Should young people get the AstraZeneca vaccine in Australia?

Young Aussies now have the choice of getting vaccinated with AstraZeneca but is it worth the risk? A Sydney party may have the answer.

A birthday party in Sydney’s West Hoxton has provided a compelling example of the benefits of vaccination — but is it something young people should consider?

Prime Minister Scott Morrison announced on Monday night that all adults regardless of age would be eligible to get the AstraZeneca vaccine.

Previously AZ was only available to those aged over 60 years old, following advice from the Australian Technical Advisory Group on Immunisation (ATAGI) on the risk of rare but serious blood clots.

However, the decision has now been made to allow people younger than 60 to get the vaccine if they are willing to take the risk.

Mr Morrison said the government would implement a new “no fault indemnity scheme” for general practitioners (GPs) who wanted to administer Covid-19 vaccines so that young people could get the jab.

It’s a tempting proposition for some young people aged under 40 who have felt frustrated they could not access any vaccines.

NSW Health Minister Brad Hazzard on Monday illustrated the power of vaccination.

He revealed that seven people who had been at least partially vaccinated were not infected at a West Hoxton birthday party.

The party was attended by more than 40 people, and 27 people later tested positive for covid.

But six health workers who were fully vaccinated at the event, were not infected.

One other aged care worker who had one vaccine dose, was also not infected.

Mr Hazzard told news.com.au the six health workers had received the Pfizer vaccine, while the aged care worker had been given one dose of AstraZeneca.

“The early and strong indications from that West Hoxton party are if you’re vaccinated … you are much more likely to not be infected with Covid-19,” Mr Hazzard told reporters on Monday.

The ability of young people to get vaccinated in Australia previously depended on where they lived, what they did for work and if they had any underlying medical conditions or were disabled.

In general only people aged over 40 years old are eligible to get vaccinated in all states except the Northern Territory, where they are vaccinating anyone over the age of 16. Those between 40 and 59 are getting the Pfizer vaccine.

It’s worth noting that the health advice from ATAGI has not changed and that Pfizer is the preferred vaccine for anyone under the age of 60.

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A paramedic receives her second dose of the AstraZeneca vaccine in Melbourne. Picture: Mark Stewart

Infectious diseases expert Professor Peter Collignon of Australian National University said it also important that those older than 70 years old were vaccinated as a priority, ahead of younger age groups as they were more likely to die if they got covid.

“The people most at risk are those over 50 years old, but particularly those over 70,” he told news.com.au.

“If they ring a GP, it’s important they are in front of the queue ahead of 30 year olds.”

About 68 per cent of Australians over 70 years old have had at least a first dose of covid vaccine.

In total, about 28 per cent of Australians aged over 16 have had their first dose, with more than seven million doses delivered. In the past week more than 700,000 doses were administered.

“I think it’s good that people can have access (to AstraZeneca), it is approved for anyone over 18 (years old) anyway, but they need to provide informed consent because the risk is higher,” Prof Collignon said.

He pointed out Australia did not have uncontrolled transmission of covid in the country and was not expected to experience this, even in NSW, which is grappling with a serious Delta outbreak.

“I don’t think the health advice should change as we don’t have uncontrolled transmission in Australia,” he said.

How much protection does vaccination provide?

The most compelling reason to be vaccinated is for the protection it provides against getting seriously ill or dying, including from the more infectious Delta variant.

Real world data from Public Health England published in a pre-print paper showed AstraZeneca was 92 per cent effective in preventing hospitalisation from those who got the Delta strain, once someone had both doses.

It’s less effective at stopping people from getting the disease, with data showing it was about 67 per cent effective in protecting against symptomatic infection from Delta two weeks after the second dose. This dropped to about 30 per cent if people only had one dose.

Other benefits to consider include protection against complications associated with long covid.

Vaccination can also help protect unvaccinated members of a person’s family or community by preventing transmission of the virus.

Eventually vaccinated people may also have greater freedoms including from lockdown or international travel, although this is not yet the case.

NSW Premier Gladys Berejiklian said once 10 million vaccine doses had been administered in the state, which should be enough to cover 80 per cent of the adult population, authorities would be able to factor in vaccinations when considering whether to go into lockdown.

So far there’s only been about two million doses delivered.

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Young people will now be able to request vaccination with AstraZeneca. Picture: Geoff Caddick/AFP

What are the risks?

The benefits of vaccination need to be weighed against the risks, especially for young people as they have a lower risk of dying from Covid-19.

Each country has a different age cut-off that takes into consideration the risk of blood clots compared to the likelihood of getting seriously ill or dying from covid. In the United Kingdom for example, authorities recently increased the cut-off from 30 to 40 years old, while Canada and Germany allow anyone over the age of 18 to get it.

In Australia, the risk of getting thrombosis with thrombocytopenia syndrome (TTS), a serious blood clotting condition, has been estimated at 3.1 per 100,000 for those aged under 50 years old.

The estimates are uncertain due to the low number of vaccinations in this age group in Australia.

Australian Government figures suggest the risk is higher for those aged 40-49, in which an estimated 5 in 100,000 developed TTS.

In comparison, no people in this age group would be expected to die in a low-risk covid scenario, in which there is an infection rate similar to the first wave of covid in Australia. About 2.6 per 100,000 would be hospitalised.

In a higher risk scenario, similar to what happened during Victoria’s second wave, there is an estimated death rate of 0.1 per 100,000. The hospitalisation rate is higher, at 16.7 per 100,000, with 2.6 intensive care admissions prevented.

“If you’re a 40-year-old, the risk of getting a clot is about one in 80,000 and the risk of dying is about one in a million,” Prof Collignon said.

In Australia, about 3 per cent of those who have developed TTS so far have died, although this figure is based on those currently vaccinated which does not include many young people.

The two people who died were a 52-year-old woman and a 48-year-old NSW woman.

Prof Collignon said for young people, getting the AstraZeneca vaccine was riskier than getting other vaccines, even though there were potential adverse events associated with every type of medication.

“The risk young people are taking are a bit higher (than older people) and the benefit is lower but if they are informed about it and are willing to take it, I wouldn’t say don’t get vaccinated, I just wouldn’t push it strongly.”

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Should I wait?

Ultimately it is up to the individual to decide whether they want to take the risk.

It will take up to three months to get full protection from the AstraZeneca vaccine as there needs to be 12 weeks in between the first and second doses.

More supply of Pfizer and Moderna vaccines will be available between September and December.

Starting in September, up to one million doses of Pfizer a week will be available and this is set to increase to about two million doses in October.

Asked whether Australians aged under 40 should get AstraZeneca, NSW chief health officer Dr Kerry Chant told reporters: “Your GP knows you best. If you want to discuss immunisation with your general practitioner, they are the best person to discuss the risks and benefits on an individual basis with you”.

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