COVID-19 vaccination in Australia

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COVID-19 vaccination program
Vacciation Map of Australia.png
COVID-19 vaccination map of Australia (as of 27th of April 2021)
Date22 February 2021 (2021-02-22) – present
Location Australia
CauseCOVID-19 pandemic
TargetImmunisation of Australians against COVID-19
BudgetA$1.87 billion[1]
Organised byFederal, state and territory health departments
Participants2,316,969 doses administered of Pfizer-BioNTech or Oxford–AstraZeneca vaccine
Websiteaustralia.gov.au/covid19vaccines
Australia's covid-19 vaccination underway

COVID-19 vaccination in Australia began on Monday 22 February 2021, and will continue throughout the year with the goal of vaccinating all willing Australians before 2022. Front-line workers[a] and aged care staff and residents will be the first Australians to be inoculated, before a gradual phased release to less-vulnerable and lower-risk population groups throughout 2021. The Therapeutic Goods Administration (TGA) has approved two vaccines in Australia: the Pfizer–BioNTech vaccine on 25 January, and the Oxford–AstraZeneca vaccine on 16 February.[2][3][4] As of 4 May 2021, Australia has administered 2,316,969 vaccine doses across the country.[5][6]

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Vaccine approval[edit]

The two vaccines currently approved for administration in Australia are classified as being "provisionally approved", meaning that they have been deemed safe and effective based on clinical and scientific data and are in the process of non-expiring registration. The authorisation means the vaccine will become part of the Australian Therapeutic Goods Register and will be up for review again in two years based on additional clinical data.[7]

Pfizer–BioNTech vaccine

This section is an excerpt from Therapeutic Goods Administration § Pfizer–BioNTech vaccine[edit]
Pfizer–BioNTech vaccine (2021)

On 25 January 2021, the TGA provisionally approved the two-dose Pfizer–BioNTech COVID-19 vaccine, named COMIRNATY, for use within Australia. The provisional approval only recommends the vaccine for patients over the age of 16, pending ongoing submission of clinical data from the vaccine sponsors (the manufacturers, Pfizer and BioNTech).[8] Additionally, every batch of vaccines will have their composition and documentation verified by TGA laboratories before being distributed to medical providers.[9]

The Department of Health has planned the administration of COVID-19 vaccinations in five phases, organised by the risk of exposure. Border, quarantine, and front-line health and aged care workers will be first vaccinated, followed by over 70-year olds, other health care workers, and essential emergency service members. Following the provisional approval of COMIRNATY, Prime Minister Scott Morrison said that it was planned for the first group to begin vaccinations by February 2021, six weeks earlier than originally planned.[10]

The first public COVID-19 vaccination in Australia actually took place on 21 February 2021 with the Pfizer–BioNTech vaccine at Castle Hill in Sydney. An 84 year-old aged care resident was the first Australian to receive the vaccine. To show confidence in the national immunisation vaccine rollout, Prime Minister Morrison and Chief Medical Officer Professor Paul Kelly also received vaccinations.[11]

On 23 February 2021, Australia's second shipment of the Pfizer vaccine arrived at Sydney airport. Health Minister Hunt confirmed the arrival of 166,000 doses, and 120,000 more doses expected to arrive in the upcoming week.[12]

On 9 April 2021, PM Scott Morrison announced that Australia has secured the other 20 million doses of the Pfizer vaccine, making 40 million doses amid concerns about the AstraZeneca vaccine. Additional doses of Pfizer are expected to arrive in Australia in the last quarter of 2021.[13]

Oxford–AstraZeneca vaccine

This section is an excerpt from Therapeutic Goods Administration § Oxford–AstraZeneca vaccine[edit]
Oxford AstraZeneca COVID-19 vaccine (2021)
On 16 February 2021, the Oxford–AstraZeneca vaccine was approved by the TGA for use in Australia. The administration of this vaccine is scheduled to start in March.[14] Two weeks later, on 28 February, the first shipment of the vaccine, around 300,000 doses, arrived at Sydney for rollout from 8 March.[15] On 5 March 2021, Italy stopped the export of AstraZeneca vaccine to Australia due to their slower rollout of that vaccine in the EU.[16] On 23 March, TGA has approved the first batch of locally manufactured Astrazneca vaccine by CSL-Seqirus in Melbourne, and 832,200 doses are ready for rollout in upcoming weeks.[17]

Vaccine rollout and distribution[edit]

COVID-19 vaccine national rollout phases[edit]

National Vaccine Rollout Strategy[18]
Order Priority group Number of eligible (estimated) [19] Number of doses targeted [b] Progress [c]
Phase 1a
1 Quarantine, border & front-line health care workers 678,000 up to 1.4 million In progress
2 Front-line health care worker sub-groups for prioritisation
3 Aged care and disability care staff
4 Aged care and disability care residents
Phase 1b
5 Elderly adults aged 80 years and over 6,139,000 up to 14.8 million In progress Registration open
6 Elderly adults aged 70–79 years
7 Other health care workers
8 Aboriginal and Torres Strait Islander people aged 55 and over
9 Adults with an underlying medical condition, including those with a disability
10 Critical and high-risk workers, including defence, emergency services and meat processing
Phase 2a
11 Elderly adults aged 60–69 years 6,570,000 up to 15.8 million In progress
12 Adults aged 50–59 years
13 Aboriginal and Torres Strait Islander people aged 18–54
14 Other critical and high-risk workers
Phase 2b
15 Balance of adult population 6,643,000 up to 16 million TBA
16 Any unvaccinated Australians from previous phases
Phase 3
17 Australians under 18 years[d] 5,670,000 13.6 million TBA

On 21 February 2021, a day before the previously announced program start date, Prime Minister Scott Morrison, Chief Medical Officer Paul Kelly, Chief Nurse Alison McMillan, and "a small group" of aged care staff and residents became the first Australians to receive the Pfizer–BioNTech vaccine. The early vaccination was heavily televised with the hopes of reassuring Australians about the quality, efficacy, and safety of COVID-19 vaccines.[20]

On 22 February, the first Canberran received a COVID-19 vaccination. She was a 22-year-old registered nurse, and a member of a COVID-19 testing team.[21]

On 22 March, Health Minister Greg Hunt announced the start of the phase-1b vaccination roll-out. In this phase, more than 6 million Australians are targeted for inoculation, and approximate 1,000 GP clinics are participating in vaccination all over the nation to ramp up the speed of vaccination.[22]

The Federal Government of Australia has decided to prioritise people 50 years or older for vaccination. They will be eligible to get a vaccination from 3 May 2021 at General Practice Respiratory Clinics and state or territory vaccination clinics. From 17 May people over 50 years-of-age can also get their vaccination at selected participating GP clinics. The Australian Technical Advisory Group on Immunisation advised the government to reserve the Pfizer vaccine for those under 50 years-of-age, and the AstraZeneca vaccine will be administered for phase 2a.[18]

Distribution[edit]

The federal government has promised to provide free vaccinations to everyone living in Australia, largely regardless of immigration status. Like most vaccines, Australians will not need a prescription to receive them.[23]

Vaccination rollout by states and territory[edit]

State or territory Population Doses administered[e] Ref.
Australian Capital Territory 431,114 30,011 [6]
New South Wales 8,164,128 215,006 [24][6]
Northern Territory 245,980 16,820 [6]
Queensland 5,174,437 147,216 [25][6]
South Australia 1,769,319 62,094 [26][6]
Tasmania 540,569 39,736 [27][6]
Victoria 6,694,884 220,133 [28][6]
Western Australia 2,661,936 102,554 [29][6]
Aged and disability care 187,300 238,282 [6][30]
GP clinic NA 1,245,117 [31]
Total 25,687,041 2,316,969 [6][32][33][5]
The federal government and NSW do not report daily, so national figures may not equal the sum of states and territories.

New South Wales[edit]

On 9 April 2021, the Australian Technical Advisory Group on Immunisation (ATAGI) advised the federal government to suspend use of the AstraZeneca vaccination for people under the age of 50. The NSW government decided to temporarily suspend inoculation with the AstraZeneca vaccine in the state for all age groups and expected to recommend it after the Friday cabinet meeting.[34]

South Australia[edit]

On 19 March 2021, South Australia faced a major setback due to the wrong shipment of the Pfizer vaccine. Pfizer vaccines were bound to deliver to Adelaide but wrongly delivered to Perth, Western Australia. Premier of South Australia Steven Marshall denied the knowledge of any delivery and said this is the federal government responsibility to deliver the vaccine. Federal government officials confirmed the error in the schedule of delivery.[35]

Vaccine on order[edit]

This section is an excerpt from COVID-19 pandemic in Australia § Vaccines[edit]

Australia's first human trials of a candidate COVID-19 vaccine, Novavax's NVX-CoV2373, began in Melbourne by 26 May 2020.[36]

The Australian government entered into agreements with Pfizer/BioNTech, University of Oxford/AstraZeneca, Novavax and the University of Queensland for the supply of vaccines.[37] The University of Queensland vaccine was abandoned in December 2020 after trials revealed that, while it was safe, it triggered false positives on HIV tests.[38][39] The Therapeutic Goods Administration (TGA) provisionally approved the Pfizer vaccine in January 2021.[40] The Australian government ordered 10 million doses, with the first 80,000 to be delivered in February 2021, but production problems and the imposition of export controls by the European Union (EU) onto deliveries to countries outside Europe made meeting the delivery schedule problematic.[41]

This would also affect deliveries of the Oxford–AstraZeneca COVID-19 vaccine, which was provisionally approved by the TGA in February,[42] and received final approval in March.[43] Orders were reduced from 3.8 million to 1.2 million doses of this vaccine, which is manufactured in Belgium,[41][44] and arrival was pushed back to March 2021.[45] CSL Limited began manufacturing 50 million doses of the AstraZeneca vaccine in Melbourne in November 2020. Deliveries were expected to commence in March.[46] The AstraZeneca vaccine could be stored at normal refrigeration temperatures of 2 to 8 °C (36 to 46 °F), whereas the Pfizer vaccine required storage at −70 °C (−94 °F).[45] However, concerns were raised about the efficacy of the AstraZeneca vaccine.[47][48] The Australian and New Zealand Society for Immunology called for a pause in its rollout, as the efficacy of the vaccine reported by trials was insufficient to achieve the desired herd immunity effect.[49] CSL management declined an invitation to appear before an Australian Senate inquiry.[50]

Although the Prime Minister of Australia, Scott Morrison, said that Australia would be "at the front of the queue",[51] and the Minister for Health and Aged Care, Greg Hunt, claimed that Australia would be among the first countries to receive COVID-19 vaccines, 61 other countries had already commenced vaccinating their citizens by the end of January 2021, while the Australian vaccination rollout was not scheduled to commence for another month.[50]

On 15 February 2021, 142,000 doses of the Pfizer–BioNTech COVID-19 vaccine arrived in Australia. The first doses are due be administered on 22 February.[52] The world-wide distribution of the vaccine has been described as "… the largest logistics effort in the world since World War" by Dr Roberto Perez-Franco of the Deakin University's Centre for Supply Chain and Logistics.[53] This was followed, on 28 February, by 300,000 doses of the Oxford–AstraZeneca vaccine, which arrived at Sydney airport. It was planned that most Australians will be immunised with this vaccine, the majority of which will be manufactured in Australia by CSL Limited.[54] On 5 March, Italy and the European Union blocked a shipment of 250,000 doses of the Oxford−AstraZeneca vaccine from Italy to Australia, citing low COVID-19 case numbers in Australia and the limited availability of vaccines in the EU.[55]

Local manufacturing began in November 2020.[46] On 16 February, the first vials of COVID-19 vaccine produced in Australia came off the production line at the CSL Behring plant in Broadmeadows, Melbourne.[56] This is the active raw vaccine material. The vaccine vials are filled and packaged into doses by Seqirus, a CSL subsidiary in Parkville, Melbourne.[57] Production of the AstraZeneca vaccine in Australia received its final approval from the TGA on 21 March.[43] Understandably, many front line health care workers preferred the Pfizer vaccine over the AstraZeneca one.[58]

The Australian government had also signed a deal with Novavax for 51 million doses of its vaccine, with supply originally slated for "mid-2021".[59] As of April 2021, it had yet to be approved by the TGA. It is not manufactured in Australia, so like the other imported vaccines, its availability was uncertain. In trials it was reported to be 95.6 per cent effective against COVID-19, and an 86.3 per cent effective against the variant identified in the UK.[59]

In a February 2021 pre-budget submission, the Australian Academy of Science renewed its call for the government to develop the capability to produce MRNA vaccine technology in Australia. The ability to mass-produce such vaccines onshore would insulate Australia against supply shocks, and cater for future pandemics and potential biosecurity situations. The MRNA vaccines had proved to be more effective than those produced with conventional vaccine technology, and easier to reconfigure to cater for new virus variants.[60][61]
Vaccine name Approval progress Quantity Doses arrived Vaccine approved Began administering
Pfizer–BioNTech Approved for use 40 million [62] 1,172,000 [32] Green check.svg 25 Jan 2021 Green check.svg 22 Feb 2021
Oxford–AstraZeneca Approved for use 53.8 million 714,000 [63] Green check.svg 16 Feb 2021 Green check.svg 5 March 2021 [64]
Novavax Phase III clinical trials 51 million None Dark Red x.svg Not yet Dark Red x.svg Not yet

Vaccine candidates in human trials[edit]

Vaccine Country of origin Type (technology) Progress Ref
RBD SARS-CoV-2 HBsAg VLP
SpyBiotech 		United Kingdom Virus-like particle Phase I–II (280)[65]
Randomized, placebo-controlled, multi-center.
Aug 2020 – 2021, Australia
COVAX-19
Vaxine Pty Ltd 		Australia Subunit (recombinant protein) Phase I (40)
Jun 2020 – Jul 2021, Adelaide 		[66]
COVIGEN
University of Sydney 		Australia DNA Phase I (150)[67]
Double-blind, dose-ranging, randomised, placebo-controlled.
Feb 2021 – Jun 2022, Sydney
bacTRL-Spike
Symvivo 		Canada DNA Phase I (24)[68]
Randomized, observer-blind, placebo-controlled.
Nov 2020  – Feb 2022, Australia
SC-Ad6-1

Tetherex Pharmaceuticals

United States Viral vector Phase I (40)[69]
First-In-Human, Open-label, Single Ascending Dose and Multidose.
Jun  – Dec 2021, Australia

Progress to date[edit]

Cumulative vaccinations in Australia

Daily vaccinations chart of Australia

Vaccine overdose and adverse reactions[edit]

Two elderly aged care residents in Queensland received a "higher than recommended dose" of the Pfizer/BioNTech COVID-19 vaccine, however, there was no adverse reaction noted.[70] It was reported that the contractor responsible for aged care vaccinations in Queensland, Healthcare Australia, found that the doctor responsible had not completed their training for administering COVID-19 vaccinations, and was stood down and subsequently reported to the appropriate medical regulator.[71]

A health worker in Queensland experienced a serious anaphylactic reaction after receiving the Pfizer vaccine and was admitted into intensive care. The person had a history of anaphylaxis and was discharged after full recovery on the same day.[72]

A 44-year-old Victorian man was admitted to Melbourne's Box Hill Hospital on 2  April 2021 when he developed serious thrombosis and a low platelet count after receiving the AstraZeneca vaccine on 22  March. He developed blood clots in his spleen, liver and gut. Similar cases had been reported overseas among those who received the AstraZeneca vaccine (30 cases in the UK alone) but none among those who had received the Pfizer vaccine. Canada and Germany had already suspended the use of AstraZeneca for people under the age of 55 and 60-years, respectively. It was estimated that this occurred in somewhere between one in 100,000 and one in a million recipients. This prompted the TGA to warn anyone who experienced persistent headaches or other worrying symptoms 4 to 20 days after receiving the vaccine to seek medical advice.[73][74]

After the latest finding and advice on the AstraZeneca vaccine by UK and EU, the Australian Technical Advisory Group on Immunisation (ATAGI) and the TGA had a meeting on 8 April to review and advise the government about the concerns of the vaccine. Chef medical officer reassured the safety of the vaccine but being reviewed and other vaccine options like Pfizer and Novavax (expected in mid-2021) for the nation.[75] ATAGI advised the federal government to use the AstraZeneca vaccine only for over 50-years-of-age as they confirmed the very rare side-effect of blood clotting could occur in young persons. So, the health department confirmed the new timeline of the AstraZeneca vaccine rollout. All people aged over 50-years were encouraged to take the AstraZeneca vaccine.[76]

The second case of blood clotting in a Western Australian woman in her 40s was linked in mid-April to the AstraZeneca COVID-19 vaccine.[77]

In the third case of blood clotting, a 48-year-old New South Wales woman died in John Hunter Hospital on 15 April after developing thrombosis with thrombocytopenia 4 days after being vaccinated on 8  April. The TGA confirmed the "likely" possibility her death was linked to the AstraZeneca vaccination. They confirmed that the woman had diabetes and had other underlying medical conditions.[78]

The fourth case of blood clotting, reported in Brisbane, is believed to be linked to the Pfizer vaccine. A 40-year older man received the vaccine on 18 April and was admitted to a private hospital three days later. According to the health department, investigations are underway to confirm the link between the vaccine and clotting.[79]

Three more cases of blood clotting reported on 23 April are believed to be linked with AstraZeneca vaccination. A 49-year-old Queensland man, an 80-year-old Victorian man and a 35-year-old NSW woman all had suspected thrombosis with thrombocytopenia syndrome (TTS). The TGA said there was a "likely link" as all three had received the AstraZeneca vaccine. All were in a stable condition and recovering.[80]

Vaccination timeline criticisms[edit]

On 11 March 2021, the Australian Medical Association attested that it was implausible that the government's target of offering vaccination to every Australian by October 2021 would be achieved and suggested that mid-December 2021 would be a more realistic date. The government had aimed to administer 60,000 doses by the end of February but ended up administering only 31,000 doses.[81] The Australian vaccination program was 85% behind its target figure by the end of March, whereby 4 million doses were targeted by the Health Department before rollout but only 670,000 had been delivered.[82]

The Australian vaccination rollout had a further setback when pharmacists postponed joining the vaccination program until June.[83] The federal government said that the EU blocked the shipment of more than 3 million doses of vaccine to Australia is a major reason for the delayed vaccine rollout, although the EU only officially confirmed the export blocking of only 250,000 doses in early March.[84][85]

The advisory discouraging the use of the AstraZeneca vaccine on people under the age of 50 proved a major setback in the vaccination rollout, given it was originally slated as the cornerstone of the entire rollout. Prime Minister Scott Morrison stated at the time that a definitive timeline for vaccine rollout could no longer be provided, and there is a need to re-evaluate and recalibrate the program.[86]

On 11 April 2021, PM Scott Morrison conceded COVID-19 vaccination's target set earlier to vaccinate all Australians by the end of this year is difficult to achieve. He also said there is no set target for the vaccine rollout timeline due to many uncertainties involved.[87] PM Morrison suggested two meetings of the National cabinet per week can be held until the issues of vaccine rollout are fixed.[88]

More than 2 million COVID-19 vaccinations had been administered by 28 April 2021, but this was 3 million short of original plans.[89]

See also[edit]

Notes[edit]

  1. ^ Front-line workers is limited to staff at border and quarantine facilities, health care staff in emergency and COVID-19 wards in hospitals, and other direct-contact workers.
  2. ^ Both doses
  3. ^ Figure shows eligible got at least one dose of the approved vaccine
  4. ^ This phase will only occur based on clinical and scientific data, as there is limited evidence currently about the efficacy of the vaccine for this age group.
  5. ^ Australians who have received at least one dose of an approved COVID-19 vaccine.

References[edit]

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