A meeting of the Immunisation Coalition’s (IC) COVID clinical assessment team was held on 31st of May 2021 to consider the COVID vaccine rollout in Australia, in light of the current Victorian outbreak.
The paucity of data about levels of vaccine stock in Australia is of great concern. While acknowledging additional stocks are on order and new vaccines are under development, the reality is that Australia has only AstraZeneca (AZ) and Pfizer vaccines available at this time; we therefore need an effective vaccination program that uses them appropriately. The IC therefore believes transparency about the available stocks in Australia is essential to help providers and the community plan their vaccinations.
Furthermore, it was noted that vaccine induced prothrombotic immune thrombocytopenia (VIPIT), associated with the AZ, and reports of anaphylaxis, myocarditis and pericarditis associated with the use of the Pfizer mRNA vaccine, occur rarely and can be well managed. It was noted that changing the vaccine interval for AZ would substantially alter its effectiveness and the benefit of earlier protection against greater long-term level of protection does not suggest a change is necessary in Australia at the moment. We do however recognise the shifting evidence, and the overseas experience suggests this can be considered if required.
The IC will adopt a role of making clearer the science around AZ and its potential side effects. For example, the guidelines for people under 50 years of age getting Pfizer and over 50s receiving AZ seem to be viewed as a choice rather than adhering to best use of vaccines in a pandemic. Letters from specialists thinking a patient should have a different vaccine seem to be propagated by convenience rather than evidence or reasons that can withstand scientific scrutiny. There is also an argument for raising the age recommended for AZ to 55+ as there is data that suggests the risk of thrombosis with thrombocytopenia syndrome (TTS) reduces remarkably by 55.
It was noted the Australian Technical Advisory Group on Immunisation (ATAGI) information is a useful resource. The IC will look at ways of increasing awareness of the evidence and improving the knowledge of risks and benefits to the community of the available vaccines.
It is important to have vaccination coverage rates at their best. As of 1st June 2021, influenza vaccines became mandatory for Residential Aged Care Facilities (RACFs), and with no evidence that flu and COVID vaccine can’t be given together, the IC recommends both vaccines be given at the same time in those settings (and other vaccines too).
Statement date: 31st May 2021