Australia has followed the lead of a few European countries in curtailing the rollout of AstraZeneca vaccines, due to the extremely low, but still existent, risk of dangerous blood clots. Last night the government announced that it would now be “recommended” for under-50s to get a different vaccine instead, of which Australia had only ordered Pfizer, and only enough to partially cover the population. Today we got the news that Australia has secured further doses of Pfizer(external link) – we’re now scheduled to get a total of 40 million doses, largely in the fourth quarter of this year – but this is still dependent on other countries not slamming export controls down against us again, and means that we won’t see widespread vaccination here for ages.

Australia’s vaccine rollout was already bungled in multiple ways and well behind schedule. We haven’t had the supply we expected, because we got slammed with EU export controls1 and local production has, apparently, been slower than expected in ramping up. Then the doses we have had, we’ve been slow to administer them, as apparently the government was very late to realise it actually needed a plan for this to happen, and then its plan was to delegate the rollout to individual GPs with whom they did not communicate at all and to whom they have sent hilariously low quantities (50 doses a week). So this clusterfuck is just the latest and most explosive delay in a process that has been plagued by delays. I’ve mentioned before that I have a pre-existing condition that makes me anxious to get vaccinated, but the government has never heard of my condition so I don’t get any kind of priority in the queue; I’m just considered a “healthy twentysomething”. I was already unhappy about the slow progress of our rollout, and the prospect that I might have to wait until the end of the year (assuming we don’t get hit with export controls again then!) has me thinking: if Australia doesn’t really want the millions of AstraZeneca doses we’re gearing up to produce, can I just have one?? I took the contraceptive pill for years and years and never got blood clots. I’m pretty willing to take the 1 in 200,000 chance(external link) on this one.

I feel like the problems here are manifold. For a start, somehow the media has run away with this narrative that the AstraZeneca is super ultra-dangerous despite the rate of this blood clot complication being very very rare. People who understand statistics have been trying to contextualise the risk to people: you’re more likely to get hit by lightning; more likely to get eaten by a shark; more likely to slip and die in a bathtub… (all things that most people don’t fret about). But despite this, it seems the waters have already been poisoned and public confidence in the vaccines has already been undermined.

So given this apparent situation, what’s the government to do? If they proceed with the rollout of AstraZeneca as planned, I guess they figure there’ll be a high rate of refusal. Perhaps their hope is to soothe public anxiety by de-emphasising this vaccine – despite the fact that it’s actually very safe – in the hopes that its tarnished reputation won’t spread to the other vaccines that we’ll have to rely on months down the track. My concern is that it’ll have exactly the opposite effect – given that anti-vax and vax-hesitant attitudes are already kind of prominent here, I fear this’ll legitimise and embolden people going, “Aha! You see! I always knew these Covid-19 vaccines were rushed and dangerous!” Australia’s safety at the moment is only because of quarantines, contact tracing and lockdowns… if we ever want to reopen our borders safely we really need thorough vaccine coverage, and I’m worried we’re not going to get there.

The other problem is, of course, that Australia pretty much bet the house on AstraZeneca. Other countries are using whole ranges of vaccines: Pfizer, Moderna, J&J, Sinovac, Sputnik, etc. and while we have some Pfizer and Novavax apparently awaiting approval, we were really kind of counting on AstraZeneca because we have the capability to manufacture it locally (we do not have the ability to manufacture mRNA-based vaccines, apparently) and therefore couldn’t be stymied by other countries withholding whatever vaccines we ordered from abroad. If we’re re-orienting to vaccinating most people with Pfizer (better hope no rare side effects become known to be associated with that one, or else we’ll really be screwed), then what do we do with the AstraZeneca? I mean, I guess if we re-orient to exporting that to heavily affected nations that can’t afford to be excessively picky about which vaccines they receive, then that would be a good outcome. But some of those (South Africa, Brazil) are also seeing variants rise to dominance that the AZ vaccine isn’t so effective against. And as the pandemic goes on and on, who knows about where else will see new variants that AZ can’t handle.

Even before this blood clot issue, AstraZeneca had already been developing a reputation as “the not-as-good vaccine”. It was known, for example, that Pfizer offers good protection against the South Africa variant(external link) while AZ does not, and authorities were worrying that vaccine take-up might be low as we move further through the rollout as people hold out in hopes of getting the Pfizer. I guess that I never really fell into this camp. My expectation was always that Covid-19 vaccinations wouldn’t be a one-and-done; booster shots are likely to be needed regularly unless/until the virus is contained everywhere in the world, and maybe just forever (if Covid-19 becomes endemic like influenza). After all, even once you get a vaccine, the protection granted is expected to start waning after a couple of years(external link). I figured I’d get AZ as soon as I could, and get boosted with a vaccine with even greater effectiveness down the road. Now, I really don’t know what will happen.

Pfizer seems like a great vaccine, but the majority of us won’t get access to it for months. You might think, “So what, Australia doesn’t even have any Covid-19 circulating in the community right now.” You’d be right, but the measures we’ve taken to get there lead to their own problems – people stuck abroad, unable to get home; carnage in the tourism and higher education industries; periodic “leaks” of the virus from hotel quarantine and getting into the community, causing knee-jerk lockdowns and border closures (not to mention, some infections). The sooner we can get large swathes of the population vaccinated, the sooner these kinds of problems can be at an end. And we also don’t know yet whether the bad publicity around AstraZeneca will discourage people from getting any vaccine; as I mentioned, vaccine-hesitancy is alarmingly high in Australia. I’m just so impatient for us to reach a state of relative safety again.

  1. Not that I really blame the EU for this, because AstraZeneca production has been lower than expected there too, and EU countries are seeing much lower supplies than they were contracted to get and have much worse situations than us, in terms of virus prevalence. It was pretty rich that they wouldn’t even let us redirect some of our supply to Papua New Guinea though. I guess their assertion we can simply send them our locally-manufactured AZ works out now that we apparently don’t want it that much any more, though. ↩︎