Vaccine changes are likely to increase hesitancy, to say nothing of the fresh headaches for GPs.
People under the age of 50 might no longer want an AstraZeneca vaccine due to safety concerns, but most will have no alternative options, at least in the short-term.
The Australian Technical Advisory Group on Immunisation announced earlier this month that the Pfizer vaccine was preferable in Australians aged under 50 years of age, in response to rare but serious events of blood clots following AstraZeneca vaccine.
But these changes to the national rollout won’t immediately remedy previous government planning that ensured the overwhelming majority of Australians would receive two doses of the AstraZeneca vaccine.
Professor Ross Gordon, a member of the WHO technical advisory board on behavioural insights said he was worried about how the public might perceive the recent changes to the vaccine rollout.
“There’s been a tendency to treat the public with an attitude of ‘We know what we’re doing, you’ll get whatever vaccine you’re given and we can assure you it’s safe and it’s the right one,” he told The Medical Republic.
“I actually think people want more information to feel more informed and in control of the decisions when they are making them.”
Professor Gordon said the government approach now more than ever, requires greater clarity in the communication from health officials.
“Underpinning that is delivering on what’s promised and communication through action,” he said.
GPs at the coalface are already seeing the fallout from ATAGI’s recent advice, with patients expressing a preference for getting the Pfizer vaccine over AstraZeneca.
“There’s been very difficult conversations already because people have been coming in saying, ‘I don’t want the AstraZeneca vaccine, I want the Pfizer vaccine” said Dr Brad McKay, a Sydney GP.
“From a GP perspective, you can only say ‘Okay’ and at the same, time tell them ‘We can’t help you because we don’t have access to any Pfizer vaccines.”
While the government has since announced the purchase of an additional 20 million doses of the Pfizer vaccine, it has continued to deny that vaccine hesitancy might increase given its changed advice for the AstraZeneca vaccine.
Health Minister Greg Hunt said at a press conference that the government expects ‘we will start to have very significant doses of Pfizer’ by the time younger people are due to be vaccinated, which would now be October at the earliest.
“I think the issue will be in the patients a few years older than 50, who are recommended to have an AstraZeneca vaccine, but look at those under 50 years old and wonder why the advice is different,” said Dr McKay.
“We’re going to have a lot of people in their 60s, 70s and older now who will just refuse to have an AstraZeneca vaccine and they’ll be wanting something different.”
And while the Therapeutic Goods Administration has approved storage and transportation of the Pfizer vaccine at domestic freezer temperatures (-25°C to -15°C) for up to two weeks, longer term storage at ultra-cold temperatures (-90°C to -60°C) is still required longer term.
These storage requirements for Pfizer are expected to continue to preclude certain adults from accessing this as an AstraZeneca alternative, such as those living in rural and remote areas.
Associate Professor Margie Danchin, group leader in vaccine acceptance uptake and policy at the Murdoch Children’s Research Institute in Melbourne, told TMR that recent events could generate positive and strong conversation around rare and serious adverse events from vaccination.
“Perhaps in the past, maybe we have oversold vaccine safety too strongly and I think what’s happening now is that there’s a very open and transparent conversation that these are the expected risks that we deal with,” Professor Danchin said.
“I think the ATAGI advice is very good and sound and, even though it’s not what the public want to hear, it should hopefully give people confidence that ATAGI are taking the international data seriously and that we have a really robust vaccine safety system in place.”
