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Why we needed more shots in the quest for a vaccine

This is a different message to the optimistic talk last August when Scott Morrison struck a deal with AstraZeneca that he said would put Australia at the “front of the pack” to vaccinate all Australians.

Prime Minister Scott Morrison struck a deal with AstraZeneca in August.

Prime Minister Scott Morrison struck a deal with AstraZeneca in August.Credit:Alex Ellinghausen

In fact, it’s a crowded pack and the finish line keeps moving because nobody has the final results on which vaccine works best.

The Prime Minister and his team have locked in a range of deals but cannot shrug off the big question: are they enough?

The big bet is on AstraZeneca. The government has an agreement for 53.8 million doses, with 50 million of them to be made in Australia by CSL. The results so far show this option is safe and effective.

Pfizer is a gamble on the side. The government only has an agreement for 10 million doses for this vaccine and appears unlikely to get more, at least in the first half of the year. Pfizer and its partner, BioNTech, are giving greater priority to other countries.

While the government has an agreement with Novavax for 51 million doses, it talks of this as a “back-up” and assumes it would have to come from Europe: CSL cannot make Novavax and AstraZeneca vaccines at the same time.

Morrison and his officials are clearly hoping the final AstraZeneca trial proves this vaccine can do better than the 62.1 per cent efficacy rate for two standard doses in its interim results. Efficacy was 90 per cent for those who accidentally received a low dose followed by a standard dose. There is a mystery about why that happened.

But Australians will not reward the Prime Minister for wishing and hoping. Everyone can now see the missed opportunity of last year – the chance to get more doses from Pfizer (this vaccine has a headline efficacy rate of 95 per cent) or a contract with Moderna (94.1 per cent).

Like everything in this pandemic, performance will be judged on the numbers. The country’s relatively low coronavirus case numbers are a vindication for Morrison and other leaders. The vaccination figures are the next test – and the task is overwhelmingly one for Morrison more than the premiers and territory chief ministers.

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What can Australia do instead? There are big practical constraints. The Pfizer and Moderna vaccines use a new technique, messenger RNA, which cannot be manufactured in Australia. Both vaccines are hard to transport: the Pfizer vials require storage at minus 70 degrees Celsius, the Moderna ones at minus 20 degrees.

And, of course, Australia does not have any Moderna contract, nor a Pfizer deal that can cover most of the population.

If the Novavax trial turns out to be much more effective than AstraZeneca, the government will have to change bets.

There are ethical constraints, too. Australians are right to want the best possible treatment but cannot expect priority when other countries are being devastated by the pandemic.

Australia does not have a Pfizer deal that can cover most of the population.

Australia does not have a Pfizer deal that can cover most of the population.Credit:AP

Jane Halton, the former top public servant who now chairs the global Coalition for Epidemic Preparedness Innovations, warns against “vaccine nationalism” and says the world can avert more deaths by ensuring poorer countries get help.

“Wealthy countries should not expect to get all the vaccines – it’s not the right thing to do and it’s also not sensible in terms of the public health perspective,” she says.

Malaysia just doubled its supply of the Pfizer vaccine to 25 million doses, but it has about 2500 new coronavirus cases a day. Perhaps Australians have to accept that other nations need swifter vaccination.

The government was upset with scientists this week for questioning its vaccine plan, but its call for public confidence in health policy would be more convincing if ministers were brave enough to rebuke wild claims from their own colleagues.

Craig Kelly is unapologetic about sharing what has been labelled health misinformation.

Craig Kelly is unapologetic about sharing what has been labelled health misinformation.Credit:Alex Ellinghausen

Political leaders are willing to muscle up when they think they can get their way. One example is the way Morrison ministers threatened non-government schools over their funding last April if they did not open during the pandemic. (It didn’t work.)

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When Liberal backbencher Craig Kelly talks up unproven cures, however, ministers are too scared to say four simple words: “Craig Kelly is wrong”. In fact, most of them will not even utter his name. He is the Voldemort of the vaccine debate.

For what it is worth, I will line up for the AstraZeneca vaccine as soon as possible, as long as the final results show it works. I expect others to get priority for the Pfizer vaccine.

But if the big bet on AstraZeneca does not pay, Morrison is exposed for promising too much and failing to deliver. The final test results, expected within weeks, will pack a political punch.

David Crowe is chief political correspondent of The Age and The Sydney Morning Herald.

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