Fears AstraZeneca reputation has been ‘tarnished’ beyond repair
By Aisha Dow and Melissa Cunningham
June 20, 2021 — 6.00amFor our free coronavirus pandemic coverage, learn more here.
Vaccination experts say they fear the reputation of the AstraZeneca vaccine could have been tarnished beyond repair in Australia, leaving the population dangerously exposed to coronavirus outbreaks in the months to come.
Following the latest decision by the Australian Technical Advisory Group on Immunisation to limit the AstraZeneca vaccine to those over 60, doctors say patients have been cancelling their vaccine appointments in droves and abusing receptionists as they demand the Pfizer jab instead.
Brendan Crabb, director and chief executive of the Burnet Institute.Credit:Jesse Marlow
While top vaccine experts say AstraZeneca may not be as widely used in Australia in future when supplies of alternatives increase, they believe negative public sentiment around the safety of the vaccine is out of proportion with the risks posed by a serious but rare side effect.
Burnet Institute director Brendan Crabb said the AstraZeneca vaccine had proven to be more effective in the real world than predicted in clinical trials. The 54-year-old said he would not hesitate to have his second dose.
“COVID is truly terrible and there’s every chance AstraZeneca induced immunity would stand between me and serious illness,” Professor Crabb said.
“But there’s no doubt its reputation is tarnished, perhaps even to the point of no return in Australia. I certainly hope that’s not the case because there’s a lot at stake here.”
His comments came as an updated information sheet released by the federal government to help the public weigh up their personal risks estimates that in an outbreak similar to Victoria’s second wave, that 100,000 doses of the vaccine would prevent 21 deaths among those aged in their 70s, for fewer than two cases of thrombosis with thrombocytopenia.
For those in their 60s, three deaths would be prevented for 1.4 cases of thrombosis with thrombocytopenia (which has a local fatality rate of about 3 per cent).
“Our message is simple, if it is your time for a second dose of AstraZeneca, or if you are aged 60 and older, do not hesitate, please come forward and be vaccinated,” a spokesman for federal Health Minister Greg Hunt said on Saturday.
And Friday brought encouraging signs, with almost 131,000 Australians turning out to have a vaccination – just short of the same time a week before.
But doctors have still been reporting that many people have been cancelling their AstraZeneca appointments, and Royal Australian College of General Practitioners Victorian chair Anita Munoz said some patients had also been verbally abusing reception staff, demanding to receive Pfizer.
Dr Munoz, who works at a GP clinic in Melbourne’s CBD, anticipated doctors would face an uphill battle to convince patients over 60, who were still eligible for AstraZeneca, to get vaccinated or have their second shot.
“There really is going to have to be a widespread campaign that informs the public that this is what medicine does, it changes with the evidence.”
Almost a million people in their 50s who had already received the AstraZeneca shot have been advised that it is safe to get their second dose, with UK data showing the chance of people developing the rare condition drastically lower than for first doses.
There were an estimated 1.5 cases of thrombosis with thrombocytopenia per million following the second shot, compared to 27 per million for first doses for those in their 50s in Australia. The AstraZeneca vaccine, like the Pfizer jab, is estimated to provide an extremely high level of protection against hospitalisation and death due to COVID-19.
Infectious diseases specialist with the Australian National University, Sanjaya Senanayake, said while he wished older Australians would take up the “very good” AstraZeneca vaccine “the reality is that we may not win this public relations campaign”.
He said the transparency of health authorities in keeping people abreast of the developments with the rare side effect (60 likely cases in almost 4 million doses of the vaccine) alongside low rates of coronavirus in Australia had culminated in hesitancy.
But he warned there was no guarantee that Australia would continue suppressing the virus, or that the new cluster in Sydney, which on Saturday grew to six cases, would be contained.
“The reality is it might take hold and we might have a Melbourne 2020 situation again,” Associate Professor Senanayake said.
“In the blink of an eye or we can go from having no community transmission to a really nasty outbreak.”
Victoria recorded one locally-acquired case of coronavirus on Saturday, a person who had been in isolation while infectious, while the state’s Chief Health Officer Brett Sutton warned the virus was “absolutely still out there”.
Mr Hunt has said supplies of the Pfizer vaccine are due to double next month, when weekly deliveries increase from an average of 300,000 a week to 600,000.
However, Professor Crabb said if there was an outbreak in Australia in the next six to nine months the rate of death and serious illness could be greatly influenced by the success or otherwise of the AstraZeneca rollout.
“The community has an inkling of this which is why they rushed to get vaccinated during the recent Victorian scare,” he said.
In poorer countries, Professor Crabb said the impact of “not going full steam ahead” with AstraZeneca and other similar vaccines was potentially devastating because those countries may not have access to alternatives for years.
“Hesitancy is already a major problem. What we do influences uptake elsewhere,” he said.
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In Australia, experts say the AstraZeneca vaccine may be less of a feature of the country’s vaccine strategy from next year, as it was quicker to develop booster vaccines using different types of vaccines.
Australia has already ordered 15 million doses of Moderna’s variant booster vaccine. Like the Pfizer vaccine, the Moderna jab uses mRNA technology.
The prospect of combining the AstraZeneca vaccine with one dose of the mRNA vaccine has also been flagged, amid emerging evidence that a mixed dose could lead to a better immune response.
Following the latest decision by ATAGI, Mr Hunt announced a new payment for GPs, allowing them to bulk bill consultations with patients to discuss their vaccine concerns.
University of Sydney infectious diseases expert Robert Booy said it was clear that public trust in AstraZeneca had been dented, and said GPs should have been notified ahead of the change in clinical advice.
Melbourne GP Alastair Stark said agitated and anxious patients, who had concerns over AstraZeneca, had been phoning his western suburbs clinic and taking out their frustrations on reception staff.
“It has become the norm for patients to just call and shout at receptionists, which is really awful,” he said.
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Another GP, John Hodgson, who runs a respiratory and vaccine clinic in Coolaroo in Melbourne’s north, is concerned vaccines may go to waste. He estimated the change in clinical advice had set back the vaccine rollout by months.
“The major problem is people are fearful again, they are worried about being vaccinated. It’s raised the question of ‘why can’t we all get Pfizer’?“
A spokeswoman for CSL, the manufacturer of AstraZeneca in Australia, said it remained committed to meeting its contracted arrangements with the Australian government and AstraZeneca.
“We are proud of our unique role in Australia as the only onshore manufacturer of a COVID-19 vaccine, and of our ongoing contribution to the country’s vaccination program,” she said.
On Saturday, Trade Minister Dan Tehan said the federal government was negotiating with Singapore about a potential travel bubble with Australia, but was in “no rush to open the borders” to international travel.
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