Why over 50s but not other Australians

On 7th April night, the government announced a recommendation that alternatives to the AstraZeneca vaccine be offered to those aged under 50 due to an approximately one-in-4m risk of severe blood clotting.

Australia’s health advice has changed to preference the Pfizer COVID-19 vaccine over AstraZeneca’s for a large portion of the country’s population. 

With the government accepting advice that the small risk of blood clots associated with the AstraZeneca vaccine means it should not be given to people under 50, its plan to vaccinate Australians against the virus is in disarray.

The government advice on the rare clotting was sensible, and that Australians should still have confidence in the overall safety and efficacy of the vaccine. But the public had already been fatigued by promises about the rollout that had gone unmet. Over the last eight months the public has been convinced by politicians that we’re only implementing measures like closed international borders and lockdowns until the vaccine arrives.

That was not something the governement could have foreseen. But other issues could have been foreseen – including vaccine nationalism, which involves other parts of the world blocking exports to secure their own supply.

/  Prime Minister Scott Morrison

So why is the vaccine OK for people over 50 but not ok for under 50?

The government says it’s taking a deliberately cautious approach by changing tack on the rollout strategy. It says it can do this because Australia has such low rates of community transmission, which reduces the urgent need to vaccinate the entire population.

But the risks of TTS — and COVID-19 — differ depending on your age.

Chief Medical Officer Paul Kelly explained it appeared that because the rare syndrome was likely an immune response, it had a greater chance of affecting young people with “robust” immune systems. And, as we know, your risk of death or hospitalisation from COVID-19 increases the older you are.

“This is based both on the increased risk of complications from COVID-19 with increasing age, and thus increased benefit of the vaccination, and the potentially lower — but not zero — risk of this rare event with increasing age,” Professor Kelly said.

/ Chief Medical Officer Paul Kelly

In a nutshell, the government believes the AstraZeneca vaccine contains fewer risks and greater benefits for older people, and therefore is worth the very small risk associated with the vaccine for people over 50.

But is it true?

We don’t know.

The government should “take a pause, and review what’s been going wrong so far to try and reset and fix a lot of those governance and logistical issues, including squabbles between states and the federal government.”

The rollout will likely be affected now that the Pfizer vaccine is preferred for millions of Australians, as we have far more arms to jab than Pfizer vaccines in supply.

The government is working to improve Australia’s access to the vaccine, and it also has pre-ordered more than 50 million doses of the Novavax vaccine, which is still in development.

But in the meantime, its plan to have everyone partially vaccinated by October is in doubt.