TELL Magazine

Fresh health advice in Australia has forced a change to the country’s embattled COVID-19 vaccine rollout program due to 12 new cases of a rare, sometimes serious, blood condition. Previously, over two million people aged 50 – 59 years were advised to take AstraZeneca vaccine but this has now been suddenly changed to the Pfizer vaccine instead.

On Thursday, June 17, health minister, Greg Hunt, explained the government made the decision on advice from the Australian Technical Advisory Group. The new advice said only persons over 60 years should now take AstraZeneca.

However, Paul Kelly, the chief medical officer, urged 815,000 people over the age of 50 who had taken only the first of two AstraZeneca doses to go ahead and take the second jab despite the changed advice.

He said though the “risk benefit equation” had now changed for the over 50s because of the reported incidence of the blood-clotting condition known as thrombosis with thrombocytopenia syndrome (TTS), those over the age of 60 should continue to take the AstraZeneca available.

Minister for Health, Greg Hunt, confirmed Thursday that COVID-19 vaccine is now only recommended for people aged 60 and over. “The benefit of AstraZeneca in the over 60s remains much higher than the risk of this particularly rare but sometimes serious syndrome. People over 60 should still be rolling out to their GP or wherever they are getting their AstraZeneca vaccine and getting that first dose,” he said.

“Anyone who has had a first dose of AstraZeneca without a problem should feel very confident to have their second dose and should keep that booking,” Kelly said, citing UK data which showed the incidence after the second dose was one in 1.5 million.

Professor Julie Leask, a social scientist with the Susan Wakil School of Nursing and Midwifery at the University of Sydney, said ATAGI had made the right decision but “the implication of this recommendation is that it will increase demand on the Pfizer vaccine. It is inevitable that some more people will feel more cautious about this vaccine, particularly those already hesitant. This is likely to be a minority.”

Professor Adrian Esterman, Chair of Biostatistics at the University of South Australia, warned the new advice would “again disrupt the vaccine rollout” given the limited supply situation.

“Unfortunately, the Federal Government put most of their eggs in the AstraZeneca basket, and this is now becoming a major problem,” Esterman said. For people aged 50-59 who had received just one dose of AstraZeneca, they should feel comfortable going ahead with the final shot.

The latest change comes eight weeks after the government ordered a major overhaul of the program to limit AstraZeneca to the over-50s. The government was confident it had enough Pfizer, saying it had secured “whole of population coverage” and would receive 2.8m doses in July.

“It is a difficult, challenging global situation. We have 40 million doses that are secured, which we believe are reliable and which will be delivered,” Hunt said.

“It’s a challenge. Every day during COVID, the world has challenges. Australia’s challenges thankfully and mercifully have been different to the rest of the world. Are we on track to offer every Australian a vaccine who is eligible during the course of 2021? The answer remains and the advice we have is yes.”

The head of the commonwealth’s vaccine taskforce, Lieutenant-General John Frewen, said it would be a “minor adjustment” to accommodate the new age group, given the ramp-up in Pfizer doses being delivered.

“From a logistics perspective, this is a relatively minor adjustment … There will be a few weeks of adjustment to get the cohort organised, and perhaps switch over to Pfizer, but we can accommodate this adjustment.”

The Therapeutic Goods Administration (TGA) reported on Thursday there were a further 12 reports of blood clots and low blood platelets assessed to be confirmed or probable cases of TTS linked to the AstraZeneca vaccine in the past week.

The new cases include three confirmed in 55 and 65-year-old women from Victoria, and a 53-year-old woman from NSW. The nine new probable cases include: a 54-year-old man from the Northern Territory, a 65-year-old woman from Tasmania; 50 and 56-year old men, and a 69-year-old woman from Victoria; a 58-year-old woman from South Australia, 59 and 80-year-old men from Queensland; and a 67-year-old woman from NSW.

It takes the total of Australian reports of TTS following the AstraZeneca vaccine to 37 confirmed and 23 probable.

The estimated risk of TTS following the first dose is 3.1 per 100,000 for people under 50, 2.7 for people between 50 and 59, 1.4 for people between 60 and 69, 1.8 for people 70 to 79, and 1.9 for people over 80 years of age.

A total of 25.5 percent of the eligible population have had their first vaccination, including 64 percent of over 70s.

Nigeria has just taken a second delivery of 3.92 million doses of AstraZeneca vaccine to complement the first supply of 3.92 million doses. That is the only COVID-19 vaccine in Nigeria. The Pfizer vaccine which has a higher percentage of efficiency, requires much lower temperature to store than Nigeria’s present immunisation logistics can handle.

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