Vaccine confusion must be sorted to protect the nation

Federal Health Minister Greg Hunt’s message to 50-59-year-olds on Thursday and Friday was clear: “If you have had your first dose of the AstraZeneca vaccine and it is time for your second dose, do not wait, please come forward for your second dose when it is due.” Despite that unambiguous advice, many Australians are confused and worried following the announcement on Thursday that AstraZeneca now will be recommended only for people aged 60 and older. People under 60 will be offered the Pfizer vaccine instead. The revision stems from a warning by the Australian Technical Advisory Group on Immunisation about a higher risk and severity of clotting related to AstraZeneca in those aged 50 to 59 than was reported initially. There is no shortage of contradictory advice from overseas, adding to the confusion. As Mr Hunt says, ATAGI is taking a conservative approach in relation to age ranges for AstraZeneca jabs. Many patients will appreciate that caution. Britain, as he says, allows AstraZeneca for people aged 40 and older, South Korea for those 30 and older and Germany for 18 and older.

National cabinet will meet on Monday to discuss the vaccine rollout, after which important questions must be clarified. Canada’s National Advisory Committee on Immunisation is recommending that AstraZeneca recipients should receive a different vaccine, such as Pfizer, for their second dose. Many Australians also are aware of a study of 600 people in Spain, reported in Nature, that found vaccinating people with both the AstraZeneca and Pfizer vaccines produced a potentially better immune response against the virus. France and Norway also are pursuing a “mix and match” approach. As health editor Natasha Robinson reports on Saturday, the nation’s top immunisation advisers are monitoring emerging evidence on mixing and matching vaccines in overseas clinical trials, including one that is under way in Britain. Preliminary results have been reported for a German study of 340 healthcare workers that found getting the AstraZeneca dose first followed by a Pfizer shot resulted in production of a high number of protective antibodies.

Depending on what national cabinet decides on Monday, the Morrison government, the states and ATAGI must explain their decision and repeat the message clearly and often. They also will need to allay concerns about potential shortfalls in supplies of Pfizer. These were raised on Friday by NSW Premier Gladys Berejiklian and Victorian Acting Premier James Merlino. General John Frewen, head of Operation Covid Shield, said he expected a drop in vaccination rates because of concerns over the supply of Pfizer. Any fall-off must be rectified quickly.

Building momentum to step up our vaccination rate in coming weeks and months will be vital. After a slow start, more than 6.3 million Australians have received their first jab since the rollout began in late February. The pandemic remains a potent threat. As Ms Berejiklian said of two of the eastern suburbs cluster cases in Sydney, “a fleeting passing is all that it takes … Some people for some reason aren’t contagious and some are extremely contagious. The randomness of that is what makes it scary”. For the sake of Australians’ lives, and the national interest, Monday’s meeting must produce a strategy to ensure the take-up continues as rapidly as possible. Mr Hunt’s introduction of a new Medicare item that will allow GPs to be paid for consultations with patients to discuss vaccinations in view of changing advice will help.

Scott Morrison has long supported containment rather than elimination of Covid. But in an exclusive interview with Geoff Chambers, the Prime Minister insisted there was no magic number for vaccination rates “at this point’’ before Australia reopens to the world. Less than 12 months from an election, Mr Morrison is disinclined to talk up an early reopening of international borders, although steps are afoot to establish a travel bubble with Singapore, which could be expanded later. Mr Morrison sensibly will be looking to what happens in Europe and Britain in the next six months for “a pretty good idea about new strains and variants”. Britain, where 80 per cent of adults have had one jab and 58 per cent have had both, has eased most domestic restrictions. But infections are rising again, with 8400 cases this week. Illnesses are less severe. But further relaxations, borders included, have been delayed. Other major centres, such as New York, where 70 per cent of residents have had at least one Covid vaccine shot, are reopening. At some point, Australia must open up too – as soon as possible, when it is safe to do so. Our best protection then, when we learn to “live with the virus”, as Mr Morrison has said, will be for as many people as possible to be inoculated.