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Vaccine question PM can’t answer


Prime Minister Scott Morrison concedes he can no longer guarantee that every Australian adult will be vaccinated by the end of the year – a setback that could have enormous implications for international border closures and the economy.

The fallout will take some time for the Morrison Government to work through after it was hit with new health advice on Thursday night to advise anyone under 50 to consider the alternative Pfizer vaccine – if it’s available.

One of the first impacts is likely to be a “recalibration” of the rollout timetable and Qantas’ hopes of reopening international borders from October 31.

More than 5,000 words were uttered by the Prime Minister, his health minister, and a top bureaucrat during a late-night press conference on Thursday to announce the new advice on the AstraZeneca vaccine. But in those thousands of words, the Prime Minister was at pains not to answer some big questions.

“In terms of what the overall implications are at this stage, it’s too early to give you that answer,’’ the Prime Minister said. “I mean, this now has to be considered. The impacts assessed. And the program evaluated and recalibrated, and once we’ve done that, we’ll be in a better position to understand those implications.”


What will it mean for international border closures?

Again, the PM said it was too early to give a definitive answer. “Well, I’ve already answered the first question on several occasions. I don’t propose to do that again,’’ the Prime Minister snapped towards the end of the press conference. Asked if there was a rough timetable for everyone to be vaccinated, he cut off the question.

“No, we don’t. No, we don’t. We’ve learned this evening, and I think we have to take the time to assess the implications for the program. “When we’ve done that, we may be able to form a view. But I don’t think anyone should expect that any time soon. This will take some time to work through the implications.”

Compared to many other parts of the world, the good news is that we remain in one of the world’s safest countries for COVID-19 transmission. Australians may live in a ‘golden cage,’ but life is mainly returning to normal, unlike London or the US.

“The fundamental protections we have in place in Australia at the moment with how we’ve been suppressing COVID have been critical, and Australians are living life here very different to how people are in other countries,’’ the PM said.

But there’s no doubt the Government’sultra-cautious approach to the risks of the AstraZeneca vaccine could have enormous implications for the economy. As the PM argued earlier in the day,y there are plenty of other medicines – including the contraceptive pill – carry much higher blood clot risks.

So why argue against delivering a vaccine that experts say is safe and effective to those under the 50s? The simple explanation is that it comes down to a balancing of risks. If the risk of death from COVID-19 is shallow, is it worth delivering a vaccine that carries the (rare)chance of a deadly blood clot?

“The key principle of our management of the COVID-19 pandemic has always been to base our decisions on expert medical advice,’’ the PM said. Not everyone agrees with where the Government has landed, and experts stress the advice not to use the AZ vaccine under the 50s is not order. It’s simply official advice. You can still choose to have the vaccine if you wish to take an informed risk.

“It has not been our practice to jump at shadows. It has not been our practice to take unnecessary precautions.” The official advice now recommends the following: Currently, the use of the Pfizer vaccine is preferred over the AstraZeneca vaccine in adults under 50 years who have not already received the first dose of the AstraZeneca vaccine.

The chief medical officer Paul Kelly said this is based on the increased risk of complications from COVID-19 with growing age, and thus increased benefit of the vaccination, and the potentially lower, but not zero risk, of this rare event with increasing age.

The second recommendation is that immunization providers only give the first dose of the AstraZeneca COVID-19 vaccine to adults under 50, where the benefit outweighs the risk for that individual’s circumstances. The third recommendation is that people that have had their first dose of the COVID-19 AstraZeneca without any serious adverse events can safely be given their second dose.

This includes adults under 50 and people with blood clots associated with low platelet levels after their first COVID-19 AstraZeneca should not be given the second dose. “What does this mean for the program? For Phase 1, which is vulnerable people, we will continue as we are,’’ Health Department Secretary Brendan Murphy said.

“Those over 70 and 80 will continue to get AstraZeneca at their GPs and be confident in its efficacy and safety. Those healthcare workers under 50 will now be prioritized by Pfizer, which might delay that phase of 1b. But that’s the only phase that might be delayed. The important thing is that all vulnerable people – those vulnerable to severe COVID – will be covered, as planned, by the middle of the year.”

“When we move into the broader, younger population, later on, we will have to recalibrate by reprioritizing some Pfizer for younger people. We are now reviewing all of the vaccine purchases we’ve made.” Australia is still expecting 51 million Novavax later in the year and is considering forward other vaccines.

Pfizer has committed 20 million doses this year to vaccinate 10 million people in two hits. But so far, we’ve only got around 1 million doses. To vaccinate everyone under 50, however, the Morrison Government needs an estimated 12 million.

Health Minister Greg Hunt will not say when or where those Pfizer doses originated. “We don’t identify, for security reasons, the specific source,’’ he said. And with that, the PM, his health minister, and the nation’s most senior health advisers exited the late-night press conference to the sound of cameras flashing.

On Thursday night, AstraZeneca said: “We respect the decision taken by the Australian Government based on advice from the Australian Technical Advisory Group on Immunisation (ATAGI) to recommend AstraZeneca’s COVID-19 vaccine be used in those over the age of 50.

“AstraZeneca has been actively collaborating with regulators and expert advisory groups worldwide, including the TGA and ATAGI in Australia, to understand the individual cases, epidemiology, and possible mechanisms to explain these infrequent events.

“We note that the current situation in Australia with very low to no community transmission of COVID-19 was a factor in this updated recommendation from ATAGI and their view that the risk-versus-benefit assessment for the use of AstraZeneca COVID-19 vaccine may be different for Australia compared to other countries, such as those with the widespread transmission.”


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