I received my second shot of the AstraZeneca vaccine a month ago. According to the TGA, I received two of the 6.1 million doses of the Oxford based vaccine administered in Australia as of the end of June 2021.
In my case, the first dose brought on a little pain in the deltoid muscle. I’ve described it in the strictly non-medical term as a bit of a dead arm, like a blow with a cricket ball from a medium pacer. Noticeable, discernible but no big deal. Play on.
The second dose came and went without any identifiable adverse reaction, mild or otherwise with the possible exception of a bit of fatigue in the 24 hours directly afterwards but who knows, I might have just been tired anyway.
AstraZeneca has been portrayed as a poor man’s vaccine or worse a roll of the dice with recipients chancing their arm. Street corner advice from resident media experts has pushed it into the shadows. A month ago, the ABC’s Norman Swan suggested the vaccine would be withdrawn from the market if it were not for the pandemic, an odd statement at best and one grounded in a hypothetical alternative that cannot be proven.
With a national vaccine roll out the like of which we’ve never experienced and with an understandable level of hesitancy in the general community, language matters. Messaging matters.
But in a flush of ill-considered rhetoric, AstraZeneca became the bête noir of Australia’s vaccination program.
Bit by bit AstraZeneca became a first world problem with even those in the age groups where the Australian Technical Advisory Group on Immunisation (ATAGI) recommends the use of AstraZeneca, opting instead to wait for Pfizer or perhaps waiting interminably before making the leap to get vaccinated.
The central issue around the use of AstraZeneca is the possibility of developing a rare blood clotting condition known as thrombosis with thrombocytopenia syndrome (TTS) or Vaccine-induced thrombotic thrombocytopenia (VITT).
A study published in Lancet on Wednesday, from AstraZeneca’s global safety database, captured reported cases of TTS in the 14 days after receiving the first or second dose through the end of April 2021, covering some 5.6 million second doses and 49 million first doses.
The data confirmed reports of an elevated risk of TTS in those receiving their first shot, which occurred at a rate of one per 8.1 per million people.
In other words, 399 people out of 49 million developed TTS after the first dose of AstraZeneca.
After the second dose, however, there was no increased likelihood of developing TTS with a rate of one per 2.3 million people. That rate is comparable to the development of TTS in unvaccinated people.
Furthermore, TTS is more easily recognised and treatable now. Initially the condition came with a mortality rate of one on four.
But actual experts rather than self-appointed ones say that TTS is recognisable, diagnosable and treatable.
In Melbourne, Alfred Health Head of Thrombosis and Haemostas Professor Huyen Tran said experts have developed a much stronger understanding of the syndrome.
“We understand this condition has a very different mechanism to all other forms of blood clots. Not understanding this difference in the past may have led to confusion and hesitancy to get vaccinated, Professor Tran said last month.
“We’re now in an extremely strong position to recognise it, diagnose it and most importantly, treat it well.
Professor Tran said blood thinning medication is a mainstay in treating TTS but the use of intravenous immunoglobulins in more severe cases also appears to impact on a positive outcome for the condition.
“Obviously we recognise that there is a risk there, but to put it into perspective, of all the AstraZeneca jabs given in Australia to last week, we’ve had just 31 confirmed cases, three quarters are already out of hospital and recovering.
ATAGI’s advice has changed in recent times. The advisory group now recommends people living in greater Sydney of all ages consider vaccination with Astra-Zeneca. Outside Sydney, however, the advice remains the same. People under the age of 60 might consider the Astra-Zeneca vaccination in consultation with their GPs. But implicit in that caveat is to wait for Pfizer and thus Australia’s roll out remains at a snail’s pace.
Fortunately, many people under the age of 60 are making informed choices with almost 400,000 Australians in that age group receiving the Astra-Zeneca vaccine over the last month.
The Morrison government has been strongly criticised for its Covid-19 vaccination ‘stroll out’. Some of that criticism might be warranted. The early indications were that the government had chosen badly or were the subject of misfortune, having put all their eggs in the AstraZeneca basket as Opposition leader, Anthony Albanese likes to say.
The AstraZeneca vaccine was the weapon of choice for the federal government when the University of Queensland vaccination fell over, due to a large number of false positives for HIV determined in its early stage testing.
But the AstraZeneca vaccine has been the mainstay vaccine in the UK which now boasts high levels of vaccination and in England at least, has led to the end of lockdowns and a return to a form of pre-Covid normal. There is no reason we cannot do the same here with AstraZeneca forming a big part of the vaccination mix.
While the Prime Minister said yesterday that by Christmas every Australian would have access to Covid-19 vaccination, supply of alternatives to Astra-Zeneca may slow. An order of the Moderna vaccine to South Korea has been delayed due to production difficulties. 25 million doses of Moderna are due to be delivered to Australia by the latter part of 2021.
The Novavax vaccine has already been delayed with the 51 million doses due to come to our shores later this year now being pushed back to 2022 where it is said it will now form the basis of vaccine boosters.
The AstraZeneca vaccine is a miracle of medical technology. It can be manufactured quickly and cheaply on our own shores. We have control over production and supply. It will form the foundation of Covid-19 vaccination in the developing world.
It’s efficacy against the Delta variant is at least as good as Pfizer, possibly better. Unlike the Pfizer vaccine, it is plentiful in Australia.
Where the Prime Minister was wrong was to suggest that Australia’s vaccination roll out was “not a race, not a competition.” It most certainly is. And AstraZeneca, abundant and manufactured under licence in Australia is a key player in the race to get the overwhelming majority of Australians vaccinated so we can look forward to a return to pre-pandemic life.
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