Mentally, Australia is finished with COVID-19. Social restrictions have dropped, travel is back on the cards and, for many, catching the virus has been similar to catching the flu.
But in reality, the pandemic is far from over. Australia is heading for its third Omicron wave thanks to a more infectious BA.4 and BA.5 variant of the virus. Today the Australian Technical Advisory Group on Immunisation (ATAGI) will meet to discuss expanding the fourth-dose rollout to include those aged under 65. On Sunday Australia’s death toll hit 10,000 — the vast majority of deaths recorded this year.
While ongoing COVID-19 jabs are likely, experts have raised concerns about the sustainability of rolling vaccine coverage, especially as Australians may be hesitant to step forward for additional doses.
Is a fourth dose surprising?
While governments have been wary to announce ongoing COVID-19 vaccines, it’s always been likely. COVID-19 is a virus and, like all viruses, is constantly mutating. The current first-generation vaccines have been designed to protect against the variant which emerged from Wuhan — a very different virus than what is spreading today, making the fourth jab akin to a second booster, rather than a new vaccine.
Second-generation vaccines, tailored for newer strains, are crucial, infectious disease expert Professor Paul Griffin tells Crikey.
“Vaccines give great protection, but it’s not going to be lifelong,” he said. “Whether the COVID-19 vaccine is going to be annual, more than that or less regularly will depend on what happens with the virus and the emergence of new variants and sub-variants.”
mRNA vaccines have a short shelf life and have to be carefully stored — making regular rollouts expensive and difficult to manage. Australia’s mRNA manufacturing centre in Victoria is set to be up and running from 2024, and Griffin warned giving more than one dose to every Australian every year was unfeasible.
This is why developing second-generation vaccines is so important, Griffin said, because they might protect people for longer. “We’re still early stages of this pandemic and there’s no sign that this is going to just go away by itself anytime soon,” he said.
“We need to be prepared to be able to combat this virus for the foreseeable future.”
But, he stressed, new therapies, pre-exposure injectable antibodies for the immunocompromised, and antiviral treatment drugs will all continue to make the virus more manageable.
Australians are slow to step up for boosters
Getting Australians to step forward for their third and fourth doses has been an issue. Boosters have been available for almost a year, yet just 70% of Australians have received one (in Indigenous populations, that number is 53.9%).
Fourth doses have been available since May for aged and disability care residents, people over 65, Aboriginal and Torres Strait Islanders over 50, and people with medical conditions, but just 58.7% of those eligible are quadruple-vaxxed. That number is only slightly higher for those in residential aged care settings at 65.7% — a major concern as winter sets in.
University of South Australia biostatistics expert Professor Adrian Esterman told Crikey for the general population three doses offered solid protection.
“Three doses for most people is optimal and, until second-generation vaccines come along, probably is sufficient,” he said.
“I think what’s happened is that those who are genuinely at risk would have gone and got their booster shots. For the fourth shot, the ones that are hanging back are those who perhaps aren’t at such high risk.”
But he warned complacency could be dangerous. While government messaging emphasises the risk is over, Esterman said Austalia wasn’t out of the woods yet — but could see the light at the end of the tunnel.
“We’ve got 95% of people who’ve been vaccinated and those who are vaccinated and have recovered from COVID-19 now have hybrid immunity, giving them some protection against even new sub-variants,” he said.
“The pandemic is ongoing but in Australia, we’re at the endgame.”
Since late 2021, Australia has gone from one of the lowest death tolls in the world (in absolute numbers, according to Johns Hopkins University’s statistics) to 64th out of about of 200, and our death toll is increasing faster than most countries. Even though we have a low percentage of deaths per 1,000 cases, thanks to high vaccination rates, our infection rates are now among the highest in the world. But politicians no longer want to talk about COVID.
A lot of conditional phrasing – ‘could’,’may’, ‘might’, ‘probably’ – and the completely reassuring reminder that those Polish/Bulgarian excess doses the government scarfed up had a very short shelf life even if they’d previously been stored correctly.
Annual, if not more frequent, shots from here to Eternity.
Welcome to the Future of past premedical vulnerability when a dental abscess or scratch while gardening could kill.
It’s a zoonotic diease previously unknown in humans, so we have no natural immunity. I’ll take all the shots I need, so probably not the fourth, but the next variant targeted one I will. I wear n95 too, no covid as of yet.
No amount of dettol or tea tree oil will prevent infection, so the scratch analogy is useless. A tooth absess, that can be deadly.
At this point, seeing the disproportionate number of unvaccinated and under-vaccinated in the statistics, part of those numbers must be taken as a testament to human stupidity / obstinacy. And that’s not even including all the time and resources our health system has devoted to those people.
All well and good, but one observes low if any following of low level advice to protect oneself and others e.g. wearing masks on public transport, offices and supermarkets etc.
Mandated for public transport still in some states. Most do the right thing but a lot don’t and there is little formal enforcement. Short memories.
My bus had a fed up hand written WEAR A MASK sign. Roughly 50% either way. I’m sick of it and pointed it out to a grown man on the way out. It’s like people go, noones wearing a mask, so I won’t. Which is the most stupid way to make a decision.
I rang the Pharmacy in our local town to ask if they were doing Covid boosters: “Yes, we are, just come in any time – except between 12 and 2 as it’s very busy then”.So we went down: “oh, no, the next time we’ll be doing them will be Friday.” “But we rang this morning and were told any time, no appointment necessary.” It was so frustrating, We came home with 4 pages of forms to fill in but no vax. Grrrrrr!