Who’s to blame for Australia’s slow vaccine rollout?
Australia’s vaccine rollout began in late February 2021 but has been widely panned for failing to meet its ever-changing targets. Australia is near the bottom of the table when comparing the progress of its vaccine rollout to other countries.
The Federal Government is blaming others while the States are blaming the Federal Government.
Who is really to blame?
Approval must be obtained from the Therapeutic Goods Administration (TGA) before a COVID-19 vaccine can be used in Australia. This involves a detailed process which is designed to ensure that the TGA doesn’t approve a vaccine that results in unacceptably high side-effects when compared to its benefits from a health standpoint.
As you can see from the TGA’s website, the TGA approved Pfizer on 25 January 2021 and then AstraZeneca on 15 February 2021. More recently, the TGA approved Johnson & Johnson’s vaccine on 25 June 2021.
How does this compare to overseas?
Well, Pfizer appears to have received the quickest approvals in the various jurisdictions I looked at.
As for AstraZeneca, the United Kingdom approved it on 30 December 2020 but the United States has asked AstraZeneca for more information before considering approving it.
For its part, the EU took another month to approve AstraZeneca, doing so on 29 January 2021.
So if we use the earliest date at which the Pfizer and AstraZeneca vaccines were approved in these 3 jurisdictions, the TGA took 8 weeks longer than the UK to approve Pfizer and 7 weeks longer than the UK to approve AstraZeneca.
While I am sure the TGA wanted to perform a thorough review before approving these vaccines – as it should – its tardiness resulted in a two month delay to the start of the rollout in Australia.
Even so, it’s one thing for the TGA to approve a vaccine but another for Australia to actually receive supplies of the vaccine once approved.
And this is where things really appear to have gone pear-shaped.
Unfortunately, Australia only has the necessary facilities to locally produce vaccines like AstraZeneca, which is a viral vector vaccine, and not mRNA-based vaccines such as Pfizer or Moderna.
This is why the government ordered a combined 85m doses of AstraZeneca and a similar, locally developed vaccine from the University of Queensland in September 2020.
While 3.8m doses of AstraZeneca were supposed to be delivered from Europe, the vast majority of AstraZeneca doses (50m) are to be produced here in Australia by CSL.
Unfortunately, instead of its March target, CSL reached 1m doses produced per week in early May 2021. Note that these doses take up to four weeks to be released for use due to the necessary quality control checks undertaken by CSL, AstraZeneca and the TGA.
As such, the 3.8m doses of AstraZeneca sourced from overseas were intended to support the early stages of the rollout while CSL got up to speed. Unfortunately, as the EU was falling behind its own rollout targets, it effectively blocked 3.1m of these doses from being sent to Australia, also severely affecting the early vaccine rollout.
Change in approvals for AstraZeneca
Meanwhile, the University of Queensland vaccine was subsequently scrapped due to people falsely testing positive for HIV.
On the face of it, this wasn’t such a big deal: there was never any certainty that this vaccine – or any others – would pass the necessary clinical trials to be approved for use.
Moreover, Australia had a back-up in AstraZeneca, which was always supposed to be the backbone of our strategy.
However, the proverbial hit the fan when the Federal Government was advised on 8 April 2021 that AstraZeneca was no longer the recommended vaccine for under-50s, with the advice again updated in June to restrict AstraZeneca to over-60s.
On top of the EU preventing 3.1m of the 3.8m early AstraZeneca doses from reaching Australia and delays in CSL cranking up production, this was probably the biggest blow to the vaccine rollout.
Australia currently has excess supplies of AstraZeneca but not enough Pfizer vaccines, which is now the recommended vaccine for those under 60.
Even though the Federal Government quickly secured another 20m Pfizer doses to add to the 20m it had purchased in November 2020 and February 2021, the bulk of the these doses will only start reaching Australia over the next few months.
Catalogue of errors
So it’s been a catalogue of errors. Initial 2-month delays by the TGA were followed by EU intransigence and delays by CSL in cranking up production of locally-produced AstraZeneca, and then topped off by changing medical advice in relation to AstraZeneca.
In any case, the rollout has improved in recent weeks, particularly as more people have rushed to get vaccinated in light of the latest lockdowns in Sydney and elsewhere.
And happily, with the bulk of the Pfizer vaccines due to arrive in the next few months, Australia’s vaccine rollout should continue cranking up.