The development of effective vaccines for COVID-19 in only a year is an outstanding achievement, but the past week has shown the need to keep the public informed if a mass immunisation program, due to start in a month, is to succeed.
The federal government has made heavy weather in the past week of explaining its strategy. Last Tuesday the Australasian Virology Society and the Australian and New Zealand Society for Immunology told The Age the government should put on hold the immunisation program which is due to start in the second half of February. Both societies later withdrew their objections.
A French health worker with a dose of the Pfizer vaccine.Credit:AP
The scientific issues are complex but they arise in part from the global shortage of the three vaccines so far approved by credible regulators. The three manufacturers, Pfizer, Moderna and AstraZeneca, cannot produce enough to meet the demand from wealthy countries battling thousands of daily deaths, let alone from developing countries.
The Australian government has access to 54 million doses of the AstraZeneca vaccine, more than enough to vaccinate the whole population with two doses each. But so far it has sourced only enough of the Pfizer vaccine for 5 million people. This poses a dilemma because in trials last year the Pfizer vaccine produced better results than AstraZeneca’s in some respects. Experts say new reports of deaths among elderly Norwegians who had been given the Pfizer vaccine do not mean the vaccine is ineffective or unsafe and that it should still be rolled out here.
The complaints from immunologists last Tuesday reflected concern that Australia was rushing out a vaccine from AstraZeneca that, while safe, was second best. They feared that the rate of protection was too low to stop the virus spreading through the community and hence to achieve so-called herd immunity, where a disease dies out for lack of targets. This protects those who cannot or will not be immunised as well as those who get the shot.
Unfortunately, when The Age asked Health Minister Greg Hunt to comment, he dismissed the question and referred to a particular commentator who raised the issue, suggesting they had made warnings in the past which had proved exaggerated. It was an unnecessary response.
On Wednesday, Chief Medical Officer Paul Kelly was able to give a serious explanation. He said both the AstraZeneca and the Pfizer vaccines prevented death from COVID-19 and serious illness in 100 per cent of cases. The difference between the two vaccines is in the number of non-serious cases. The Pfizer vaccine reduced them by 95 per cent and the AstraZeneca vaccine by between 62 per cent and 90 per cent.
It was true that there was no guarantee that the AstraZeneca vaccine would achieve herd immunity, but the same was true for Pfizer since the first clinical trials for both drugs had not adequately tested how effective they would be in slowing community spread.
It would have been better to have all these matters explained in advance and it is regrettable that the government has not been more transparent in sharing its thinking.
What seems clear is that the AstraZeneca vaccine saves lives, which makes it worth using at least until other vaccines are available and perhaps even longer. Dr Kelly suggested the data from the mass immunisation using the AstraZeneca vaccine under way in Britain and other countries could show that it was just as effective as the Pfizer vaccine if used correctly. As our science reporter, Liam Mannix, has written, until last week many scientists, doctors and the public did not know about this strategy of prioritising saving lives with the eventual goal of achieving herd immunity – and that lack of detailed explanation was in part the cause of confusion.
Overall, Australia is in a good position. Unlike in other countries where deaths are soaring, Australia, with its low case numbers, has more time to wait for the evidence. By late February, once the Therapeutic Goods Administration is expected to have approved the drugs and the immunisation program is under way, science will have answered many of the outstanding questions.
The challenge for politicians is to ensure that people trust the vaccines enough to come forward and be immunised. A Roy Morgan poll on Sunday found that 77 per cent of Australians are ready to do so, which is high by global standards. The federal government must send out clear and honest information about its strategy if it wants to keep the public on side.
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