On 22 February 2021 what should have been the biggest logistical exercise in Australia’s history got underway – the vaccination of the population against the COVID-19 global pandemic caused by the SARS-CoV-2 virus.
“This vaccination program launches us down our path out of the COVID-19 pandemic in 2021. Every Australian will be given the opportunity to receive a COVID-19 vaccine, free of charge that has been proven to be safe and effective by our own medical experts.” [Australian Prime Minister Scott Morrison, media release, 21 February 2021]
Eleven months earlier in an effort to contain the spread of viral infection within Australia, the Morrison Government had finally closed Australia’s borders at 9pm AEDT on Friday, 20 March 2020, with exemptions only for Australian citizens, permanent residents (including NZ permanent residents) and their immediate families, including spouses, legal guardians and dependants, as well as Pacific Islanders transiting to their own countries.
From the very start of the pandemic the Morrison Government had refused to take responsibility for creating/re-establishing a national human quarantine system with dedicated purposed-built quarantine facilities.
Instead an ad hoc system of leased hotels in capital cities was established, primarily operating as quarantine sites under the control of state governments, in order to fill the unmet need to isolate those who at the time were still coming to Australia as tourists, as well as Australians returning from overseas or those transiting through Australia. This ad hoc system allowed COVID-19 to spread into the community on multiple occasions and state border closures became a feature of domestic pandemic response measures.
Commencing on 3 March 2020 there had been repeated announcements from the Prime Minister concerning the development of a COVID-19 vaccine and his government’s successful efforts up to November 2020 to secure over 134 million vaccine doses for the national vaccination program.
In Morrison’s own words “our strategy puts Australia at the front of the queue” for vaccine supply.
By February 2021 most Australians were anticipating the pledge that the adult population would be fully vaccinated by the end of October 2021.
Then we discovered how comprehensively we had been mislead.
There had never been a well-defined strategy behind efforts to obtain enough vaccine doses to provide the Australian population with protection against COVID-19 infection – just what looked suspiciously like a game of mates.
With the AstraZeneca COVID-19 vaccine becoming flavour of the pandemic with Morrison (there was already a Liberal Party connection with that big pharma corporation and with CSL) and an early offer by Pfizer to supply Australia with its COVID-19 vaccine rejected.
Then as international circumstances changed and demand for vaccines began to exceed big pharma stockpiles, it became much more difficult for Australia to successfully compete with other nations for vaccine doses.
As for the national COVID-19 vaccination program rollout, Morrison's plan avoided using the mass vaccination expertise of state and territory departments of health and put together a pottage of primarily private sector vaccine delivery methods which failed to meet the vaccination target of 4 million people receiving their first vaccine dose in the first four weeks of the rollout.
When one looks at the identified priority groups it is clear that by 8 May 2021 only around 260,000 vaccine doses have been administered across the aged care and disability sectors and many frontline health workers were yet to receive their first vaccine dose.
The wheels really fell off the bus when the AstraZeneca vaccine was shown to produce a life threatening adverse reaction in some people days or weeks after receiving a vaccine dose - thrombosis with thrombocytopenia syndrome (TTS).
After one woman died from TTS Morrison declared that the AstraZeneca vaccine would no longer be given to individuals under 50 years of age and, with not enough Pfizer vaccine on hand to vaccinate the under 50s Morrison declared there was no longer a fixed time table for the national vaccination program rollout and no new target would be set for when the Australian population would be fully vaccinated.
Since that early April 2021 decision to keep vaccinating those 50 years of age and older with the problematic AstraZeneca vaccine, 5 people aged between 51 and 74 years of age have been hospitalised with TTS. Bringing to 11 the number of people diagnosed with TTS after receiving an AstraZeneca vaccine dose - that is 11 TTS adverse events in approximately 1.4 million doses administered - with 5 of those 11 people being 64 years of age and older.
So this is now Australia's reality……
The Guardian graph showing Australia's vaccine supply as of March-April 2021:
The Guardian graph showing changing 'aspirational' targets and the 2.7 million doses gap between expected doses administered and actual doses administered by 10 May 2021:
The end result of what appears to be Prime Minister Scott Morrison's personal pandemic strategy - to offload as many federal responsibilities onto the states and territories in the hope of avoiding political blame if things go awry - is that Australia still has (i) no safe and secure national human quarantine system in place; (ii) an inadequate vaccine supply currently on hand; and, (iii) only est. 12 per cent of its eligible population having received at least a first vaccine dose; at a time when the global pandemic is escalating in the south-east Asia region and highly infectious COVID-19 variants are spreading globally.
Morrison has created the risk that a wave of COVID-19 community transmitted infections, possibly exacerbated by a virus variant, could take off between now and the end of first quarter of 2022.
In a classic political ploy on Tuesday 11 May he began sending his MPs forth to leak his 'private' concerns that the global pandemic was more threatening now than it was a year ago, that COVID-19 remained a danger to Australia as it is "racing" through countries such as India, Indonesia and Papua New Guinea like nothing we had seen in our lifetimes. He warned his MPs against complacency.
Those allegedly private concerns and, an election campaign inspired Budget 2021-22 (that continues to leave establishing Commonwealth human quarantine stations out of federal budgets) which he revealed later on the same day, are apparently supposed to divert the attention of voters. So that we all fail to notice that it is because of his own mismanagement of the federal government's role in the national response to the global pandemic that Australia's national border will need to remain closed until well into the 2022 calendar year.
Prepare for his office to release more publicity photos of prime ministerial visits to defence force bases, walks down red carpets, chin-jutting poses surrounded by flags or twee pics with wife and children. As well as more keynote speeches to industry & assorted lobby groups, along with upbeat announcements of a better future. All scattered as media releases in order to distract both mainstream journalists and the national electorate from pondering that looming public health risk he created.
BACKGROUND
The Guardian, 22 April 2021:
Australia has received just 70% of the vaccine doses the government expected to have on hand by mid-April, according to a Guardian Australia analysis.
In a presentation published online on 14 March, the government included monthly forecasts for Australia’s expected vaccine supply, accounting for the disruptions to overseas supply that had already occurred leading up to that point.
Based on these forecasts, and figures cited by the health minister, Greg Hunt, for the number of doses received from domestic and international suppliers, there is a shortfall of about 1.8m vaccine doses.
The federal government has previously blamed international shipment delays for the slow rollout, which could take a couple of years to complete at the current pace.
However, comparing the government’s forecast with the number of doses we have actually received shows there has also been a shortfall in domestic production, with the number of locally-produced AstraZeneca vaccine doses lower than the government expected.
CSL, the company producing the AstraZeneca vaccine locally, put out a press release in February suggesting it would be able to produce 2m doses by the end of March.
On 24 March, CSL confirmed the release of 830,000 doses, and on 7 April, Hunt revealed CSL had produced at least 1.3 million doses by that point.
When asked why the 2m doses target had been missed, Hunt went into detail about the production and approval process, but did not directly answer the question.
Hunt did, however, indicate that CSL would be scaling up production, and called the production of 1.3m doses so far an “extraordinary achievement”.
It is not clear whether the March forecasts were too optimistic or if there are other issues involved.
According to people familiar with how vaccines are made, the process for creating such a vaccine involves a series of complex biological procedures and involves ongoing refinement, sometimes over several years, to reach peak levels of production.
Guardian Australia sent detailed questions about the vaccine supply shortfall to the health department, and a spokesperson said Pfizer shipments were expected to increase and CSL would produce more than 50m doses this year.
“Australia has entered into four separate agreements for the supply of Covid-19 vaccines, if they are proved to be safe and effective,” the spokesperson said in a statement.
“These include agreements with Pfizer, AstraZeneca, Novavax and the Covax facility. Combined, these agreements will ensure access to approximately 170 million doses.
“As shipments of Pfizer and AstraZeneca are made available, they will be dispatched across Australia to vaccinate the population. Deliveries from Pfizer are expected regularly and will increase over the coming months. CSL is producing 50 million AstraZeneca vaccine doses over the course of this year.”
A CSL spokesperson was positive about production, saying: “Production of the AstraZeneca Covid-19 vaccine is progressing well at both CSL Behring and Seqirus, and the teams continue work around the clock to meet our commitment to the Australian community.
“The process for releasing vaccines involves extensive safety and quality checks and no batch is released until all parties – CSL, the TGA and AstraZeneca – are satisfied that each vaccine meets the required quality standards.
“CSL is proud of our unique role in manufacturing this vaccine for Australia.”
The government has also now made figures on vaccine utilisation by states and territories available, with the most recent update on 19 April.
South Australia had the lowest utilisation rates, having administered just 59% of the vaccine doses available.
Tasmania and the Australian Capital Territory both had very high rates, at 97% and 98% respectively.
Guardian Australia analysis had previously found that the smaller states were doing better in their rollout on a per-100 population basis. Tasmania, the Australian Capital Territory and the Northern Territory each have administered more than four doses per 100 population.
With more vaccines on the horizon, Dr Mark Hanly from the University of New South Wales says the groundwork has to be laid now for how to administer them out.
“[Federal] and state governments need to be planning now for how they will administer 1,000,000 doses a week,” he says. “We need to plan the logistics of how to administer vaccine at a rate that can match supply once local production is up and running. If suitable vaccination facilities aren’t in place, it is possible that the bottleneck will simply shift from supply to administration.”
South Australia is the latest to announce the creation of mass vaccination hubs to speed up the rollout, something Hanly was calling for in February, even before the rollout faltered.
“Mass vaccination sites and GPs have different advantages, so a rollout that draws on the benefits of both delivery modes is likely to help us get to high levels of coverage faster than drawing on either mode alone,” he says. “All of this, of course, is contingent on supply and people’s willingness to come forward to be vaccinated.”
