COVID-19 vaccines - including the recommended booster shots - are no longer available within the Coonamble Shire region due to a lack of demand, despite a recent spike in positive cases.

While health services in other western plains towns continue to offer the vaccinations representatives say they are being forced to choose between wasting doses of the valuable vaccines or not providing them unless demand reaches a threshold that is unachievable for most smaller communities.

The Coonamble Shire's COVID-19 cases count on COVID LIVE was last updated on 25 November, recording 1,338 active cases within the week.

The numbers reflect a reported surge in cases across the state with more than 40,000 new cases recorded last week alone.

There are 1526 people in hospital (40 of those in intensive care) and, tragically, 48 deaths. However, the real number of COVID-19 cases is unknown since reporting is no longer mandatory.

Some residents in Coonamble say they are feeling increasingly vulnerable.

A Coonamble Aboriginal Medical Service staff member said that unless requests for the COVID-19 vaccines increase dramatically, the service will not have any in stock to offer.

"We will not get them again unless demand is high for them within the community. If we do get them, we need to use them," she said.

"We have ordered them in and they have gone to waste. The lowest number of vaccines we can order is 60.

"I am more than happy to order them, however we have had times when we have had them in, advertised it online and they have gone to waste which is why we do not have any COVID-19 vaccines at the moment," she said.

Similarly, a spokesperson for Coonamble's Ochre Health clinic said they also are not offering COVID-19 vaccinations or boosters.

"There has not been a high enough demand for boosters to order the vaccines in. We will not be getting them back until next year at least," she said.

Other medical practices from surrounding towns including Lightning Ridge, Walgett, Gilgandra, Bourke and Nyngan are all offering book-ins or walk-in COVID-19 vaccination clinics.

However, both Ochre Medical Centres in Walgett and Lightning Ridge reported significant vaccine wastage.

A member of staff from Ochre Medical Centre in Lightning Ridge said it would be useful if medical centres in small townships could order minimal amounts of the COVID-19 vaccines.

"We are currently holding walk-in vaccination clinics to try and build up demand within the community and to also stop wastage".

"It would be helpful for the Government to allow rural and remote communities to order smaller amounts of the vaccines so there isn't as much wastage. The Government makes us report on vaccine wastage and they ask why is it so high. I always put that it is rural and remote towns, like ours, we have to order over a specific amount, instead of ordering a smaller amount that would meet public demand and reduce wastage," she said.

Walgett Ochre Medical Centre Nurse Practioner Cody Hatch said she is currently sourcing her vaccines from out of town.

"I had to get some COVID-19 vaccines from Dubbo. However, you can only order twenty vials, which is around sixty doses," she said.

"We are currently running walk-in clinics to reduce the wastage this week. It would be helpful if we could order smaller vaccine doses to meet local demand."

 ABOVE: Small medical centres located in Coonamble NSW cannot order COVID-19 vaccines unless demand is over 60 people.

Since 5 August the Australian Technical Advisory Group on Immunisation (ATAGI) have recommended everyone aged 5 years and older gets a COVID-19 vaccine to help protect them from contracting COVID-19.

Mother Alanna McHugh lives 60km north west of Coonamble. She says that having no COVID-19 vaccines available locally is not ideal for her son that has recently turned the recommended age for the vaccine.

"Due to no vaccines being available locally unfortunately I will now have to take my son to Dubbo," she said.

"I have been trying to get him vaccinated here since he turned 5 back in July.

"I will be doing it before Christmas due to the increased risk and increased number in positive cases at the moment. It is not ideal at all to travel around 4.5 hours for a standard vaccination."

Mrs McHugh says that the minimum of 60 doses is unrealistic for a small communities like Coonamble and will put local residents at risk.

"That number will not work in any western division town, let alone Coonamble," she said.

"This approach will reduce vaccination rates in small communities where our susceptibility to disease and illness is already substantially higher. It is not good enough," Mrs McHugh said.

The Western NSW Local Health District have advised that the Federal Government determines the COVID-19 vaccine limitation regulation.