Sometimes good people do bad things. Enter the Australian Technical Advisory Group on Immunisation, which almost single-handedly (and probably unintentionally) derailed Australia’s vaccination campaign when it recommended against the use of the AstraZeneca vaccine for people under 50.
The group, led by Professor Christopher Blyth from the University of Western Australia and the affable Victorian deputy chief medical officer, Allen Cheng, no doubt thought the decision would save lives. The problem is the recommendation, coupled with unfortunately misleading reports regarding AZ’s effectiveness (real-life results from the UK show almost identical efficacy to the lauded Pfizer vaccine), has led to upwards of a third of Australians being unwilling to take a vaccine.
With the benefit of hindsight, the advisory group appears to have got it wrong. Not with regards to the rate of clotting (which at 1:100,000 is more common than what was predicted) but rather the fatality rate. So far, after more than 1.8 million doses, 24 Australians have reportedly suffered clots but only one person has died. The death occurred before physicians were fully aware of the issue and well before treatments had been refined (plus the victim had severe chronic underlying health conditions, including diabetes). Given the understanding and treatments it is likely that very few others, if any, will die as a result of blood clots resulting from the vaccine.
The decision to preference against AZ is therefore likely to have saved very few (and possibly zero) lives. This may not have been a problem had the announcement not led to a massive wave of vaccine hesitancy.
It’s almost a mathematical certainty that even with quarantine workers vaccinated there will be breaches of hotel quarantine in the next six months. For example, a recent case involved a returned traveller who came back healthy catching COVID while in quarantine in South Australia before returning to Melbourne.
The possibility of widespread infections during winter in a largely unvaccinated population is likely to lead to some deaths (COVID kills about one in every 200-300 people who catch it).
Given most COVID deaths involve older people (who would otherwise have taken the AZ vaccine), the calculus of the advisory group’s decision was almost certainly wrong. And it was wrong because the group not only significantly overstated the risk of clotting deaths, but badly underestimated the psychological impact of the decision with regards to vaccine hesitancy.
Then there are externalities that a medical board would almost certainly not consider.
Take for example Australia’s refugee intake (which pre-COVID was about 15,000 annually). As people delay taking the vaccine, that slows border openings and prevents refugees from coming. Refugees come predominantly from countries like Iraq, Congo (DRC), Myanmar, Syria and Afghanistan, meaning many are literally fleeing war zones. It’s impossible to know how many refugees who can’t come to Australia will die as a result of our closed borders, but it’s almost certain to be a higher number than incremental AZ clotting deaths.
The data coming out of Europe regarding AZ’s efficacy (even against the Indian strain) is strong. Plus not a single person has died since the group’s decision, which gives it reason to update its recommendation.
Can the advisory group put the genie back in the bottle? Possibly. Yesterday it released a statement clarifying its position. But it needs to happen quickly and forcefully, otherwise a decision intended to save lives could achieve the opposite.
Have you opted against getting the AZ vaccine? Let us know by writing to letters@crikey.com.au. Please include your full name to be considered for publication in Crikey’s Your Say section.
Adam Schwab is a commentator, business director, and the co-founder of LuxuryEscapes.com. He is also the author of Pigs at the Trough: Lessons from Australia’s Decade of Corporate Greed.
I am eligible for a vaccination, but I am waiting until I have a choice of which vaccine, not something promoted by a Government that I have even less trust in than the vaccine they pushing.
The trouble if you do wait for the other vaccine, you may find yourself AT THE BACK OF THE QUEUE, behind all the 16 to 49 year-olds.
Big deal, you say “I can wait”. But COVID-19 is a sneaky disease, and from time to time will evade quarantine. Additionally, probably sooner rather than later, business and educational travel will resume, followed soon enough by tourism travel.
So maybe the very low chance of serious or fatal blood clots is actually much less risky than waiting, and waiting, and waiting…
My concern is the fact that NSW has mass vax clinics for Pfizer, but the old folks get AZ at the GP. The messaging is way to mixed and the blathering of Kelly, Hunt and Coatsworth seems worthless because initially they were not upfront about the clotting issues or even more so in Hunt’s case, the problems with the logistics.
They weren’t “upfront about the clotting issues” because those issues were not known and recognised until some months into the vaccination program.
Spot on KeithT. I would also comment that recent data suggests that the risk of blood clot is about 1 in 100000. However the risk of death is much less that originally estimated, seemingly about 1 in 1800000 ie 1 in almost 2 million. Given the rate of long term effects from covid (if you are bad enough to be hospitalised, data from the UK suggests about 1 in 3 will suffer covid long term) I reckon thats a bet worth taking.
One in a hundred thou is still about 80 over 50s who are going to find themselves in hospital with blood clots. Whether or not they die, like the “only one woman” (with apologies to her partner and or kids, I’m sure she wasn’t an “only” to them), will no doubt still be enough of a concern to turn otherwise healthy people off rolling the dice.
It’s a small risk, but some people are going to draw the short straw. Giving yourself blood clots when you were previously healthy will seem in hindsight, a great source of annoyance and regret.
But isn’t it still better than risking getting Covid itself? That depends on what the odds are of getting Covid, in Australia, today, right this minute. Taking into account the quarantining, screening and tracking, i reckon they’d be pretty low…possibly lower than the blood clot risk from AZ? I haven’t seen anyone posit a guess at what those odds might be – instead the odds used for comparison tend to be the general worldwide fatality ones, rather than Australia-specific ones.
So I stay confused – are we the “envy of the world” in terms of Covid defence or “sitting ducks for a massive future outbreak”?
Just like we are simultaneously drowning in “160 million doses of vaccines”, while also nervously unsure of supply and delivery.
Even the AZ blood clot odds are one in a million one day then one in a hundred thousand the next.
We seem to be fed one dodgy story after another, depending on what Morrison and his cohorts decide is their spin du jour. They are so caught up in bs, they couldn’t lie straight in bed.
So unless they’re going to open the international travel floodgates before Pfizer comes in, I would say that waiting for the mRNAs could be in fact playing the safest odds.
This is how it looks to me at the moment too.
This month we have had more vaccine-related blood clots than people catching Covid-19 in the community.
And we have had more deaths from vaccine-related blood clots than from Covid-19.
Morrison and his cohorts… are so caught up in bs, they couldn’t lie straight in bed.
Wrong! Morrison can lie ANYWHERE, and does, straight-faced but crooked, all the time.
Chances of getting Covid, in Australia, right this minute? Extremely low. Long term chances of contracting Covid in Australia? A lot higher. Eventually the international border is going to have to open. Once that happens, we become reliant on the efforts of every country Australian tourists have visited, the home countries of foreign tourists arriving here, and everybody who has been in close contact with someone who has flown into Australia. Covid will return to Australia.
There’s also the fact that one major difference between vaccination-related blood clots and viruses is that the blood clots don’t spread through the community exponentially. A waiter with a blood clot isn’t going to infect a restaurant full of customers with blood clots.
There is an important statistic that I keep noticing is missing: The chance of ending up with a blood clot linked with an Astrazeneca vaccination is, at most, around 1 in 100,000 (<0.001%). It’s actually less than this but the exact rate changes because we have months of statistics to measure rather than years, so we’re all on a steep learning curve. The statistic never mentioned – and you would think it would be – is the general incidence of blood clots in the population. It turns out that this is around 1 per thousand adults (according to the NIH, so US population and other countries with different diets may have slightly higher or lower rates). So, we’re talking here about the risk increasing from 0.100% to 0.101%.
That’s rather underwhelming as risks go.
So do you reckon waiting til later this year to have an mRMA shot, would be way to go assuming that international borders won’t open this year? ie the current short to medium term risk in Oz over this period will remain where it is, very low?
sitting ducks
Have had first jab AZ. No problem. Second due July. Hesitancy, solely related to efficacy differential. ie Pfizer alleged higher? Age 83.
Graybul
had AZ one myself. Later data out of UK suggests there is little difference between AZ and Pfizer/Moderna in efficacy and side effects
I’m booked to have the AstraZeneca vaccine on Saturday. I’m having it regardless.
Likewise.
If the vaccine – any vaccine – won’t stop you from being infected with the SARS-Cov-2 virus, AND it won’t stop the virus replicating and mutating in your body, AND (on balance) it won’t reduce the likelihood that you pass the virus on to someone else, why would you take it “Regardless”?
You need to do some research. Both Pfizer and AZ lower the transmission rate significantly according to work in the UK and Israel. It lowers the shedding rate and makes you significantly less likely to get it.
Except its proven that the AZ vaccine is less effective at lowering transmission rates-especially with respect to the newer variants.
Are you saying that if someone else has been vaccinated, their shedding rate is lower and so I will be less likely to become infected with the virus from them?
These are genuine questions. I am not a vaccine sceptic and will be going for a tetanus booster next week.
most certainly. However if you are relying only on other people being vaccinated, you need enough people vaccinated so that you chances of exposure to person who has covid are basically zero. ie you need enough people vaccinated to ensure the virus cant keep spreading amongst non-vaccinated people. Otherwise the virus can still maintain a presence amongst non-vaccinated people.
The level of vaccination for this to occur with Covid is around 80-85% people vaccinated. The chances of Australia reaching that level are frankly, low. So if you wish to protect yourself, as well as help stop covid, I’d suggest vaccination asap. It is inevitable that covid will become more prevalent in Australia – so far virtually no country has succeeded in keeping it out, being so contagious covid seems to always escape
KeithT
your information appears to be incorrect. Scientists were initially uncertain whether covid vaccines would stop virus replication and reduce the level of virus shedding. This was a conservative position, as virtually all vaccines reduce viral load and lower or prevent viral spread, but in the absence of certainty, scientists said ‘we don’t know” . We now DO know, and all Western covid vaccines certainly lower viral load and reduce shedding.
One of a dozen, and counting, exotic, untested potions which may “lower & reduce” illness & infectiousness – I’m sold.
NOT.
Because it dramatically reduces your tusk of severe illness or death from Covid-19
On Thursday for me.
Tomorrow. Aged 68. Wife, 65, had it on Saturday – no ill-effects.
Had the first jab four weeks ago, two and a half weeks after my flu jab, which makes me feel safe but still wearing a mask on public transport and in supermarkets where people will not keep their distance.
Age 81.
I’m having it this arvo.
PS 63
I’m having my first shot on Tuesday.
Had last week. Arm ache. That’s all. Wife had it. Mild headache for a few hours next day that’s all. What people forget is on ce there is a new outbreak….vaccines will be like toilet rolls…..none available. Now is the time.