Friday, July 23, 2021

Vaccine miscalcuations

 The vaccine situation in Australia is a mild clusterfuck.  But at least the spread of the delta variant has lit a fire under the seats of both the government and population.  As I write this, I am half-vaccinated, and scheduled for my second dose of AstraZenica.  However, projections are that Australia will not reach 70% vaccination rate until the end of the year or slightly later.

The initial problem was two-pronged - a strategy that made perfect sense, but didn't pan out.  The government decided to put all or most of its eggs in one basket - contracts for AstraZenica.  That is the vaccine that can be stored at refrigerated temperatures; it's a traditional vaccine; not the RNA technology. Arrangements were made for both importation and locally licensed production.  The easier storage and transportation of AstraZenica, combined with easily ramped-up local production made it a logical choice.  And then news came out of the rare possibility of a clotting disorder.  

The USA paused to make sure all doctors were aware of how to treat the condition, should it arise, and issued the data on who was most at risk.  Australia, which at that moment had virtually zero COVID cases, outside of quarantined incoming travelers, decided to declare AstraZenica only be used for people over 60 years old.  For people under 60, since there was little risk of catching COVID, and less risk of it being fatal, the Pfizer vaccine was recommended - as soon as supplies arrived.  And there was a contract for Pfizer from a supplier in Italy.  Which all seemed fine until the delta variant hit Italy and the EU decided it couldn't spare the supply.  

At that point, things were getting back to normal in Sydney.  There was a flare-up in Melbourne, but lockdown knocked it back.  And so there was no urgency among the population to get vaccinated, since there were virtually no cases on the loose.  At that point I was happy to be in Australia instead of the US.  We went to a theater to see Hamilton (wearing masks).  Then... delta variant.  One limousine driver - who happened to do a fair amount of shopping while contagious, and even brief contacts were coming up positive.  And two guys from a moving company, who drove a truck from Sydney to Melbourne, then Adelaide - not only carrying the virus to those cities and small towns along the route, but as news of their fine of a thousand dollars each hit the news, within a day or two, news also that their mother had just died from the delta variant.  Shortly after, I received a text from my physician's office saying their switchboard had gone from 80 calls a day to about 800; seems everyone was looking for vaccine.  The physician's office gave an email address for regular patients who couldn't get through their phone line.

The Prime Minister, feeling heat for having gone entirely with AstraZenica at the outset, announced, apparently without broader consultation with medical groups, that those under 60 should consider getting the AstraZenica vaccine - the risks from COVID were now higher than any risk from AstraZenica.  This caused backlash from one state premier, and another, who had requested Pfizer as a priority for areas with critical threat, complained about the lack of supply - the federal government's responsibility.  

As a direct result of this back-and-forth about the risks of AstraZenica, some of the public, even those over 60 with little risk, began to see Pfizer as the preferred alternative.  Except there wasn't enough supply.  An acquaintance who will remain unnamed said they registered a false birth date for their mother, in hopes that she could get Pfizer along with the family members under 60.  Considering you are required to present your Medicare card (everyone here has Medicare) - I doubt the fake birthday will go unnoticed; the question is whether it will cause a disturbance at the vaccination site.  It seems if they were smart, they'd have both vaccines on hand for just such situations.  

And so, as the delta variant is still spreading in the community: 105 people hospitalized; an additional 32 in ICU in Sydney; we have a fair number of younger people who are saying they'll take whatever vaccine they can get as soon as possible.   But we also have a significant chunk of all ages who want Pfizer, and are holding off, not getting AstraZenica in hopes of getting Pfizer before they catch COVID.  The Prime Minister has said he will not rush any shipments of Pfizer to critically affected areas; everyone will have to wait (some of this almost seems a retaliation for criticisms by state premiers).  As I mentioned; I already have my first shot, and an appointment in a couple of weeks for my second at my regular physician's office.  They moved the date forward by a few days because they're re-shuffling to have fewer people in the waiting area, due to increased virulence of the delta strain.  My wife was vaccinated with Pfizer as a priority, since she works in healthcare.  I could have gotten Pfizer as her spouse, but at that point, already had an appointment with my physician, and carried through that route.