjusted according to this interval.

Note: On 20 May 2021,the opinion of the Czech Vaccinology Society of the Czech Medical Association of J. E. Purkyně and the State Institute for Drug Control on the use and safety of vector vaccines against covid-19 (Vaxzevria and Janssen) which recommends that Vaxzevria (formerly AstraZeneca) and Janssen vaccines should not be administered to persons under 60 years of age. The two professional institutions are responding to the results of an analysis by the European Medicines Agency (EMA) that compared the serious risks of covid-19, the disease against which the vaccine provides protection, with a very rare specific side effect of both vaccines, thrombotic -thrombocytopenia syndrome (TTS). On 9 June 2021, the Ministry of Health of the Czech Republic endorsed this expert opinion and also recommended not to vaccinate people under 60 years of age with AstraZeneca and Johnson & Johnson vaccines.  The Ministry informs vaccination centres and vaccinating GPs, to whom the vaccines of these manufacturers are usually directed, of this decision. Experts have also prepared recommendations on how to proceed when these thromboses occur in patients. Further information on the decision of the Ministry of Health is available at coronavirus.mzcr.cz.

How do people interested in getting vaccinated register with a general practitioner?

General practitioners vaccinate patients who express an interest in being vaccinated and patients whom the GPs actively call upon to be vaccinated because they fall into any of the appropriate categories according to the priorities set by the Ministry of Health of the Czech Republic. In view of the need to monitor the progress of covid-19 vaccination, it is desirable that general practitioners enter all patients who have expressed an interest in vaccination into the Vaccination List in the Infectious Disease Information System ISIN OČKO.

How are the vaccines coordinated and distributed to general practitioners?

The National Vaccination Coordinator (NVC) will allocate doses to the regions based on population criteria and then sends them to the Regional Vaccination Coordinator (RVC) and the Regional General Practitioner Coordinator (RGPC). The Regional Vaccination Coordinator will inform the Ministry of Health (MoH) of the amount of vaccine needed for doses at covid vaccination sites (CVS) and also for dispensing from CVSs to general practitioners. Subsequently, the MoH will provide the distributor with information on the amount of vaccine that will be available to cover orders from GPs. The Regional Vaccination Coordinators will then place orders for the necessary quantities in a usual way from the distributor. General practitioners will place orders for vaccines directly in the distributor’s ordering system. GPs who received first doses other than by direct delivery from the distributor, i.e., from the regional office by dispensing from the CVS, will receive their second doses via the same route. GPs who received first doses by direct shipment from the distributor will again receive the second doses by direct shipment from the distributor, based on an order from the CFA or directly from the distributor, depending on the specific vaccine. Deliveries are monitored by the Ministry of Health’s Central Management Team. The distributor’s system is used to monitor the necessity of ordering second doses according to the valid Extraordinary Measure of the Ministry of Health. Orders for the Vaxzevria vaccine (formerly AstraZeneca) are placed through the CFA app, while orders for the Moderna vaccine are placed directly with the distributor, Avenier. The Janssen vaccine is allocated directly based on orders with the distributor Avenier, not through the RVC.

How are vaccines ordered to the general practitioners’ surgeries?

The distribution of Vaxzevria (formerly AstraZeneca), Janssen and now, as of Thursday 20 May 2021, Moderna vaccines is ensured by contracted distributors directly to GP offices, unless the Vaxzevria and Moderna vaccines have been allocated by the Regional Vaccination and GP Coordinator by dispensing from the Vaccination Site pharmacy.

The distribution of vaccines to general practitioners proceeds as follows:
VAXZEVRIA (formerly AstraZeneca) based on:

orders for first doses placed in the ordering system in Covid Forms Applications (CFA), the implementation of which is approved by the National Coordinator of General Practitioners (NCGP). Given the limited quantity of Vaxzevria, orders for the first doses are not currently being approved, as priority will need to be given to securing the vaccine for the second doses in the upcoming weeks. Once this vaccine is no longer needed for the second dose, the NCGP will return to approving orders for vaccines, in particular to ensure that vaccine is delivered as soon as possible to all GPs who are interested and have not yet received any. The vaccine will be distributed directly to the offices of these GPs.  For more information about the ordering system, see here coronavirus.mzcr.cz;

orders for second doses in the CFA ordering system for those general practitioners who have received their first doses by direct shipment from the distributor Alliance Healthcare – these orders will be processed this week and in the following weeks. The second doses are distributed such that all general practitioners receive the vaccine in time, i.e. for re-vaccination according to the interval of 84-91 days specified in the emergency measure. Earlier delivery is not guaranteed due to limited quantities of vaccine. Timely approval of orders for second doses in the CFA is ensured by the Central Management Team through the National Vaccination Dispatch Centre. If the Dispatch Centre finds out that a second dose order has not been placed in the system for a general practitioner who was previously supplied by a distributor, that GP will be subsequently contacted by the Dispatch Centre and asked to place an order for the second dose in the CFA ordering system. The vaccine will be distributed directly to the offices of these GPs;

the need to cover second doses for general practitioners who received Vaxzevria for the first dose by dispensing from the Covid Vaccination Site pharmacy (timely delivery is ensured by the Regional Vaccination Coordinator in collaboration with the Regional Coordinator of General Practitioners). In this case, GP shall not place the order for the second dose into the CFA system. The second doses are distributed such that all general practitioners receive the vaccine on time, i.e. for re-vaccination according to the interval of 84-91 days. Earlier delivery is not guaranteed due to limited quantities of vaccine.

–  if a general practitioner has created an order for Vaxzevria for the first dose and is no longer interested in this vaccine, they need to cancel this order in the CFA.

JANSSEN based on:

orders from general practitioners placed in the Avenier distributor’s ordering system. Due to the limited quantity, orders are processed sequentially, according to the order in which they have been entered into the system. This single-dose vaccine is distributed directly to the offices of general practitioners.

MODERNA:

– until now, this vaccine has been distributed to general practitioners in some regions by dispensing from Covid Vaccination Site pharmacies. In these cases, delivery of the vaccine for the second dose will be done in the same way (timely delivery is ensured by the Regional Vaccination Coordinator in colaboration with the Regional Coordinator of General Practitioners);

newly, as of 20 May 2021, Moderna will be distributed directly to general practitioner offices, based on an order for this vaccine placed directly in the ordering system of the distributor Avenier a.s. (orders are accepted via the website vacciny.avenier.cz as of 19 May 2021). Based on the order for first doses, an additional order for the second doses will be created automatically in the same quantity. There is no need to create additional order for second doses. Distribution of the second automatically created order will take place 3 weeks after the first delivery of vaccines to the office. The vaccine will be delivered to GP offices thawed, but with regard to storage conditions according to the SPC, it can be stored in a refrigerator at a temperature of 2°C to 8°C for a maximum of 30 days. Find out more information at vacciny.avenier.cz/cz/distribution-covid-19-vaccine-moderna.

*Diagnoses and states of health with a high risk of a serious case of Covid-19

Haematology-oncology patients outside the intensive therapy interval; haematology patients with an immunodeficiency (innate, acquired or therapy-induced) or with significant thrombophilia. The vaccinating physician or specialist haematologist decides on the suitability of the vaccination.

Patients with solid tumours who are undergoing anticancer treatment or have it planned or whose treatment ended less than 12 months previously. It is advisable for oncology patients to seek a recommendation from their oncologist with regard to Covid-19 vaccination.

Serious acute or long-term heart disease (the patient is under the care of a specialised outpatient unit, for example, heart failure, ischemic heart disease, valve defects, cardiomyopathy, pulmonary circulation disease or conditions after pulmonary embolisms).

Serious long-term pulmonary illnesses (the patient is under the care of a specialised outpatient unit or is being treated with the administration of oxygen at home).

Patients with diabetes treated with insulin or orally administered PAD antidiabetic medicines.

People with obesity (BMI > 40 kg/m²).

People with high blood pressure treated with two or more medicines.

Patients with any other serious illnesses that increase the risk of the occurrence of a severe case of Covid-19 on the basis of a clinical decision reached by the attending physician and/or general practitioner. Patients under the care of specialist units should request the unit’s recommendation for a Covid-19 vaccination.