Shortcuts / 26 August 2021

Australia’s COVID vaccines

There are set to be four different vaccines available to Australians in the coming year. If you’re anything like us, incessant reporting about AstraZeneca and Pfizer has meant things can often get confusing – and now there are two more to consider… So in this Shortcut, we step back and talk through each vaccine that will become available to Australians, including how the deals were done, how they’re funded, who can get what and how the rollout is tracking.

Let’s dive straight in…
Roger that. Australia has contracts for 4 vaccines: Oxford/AstraZeneca, Pfizer/BioNTech, Moderna, and Novavax. The first 3 have been provisionally approved by the Therapeutic Goods Administration (TGA) and Novavax is currently under evaluation.

Tell me about AstraZeneca…
It was the first COVID vaccine to get provisional approval in Oz. Efforts to make it started back in mid-January last year, after reports surfaced that an unknown infectious disease was breaking out in China.

Who spearheaded that?
An immunologist named Teresa Lambe. She got a message from a Chinese researcher who disagreed with China’s refusal to share the genetic code of the disease with those outside the country. She then got an email with the information on a Saturday morning, and still in her PJs, she got to work…

Legend. Was she working on the vaccine alone?
No. Working with Lambe was Oxford vaccinologist, Professor Sarah Gilbert.

Why does she sound familiar…
She was the one who received a standing ovation at Wimbledon earlier this year. But both women received Queen’s honours this year.

That’s right. Okay, back to the vaccine… When did the first batch come through?
That was in March 2020. And there was a lot of interest from the UK government, the World Health Organisation and the world about what Oxford was working on.

How did it go from the lab to the people?
There were talks with commercial partners to manufacture and distribute the vaccine and the partner they ultimately chose was AstraZeneca, an Anglo-Swedish company.

How much dosh are they getting out of this?
Nada. For now… the deal was they would manufacture and distribute the vaccine for no profit while the pandemic is ongoing. And they’ve honoured that…

What’s in it for them?
Well, there could be money to be made once the pandemic is over if annual boosters are needed.

Gotcha. Which explains the name AstraZeneca…
Yup. But before you get too comfortable with that – it’s having a name change. It’ll now be called Vaxzevria.

Why is that?
The company has asked the TGA to approve the rebrand because that’s what the vaccine is called in European countries and Canada. And if there’s an international vaccine passport, it’s important the names are the same.

So Vaxzevria it is…
Yep, but we’re not quite out of the habit of calling it AstraZeneca/AZ yet, so let’s stick to that for the time being.

Okay, I’m just going to say it – what’s the deal with the blood-clotting issue?
AstraZeneca has had its controversy – especially in Oz with concerns of blood clotting. But the risk of getting a blood clotting condition after getting an AZ jab is very low.

How low?
One a million. But the risk does increase the younger you are. That aside, Oxford University says one billion doses have been released. So it’s very popular…

Hasn’t the whole of the UK used it?
That’s not entirely true. The only vaccine currently approved for under-18s in the UK is the Pfizer vaccine, while people aged under 40yo are being offered alternatives to the AstraZeneca vaccine due to evidence linking it to rare blood clots. But still, a lot of the UK have had AZ…

Okay, bringing it back home…
AstraZeneca was the first vaccine made available here and it’s still available because it’s the only one we are able to make a fair bit of.

How so?
Our government signed up for 3 million AstraZeneca doses to be shipped here and then 50 million doses are set to be manufactured here in Oz by our homegrown vaccine manufacturer CSL.

But it’s not recommended for everyone…
No, it isn’t. ATAGI – the group that gives advice on who should have what vaccine – has said that for people over 60 years and over, the benefits of vaccination with the AstraZeneca vaccine outweigh the risks.

And under 60yos?
Well, let’s stick to the official wording: “The COVID-19 AstraZeneca (Vaxzevria) vaccine can be used in adults aged under 60 years where the benefits clearly outweigh the risk for that individual and the person has made an informed decision based on an understanding of the risks and benefits.”

Which means…
If you’re aged 18-59yo you can choose to receive the AstraZeneca vaccine after you’ve seen your doctor or if you provide verbal or written consent.

What about under 18yos?
That’s a hot topic. At the moment, no one is recommending AstraZeneca for that age group.

Okay, enough about that. What else is on offer?
The next big name in the game is Pfizer/BioNTech.

How did that come to be?
If we look back to January last year, biotech firm BioNTech clocked that the coronavirus outbreak in China was going to be a whole thing…

Did they have a crystal ball?
Something like that… After looking at the reports Dr Sahin – a German scientist and founder/chief executive of BioNTech – summoned his board to announce that the company would start work on a COVID vaccine.

How did that go down?
The way he’s told it, there was a lot of pushback because people were on their winter holidays and the early reports were sketchy.

But they persevered…
They did. But it was a longer process for BioNTech than it was for AstraZeneca.

Why’s that?
BioNTech uses mRNA technology to produce medicines – which is a new development. And it wasn’t until October that BioNTech partnered with big American pharmaceutical company Pfizer.

What’s in the fine print?
Pfizer, unlike several rival manufacturers which vowed to forgo profits, is making money on the vaccine. That’s controversial because German taxpayers put up about $600 million to fund BioNTech’s work.

What does Pfizer say?
They have opted not to take federal funds in the US to support the development of the vaccine. And, they argue their investment in taking the punt on a new vaccine will benefit people around the world for years to come.

I bet they’ve earned some coin…
They sure have. The vaccine brought in US$3.5 billion in revenue in the first 3 months of this year – that’s about a quarter of Pfizer’s total revenue in that period. So, on the other hand, critics say it’s a shameless grab for hundreds of millions of dollars.

It’s had a pretty good wrap in Oz though, no?
It has. That’s because it hasn’t had the same issues as AstraZeneca when it comes to who can or should have it. But it’s proven to be a bit difficult for us to get our hands on it…

What’s the deal with that?
Well, initially we had 10 million shots on order and when things with AstraZeneca and blood clotting went a bit skewiff, Pfizer became the hotshot. So the scramble to find more was on.

Didn’t we get one million doses from Poland?
Yup. The government hit the phones to find more supplies and Poland had a million for sale after its vaccination rate slowed.

Cheers, Poland. So issue solved?
Not quite. The problem isn’t that we aren’t getting Pfizer – we’re expecting a delivery of 40 million doses this year.

What’s the problem?
The problem is they weren’t coming fast enough. But after a lot of concern, PM Scott Morrison said they’d be coming home strong in the last quarter of this year. And, they’re starting to roll in now at 1 million doses per week.

Who’s eligible for those?
Experts say it’s fine for anyone over 16yo and the TGA is looking into it for children aged 12–15yo. But because supply is limited, it has been mainly reserved for vulnerable groups.

Including…
Those with underlying health conditions, frontline workers, those in aged care, pregnant women and just this week – Aussies aged 12yo and over who are on the National Disability Insurance Scheme.

So that’s the big 2. But there’s more coming?
Yup. Moderna and Novavax.

Let’s start with Moderna…
Moderna is an American company that develops and manufactures its COVID vaccine. It was another company that was onto it early, and like Pfizer, it also produces a vaccine made using mRNA technology.

And it’s also making a profit from its vaccine…
It is. Moderna has a market capitalisation of US$166 billion, up from about $7 billion before the pandemic.

When is it coming to Oz?
The first million doses are expected to arrive in September. Of the 25 million doses we’ve bought, 10 million doses will be dispatched this year, and a further 15 million booster doses in the first half of 2022.

Has it got the tick of approval?
It’s been approved for people aged over 18 years, and the TGA is looking into whether it’s suitable for kids. The idea is that Moderna will be administered via pharmacies and community services.

Gotcha. How about Novavax?
It’s another American biotech company and is also a for-profit outfit. So by all accounts, its executives are making good coin as the value of that company soars. What’s interesting about Novavax is it has never brought a product to market before.

So how did it get its skin in the game?
It benefited from the billions of dollars in funding former US President Donald Trump put into the Operation Warp Speed program to get vaccines developed ASAP.

I won’t even ask about the name…
Good idea.

Moving on… Where is Novavax on our vaccine rollout schedule?
It hasn’t been cleared by the TGA yet, but the first of the 51 million doses we have ordered are expected to arrive in Oz next year as part of that booster program.

Where does that leave things?
What we know is that across Australia more than 17 million doses have been administered. And reports say Oz has a stockpile of more than 6 million AZ vaccine doses. So we’ve had about 23 million doses delivered.

And are Aussies getting vaccinated?
Our rate of jabs is on the up. As a percentage of the population 52.8% of eligible Aussies have had at least one dose of a vaccine, and 30.3% are fully vaccinated against COVID 19.

There’s a lot of moving pieces in this complex puzzle…
And we can expect more where that came from.

Squiz recommends:

ABC’s 7.30 Report – Children and COVID – Dr Norman Swan has the facts

Forbes – Covid’s Forgotten Hero: The Untold Story Of The Scientist Whose Breakthrough Made The Vaccines Possible

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