Coronavirus: If we had a Covid-19 vaccine, would we take it?

Any COVID-19 vaccine may be clouded by the impression of having been rushed to market.

Yesterday the federal government announced it had ordered 25 million doses of a vaccine to COVID-19, and on cue everyone lost their minds.

Labor’s Kristina Keneally and Chris Bowen both tweeted the PM’s announcement of the release of a vaccine from pharmaceutical company AstraZeneca was nothing more than a letter of intent between the company and the Commonwealth.

Can @ScottMorrisonMP even lie straight in bed? Is there anything #ScottyFromMarketing won’t spin?

Within hours of his “announcement” of a vaccine deal with AstraZeneca - the company issues a statement saying THERE IS NO DEAL. pic.twitter.com/tD9266AfLf

— Kristina Keneally (@KKeneally) August 19, 2020

A vaccine does not yet exist. While the PM may have been gilding the lily somewhat, does anyone expect the federal government to order and pay for a dose of a vaccine without appropriate clinical testing?

However, making these arrangements now is essential. I’d expect the government to be making similar arrangements with other pharmaceutical companies to supply the Australian population with a vaccine once it has been through comprehensive clinical testing and its safety and efficacy proven.

There are currently 180 companies around the world working on a COVID-19 vaccine. Almost 20 have begun human testing, including AstraZeneca who are developing their vaccine (and hopefully ours) with Oxford University.

Anti-lockdown and anti-vaxxer protesters on the steps of Victoria's state parliament in Melbourne. Picture: AFP

There can be no return to normal, to Boxing Day crowds buzzing at the MCG, to boozy Melbourne Cup lunches, to concerts, the cinema or the theatre or even a Sunday morning at church without a vaccine.

Six months into a pandemic that has swept across the globe there are no cures and no preventatives. Clinical data does show the anti-viral drug remdesivir can shorten recovery times and the steroid dexamethasone reduces deaths for those who are hospitalised and require respiratory assistance.

Nevertheless, we are at the point where it is not so much if but when a vaccine is developed. Australia needs to be part of the supply chain and needs to make arrangements for the manufacture and distribution of a vaccine so it can be rolled out to the people as quickly as possible.

Scott Morrison meets with members of AstraZeneca’s laboratory staff. Picture: Getty Images

I’m no pharmacologist but I would say there are some vaccines that we can happily ignore, including Russia’s vaccine that has been released without any appropriate clinical data other than Vladimir Putin stating that one of his daughters made up the numbers on the clinical trials. This begs not one but two questions: how many daughters does Putin have (two or three we can’t be sure) and why didn’t the bare-chested, bear-wrestling man among men, Vlad himself sign up to the clinical trial?

The PRC has begun clinical testing, essentially using members of the People’s Liberation Army as guinea pigs. The Chinese government promised to release its vaccine to the world. Now it says it will only ship the vaccine to countries that acknowledge China’s territorial claims to the South China Sea. Nuts to that, I say.

In the wake of the government’s announcement on the non-existent vaccine yesterday, Mark Latham raised the spectre of Thalidomide on his Twitter account, a drug whose side effects led to thousands of appalling congenital birth defects and thousands more still births.

People of my age are still haunted by the memory of Thalidomide, a supposedly safe drug that wrecked lives.
I recall a girl up the road with one arm.
Policy must be: Safety first, every precaution taken.
Not a PM shooting his mouth off.
He'll be shocked by the resistance to this.

— Real Mark Latham (@RealMarkLatham) August 19, 2020

Clearly this is highly emotive stuff. Thalidomide was not a vaccine. But it was a drug rushed on to the market with tragic consequences. But the lessons learned from that tragedy should give people confidence that institutions like the FDA will make sound decisions.

For the record, Thalidomide was not approved for use by the US Food and Drug Administration or at least it wasn’t until 1998 where the drug found an application as a frontline treatment in multiple myeloma, a type of cancer of blood plasma.

The drug was developed in West Germany by the pharmaceutical company, Chemie Grünenthal in 1957 and was marketed as an over the counter sedative with almost universal applications that tragically included pregnant women suffering morning sickness.

Australia was especially prone as one senior obstetrician began prescribing its use to pregnant women under his care. The word spread and it became established practice to recommend the drug to pregnant women.

It is certainly true that Thalidomide entered the market without adequate clinical data being made public, but it is here where the FDA established its credentials as the world’s foremost overseer for the safe use of drugs. The FDA believed Chemie Grünenthal had not released sufficient data to show whether the drug’s effects would pass through the placenta in pregnant women. In hindsight we know that it did. Sixty years ago, the FDA declined to approve thalidomide for use in the US and that should have been the end of it for the rest of the world.

A more useful and less emotive parallel might be the vaccine developed for SIV or Swine flu where in 1976, 45 million doses were administered in the US before it became understood that its worst side effect, albeit in a very small number of cases, was the development of Guillian-Barrè syndrome, a crippling condition where the immune system attacks the nervous system. One of the great novelists of the 20th Century, Joseph Heller, fell ill this way. It almost killed the author of Catch-22 and left him bed ridden and paralysed for two years.

The point is even the most dependable public health institutions can make mistakes.

In terms of public perception, the bigger problem is that any COVID-19 vaccine will have been subject to a truncated period of clinical trials and this will give rise to suspicion.

Anti-vaxxers and those who refer to themselves as libertarians (anti-vaxxers who are too timid to admit their dismal ideology promotes anti-vaccination behaviours) pollute our public arenas. They’ve been babbling about child vaccinations. The next item on their agenda is to spook the general population into believing a COVID-19 vaccination will allow Bill Gates to control every single one of us through a complex system of pulleys and levers.

The big question is, will enough of us have confidence in the FDA and our own Therapeutic Goods Administration to take the vaccine in the number required to create herd immunity?

I’ve read a lot of nonsense about herd immunity on social media written by people who do not understand it or basic arithmetic. What we would be looking at is a vaccination rate at a minimum in the high sixty percentile for herd immunity to kick in.

That means more than two thirds of us would stand dutifully in line for the jab or jabs on the understanding that the FDA and TGA had approved the vaccine for use. In other words, how many sane people are left in this country?

I’d suggest we are about to find out.

The use of the word mandatory when it comes to any vaccination as it has from the Prime Minister over the last day or so is probably not helpful in these hyper-volatile times. This creates images of screaming people being forcibly restrained with their arms or backsides punctured with syringes and plays directly into the hands of the conspiracy theorists.

There is another way and it’s already in place and running smoothly.

Australia has been quietly going about wiping out genital warts and cervical cancer with the human papilloma vaccine delivered free of charge through the National Immunisation Program since 2007. Both young females and males are immunised by injection.

For all the shrieks from anti-vaxxers, I’ve never heard anyone come out and say they are pro genital wart or pro cervical cancer for that matter.

Parents of teenagers who have gone through the program will know the vaccine is not mandatory but very actively encouraged. One can opt out, but few do. With HPV vaccinations in the relevant age group, there is a take up almost 90 per cent because well, young people don’t want genital warts when they become sexually active and they sure as hell don’t want to die horribly of cervical cancer.

Here is an example of science overcoming ignorance and stupidity and the federal government should use it as a model for when the time comes to roll out a COVID-19 vaccine.

At the same time, there is a social contract in place. If people are recipients of welfare and let’s face it, more than half of us are at the moment, the Commonwealth would be well within their rights to say, you get the COVID-19 jab or you don’t get your dough. I’ve got no problem with that.

But let’s not call it mandatory. Let’s call it a matter of collective responsibility.

After all, the Boxing Day Test awaits. A vaccine may not come in time to have a throng enjoying a beer at the bull ring in 2020. But 2021 is looking good. We should all have a decent thirst up by then.