Coronavirus eradication is among the known unknowns

It’s one the biggest public health interventions in the nation’s history but there’s been precious little time to plan the rollout of COVID-19 vaccines to millions of Australians, let alone develop a strategy.

The decisions taken by the Morrison government about vaccine investment have been made at lightning-speed, driven by a need to hedge bets, ensuring we have contracts for the supply of each of the different types of vaccines that are proving effective in what’s described as a “balanced” strategy.

A year ago, it wasn’t clear that the new vaccines on the block, mRNA vaccines, would come to fruition. It now turns out that the mRNA vaccines produced by Pfizer-BioNTech and Moderna have apparently very high efficacy, but we still don’t know whether they will stop transmission of SARS-CoV-2 to any large extent.

Australia has secured 10 million doses of Pfizer’s vaccine, but in line with its “balanced” strategy, it’s also relying on the AstraZeneca viral vector vaccine, of which we’ve ordered 53.8 million doses, and the Novavax traditional protein-based vaccine. “If you’d asked me a year ago which is the most likely to work, I would have said the protein vaccines will be fine and the mRNA is pretty speculative,” says the chair of the Australian Technical Advisory Group on Immunisation, Allen Cheng.

“But, fortuitously, it looks like anything works to some extent.”

Recent scrutiny of its vaccine strategy as questions were raised as to whether Australia’s approach would result in herd immunity presented a challenge for the government.

Health chiefs were aware of the need to communicate openly with the public about the pros and cons of Australia’s vaccine approach. The fact Professor Cheng is showing up in public, explaining the nuances of Australia’s approach, is welcome.

Health Minister Greg Hunt was on the front foot at the weekend after reports of the deaths of 30 very frail elderly people in Norway after receiving the Pfizer jab. While no causal link with the jab has been established, Mr Hunt reassured Australians the medical regulator was taking the reports seriously, while stressing the deaths were no cause for alarm.

The issue was a stark reminder that no one can tell what wildcards this global vaccination juggernaut will turn up. Herd immunity is the prize countries are chasing as the world eyes an eventual return to normal life. In heavily relying on the AstraZeneca vaccine, the government will continue to face questions over whether it’s giving the nation the best shot at herd immunity. There is still the opportunity for Australia to secure a bigger supply of the Pfizer vaccine, but geographic and cold-storage challenges with rolling out that vaccine remain.

Whether transmission can be stopped by any vaccine is an open question, but Professor Cheng is confident our vaccine strategy will mean life can return to some semblance of normality even if herd immunity is not immediately achieved.

Nevertheless, one of the biggest vaccination programs in memory is somewhat of a movable feast. You can be pretty sure vaccines will stop people from getting sick and dying, but whether they end the pandemic is another matter entirely.