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A top Australian infectious diseases expert has questioned the country’s choice of COVID-19 vaccines, saying: “We need to be reaching for the big guns.”
“We’re talking about an immune naive population. We have no immunity whatsoever,” Monash University’s Dr Michelle Ananda-Rajah said on ABC’s Q&A on Thursday night.
“We’re literally sitting ducks. We need to have the most efficacious vaccines.”
But Federal Government infectious diseases advisor Dr Nick Coatsworth, also appearing on the panel, stressed “all of the vaccines Australia has a stake in have been shown to prevent severe disease”.
“We want to prevent severe disease and death,” he said. “We can do it with the vaccines we’ve got.”
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Australia’s Therapeutic Goods Administration (TGA) has approved the Pfizer vaccine, which demonstrated 95 per cent efficacy in its late-stage trial.
It’s set to be used for Phase 1a of the nation’s COVID-19 vaccine rollout in a few weeks, covering up to 1.4 million doses for quarantine and border workers, frontline health care workers, aged care disability staff and aged care and disability residents.
The majority of the population is then expected to receive the AstraZeneca vaccine, with an efficacy of about 76 per cent after the first dos,e which is maintained until the second dose.
Australia has secured 53.8 million doses of this vaccine — 3.8 million to be delivered early this year and 50 million manufactured in Australia in monthly batches by biotech firm CSL.
Dr Coatsworth noted that the TGA is independent and he doesn’t know whether “full approval” of the AstraZeneca jab will occur but it is “likely to come before the end of February”.
Dr Ananda-Rajah asked: “Why not just start with a highly efficacious vaccine in the beginning?”
She pointed to the Pfizer, Moderna and Novavax vaccines, noting Pfizer recently announced in an investor call they had slashed batch production from 110 days to 60 days and were going to be delivering 200 million doses to the US two months ahead of schedule.
University of Melbourne epidemiologist and public health medicine specialist Professor Tony Blakely said it was not something that needs to be decided “tonight or tomorrow”.
“Let’s roll out the Pfizer doses we’ve got,” he said. “As we’re getting to the point where we need to decide what we need to use in the next tranche, we can pivot away from AstraZeneca or stay with AstraZeneca.”
He added that it was “inappropriate and unethical” for countries like Australia to hold onto the vaccine over developing countries with high COVID-19 cases.
“The one instance we should probably have used emergency measures to get in earlier was to vaccinate our 80,000 people at the border, at quarantine, because look what’s happening now,” he said.
“If we had vaccinated those people, we would have reduced the chance of the virus getting out. Not completely but it would have been probably a good thing to do.”
Dr Coatsworth said it was important not to diminish confidence in the vaccination program.
“We have a vaccine that will protect us from what happened in Victoria last year,” he said.
“It’s Pfizer, AstraZeneca and we’re going to use them.”
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He told host Hamish Macdonald that Australia is not at the front of the vaccine queue given the millions of people already vaccinated across the globe, but there could be advantages to that.
“We’re not first in the queue … but there are certain benefits of where we are at the moment,” he said. “Firstly, the TGA has got the time to do their detailed approvals process.
“Secondly, we’ve actually seen post-marketing evidence. Actually, what are these vaccines doing in real life? That is a fortunate position to be in.”
Vaccinating against COVID-19 is the easiest way for Australians to get their normal lives back, but millions are hesitant. News.com.au’s Our Best Shot campaign answers your questions about the COVID-19 vaccine roll out, so visit the section to find answers to all your concerns and details on when you can get your shot.
VARIANTS ‘KNOCKING ON OUR DOOR’
Dr Ananda-Rajah said there was “some merit” to a slightly delayed rollout given “interesting data” coming from the field.
She believes there has been “a little bit of downplaying” of study results out of South Africa where a rollout of the AstraZeneca vaccine has been suspended in recent days.
“Due to the fact that in about 1700 people, young people who were around 30 years old, the vaccine failed in terms of its efficacy,” she said.
“It dropped to an efficacy of 20 per cent and in the people who had that South African variant, it dropped even further down to 10 per cent. This was enough for the government to hit the pause button.”
She said it was a “predictable” result given the vaccine “lost its potency” when the blood of people vaccinated with AstraZeneca was tested in tubes against the virus and the variant.
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Dr Ananda-Rajah said the variants, such as those originating in South Africa and the United Kingdom, are “literally knocking on our door, the doors of hotel quarantine”.
“I think we do need some answers from South Africa,” she said, noting the TGA contacted Norway’s regulators after reports of deaths in very frail patients who had received Pfizer jabs.
Fellow panellist and infectious disease expert Professor Sharon Lewin, director of the Doherty Institute, said it was important to “put this into perspective” as the South African study involved around 2000 participants.
Prof Lewin said the benefit of time and seeing 150 million people vaccinated in countries around the world “gives us enormous safety and security”.
“Had we rolled out vaccines really quickly, our lives would actually be no different,” she said.
“We would still be quarantining visitors, we would still be pouncing on every single case and quarantining it.”
Prof Lewin believes Australia has “backed the right vaccines”.
“We need to be able to manufacture a vaccine, it gives us incredible flexibility knowing that we’ve got a pipeline of the vaccine,” she said.
“The goal of our vaccine program is to stop people going to hospital and to stop severe disease and convert coronavirus into the common cold, that’s essentially what we want to do.
“We are not going to eradicate coronavirus. We are going to learn to live with it and change the way it behaves in populations.”
Prof Blakely said Australia is behind a “fortress” and “doing really well”, with enough Pfizer doses to cover our first phase.
“Let’s get that done,” he said.
“We can then reassess what’s happening at that point as to whether we then bring in the AstraZeneca for the next tranche of people. We’ve got some time. Let’s get the Pfizer rolled out and then we can reassess.”
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