AstraZeneca is not a poor man’s vaccine

AstraZeneca has been portrayed as a poor man’s vaccine or worse a roll of the dice with recipients changing their arm. A month ago, the ABC’s Norman Swan suggested the vaccine would be withdrawn from the market if it were not for the pandemic, an odd statement at best and one grounded in a hypothetical alternative that cannot be proven.

ATAGI’s advice has changed in recent times. The advisory group now recommends people living in greater Sydney of all ages consider vaccination with Astra-Zeneca. Outside Sydney, however, the advice remains the same. People under the age of 60 might consider the Astra-Zeneca vaccination in consultation with their GPs. But implicit in that caveat is to wait for Pfizer and thus Australia’s roll out remains at a slow pace.

The answer of concerns on AstraZeneca

The central issue around the use of AstraZeneca is the possibility of developing a rare blood clotting condition known as thrombosis with thrombocytopenia syndrome (TTS) or Vaccine-induced thrombotic thrombocytopenia (VITT).

A study published in Lancet last Wednesday, from AstraZeneca’s global safety database, confirmed reports of an elevated risk of TTS in those receiving their first shot, which occurred at a rate of one per 8.1 per million people. In other words, 399 people out of 49 million developed TTS after the first dose of AstraZeneca.

After the second dose, however, there was no increased likelihood of developing TTS with a rate of one per 2.3 million people. That rate is comparable to the development of TTS in unvaccinated people. Furthermore, TTS is more easily recognised and treatable now. Initially the condition came with a mortality rate of one on four. 

In Melbourne, Alfred Health Head of Thrombosis and Haemostas Professor Huyen Tran said experts have developed a much stronger understanding of the syndrome.

“We understand this condition has a very different mechanism to all other forms of blood clots. Not understanding this difference in the past may have led to confusion and hesitancy to get vaccinated. We’re now in an extremely strong position to recognise it, diagnose it and most importantly, treat it well.”  Professor Tran said last month. 

Professor Tran said blood thinning medication is a mainstay in treating TTS but the use of intravenous immunoglobulins in more severe cases also appears to impact on a positive outcome for the condition.

/ Alfred Health Head of Thrombosis and Haemostasis Professor Huyen Tran

“Obviously we recognise that there is a risk there, but to put it into perspective, of all the AstraZeneca jabs given in Australia to last week, we’ve had just 31 confirmed cases, three quarters are already out of hospital and recovering.

AstraZeneca’s impact

AstraZeneca has been the mainstay vaccine in the UK which now boasts high levels of vaccination and in England at least, has led to the end of lockdowns and a return to a form of pre-Covid normal. There is no reason we cannot do the same here with AstraZeneca forming a big part of the vaccination mix.

An order of the Moderna vaccine to South Korea has been delayed due to production difficulties. 25 million doses of Moderna are due to be delivered to Australia by the latter part of 2021. The Novavax vaccine has already been delayed with the 51 million doses due to come to our shores later this year now being pushed back to 2022 where it is said it will now form the basis of vaccine boosters.

AstraZeneca can be manufactured quickly and cheaply on our own shores. We have control over production and supply. It will form the foundation of Covid-19 vaccination in the developing world. It’s efficacy against the Delta variant is at least as good as Pfizer, possibly better. Unlike the Pfizer vaccine, it is plentiful in Australia.