Scott Morrison holds a vial of the AstraZeneca vaccine.
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We asked for your questions about Australia's COVID-19 vaccine rollout. Here's what you wanted to know

Vaccine waiting times and when international borders will reopen - here's what you wanted to know about the updated AstraZeneca advice and Australia's vaccine rollout.

Published Wednesday 14 April 2021
By Jodie Stephens

Australia’s COVID-19 recovery timeline is up in the air after authorities scrapped AstraZeneca as the preferred vaccine for adults under 50, in favour of the Pfizer jab.  

The Australian government moved after the European Medicines Agency investigated 86 blood clotting cases, 18 of which were fatal, out of around 25 million people in Europe who received the AstraZeneca vaccine.

Most of the cases were in women aged under 60.

Most Australians had been expected to receive the AstraZeneca shot. 

In the wake of the updated vaccine advice, we asked our readers what questions they had about the AstraZeneca shot and Australia’s vaccine rollout. Here is what they wanted to know.

Why do adults under 50 have to take a different vaccine to those over 50?

The Australian Technical Advisory Group of Immunisation (ATAGI) issued its updated advice last week, following evidence of a “rare but serious” AstraZeneca side effect involving blood clotting - otherwise known as thrombosis with thrombocytopenia syndrome (TTS).

ATAGI considered the vaccine benefits versus the risks - and the balance varies with age. The increased risk of severe COVID-19 outcomes in older adults means there’s a greater benefit to them getting vaccinated, while the rate of TTS may be higher in younger people.

However, it is worth noting the advice amounts to a recommendation rather than a ban. The benefits may outweigh the risks for young people with underlying conditions, and the prime minister last week said Australians should make informed vaccine decisions with their doctor.

The Department of Health has stressed that the AstraZeneca vaccine is still highly effective, and that blood clotting events are very rare.

When will healthy people aged under 40 be eligible to be vaccinated?

This is a tough question to answer, given the government has scrapped Australia’s vaccine rollout timetable. While we were previously told all adults would receive their first vaccine dose by October, the prime minister has now conceded that not all Australians will get their first dose by the end of the year.

“The government has also not set, nor has any plans to set any new targets for completing first doses,” Mr Morrison said in a Facebook post on Sunday.

“While we would like to see these doses completed before the end of the year, it is not possible to set such targets given the many uncertainties involved.”

Does this mean international borders will not open this year?

It’s not clear when we can expect international borders to open. However, the prime minister on Friday said the government was seeking expert health advice on the thresholds Australia would need to meet to relax border and hotel quarantine rules.

He raised the possibility of vaccinated Australians being able to make a return overseas trip without going into hotel quarantine on their arrival home - whether it’s because they’re going into home quarantine instead, or not quarantining at all.

Travellers adhere to social distancing rules as they check in for their flights at Sydney International Airport in March 2020.
Source: AAP

Mr Morrison said they are also seeking advice on the extent to which vaccinated Australians stuck overseas can return home on the same basis, as well as the potential for other travel bubbles with countries that have similar vaccination arrangements to Australia.

"No one is saying that any of those things are coming in today," he said.

“What we are working and planning for, and have tasked the medical professionals who advise us on, is what are the marks we have to meet to enable us to start opening up Australia more than we are now.”

While Australians await that advice, economist Chris Richardson has suggested that international travel is likely to remain restricted until 2024. That’s not to say restrictions won’t ease.

Do contraceptive pills have a similar risk of blood clotting to AstraZeneca?

Sexual health physician and University of NSW conjoint lecturer Terri Foran says the contraceptive pill carries a greater risk - but even then, the numbers are very low.

Dr Foran says about five to 12 women out of every 10,000 who take the contraceptive pill are affected by clots. To put that in perspective, clotting also affects three to five out of every 10,000 women of reproductive age who don’t take the pill. The evidence out of Europe suggests about one in every 250,000 people vaccinated with AstraZeneca is diagnosed with rare blood clots.

“The difference is that with the pill, you’ve only got about a three per cent chance of dying [if you get a clot] so it’s tragic if it happens, but the actual risk of dying is still very small,” Dr Foran told SBS News.

The clots associated with the AstraZeneca shot can cause a death rate of up to 25 per cent in the rare instances that they occur, Chief Medical Officer Paul Kelly said last week.

Dr Foran urged caution when comparing clotting from both the contraceptive pill and the AstraZeneca vaccine - noting that women are at greater risk when they get pregnant than when they are on the pill.

COVID-19 itself has also been linked to some clotting risk.

Are the underlying medical conditions listed for phase 1B an exhaustive list?

A Department of Health spokesperson told us the list of medical conditions is guiding phase 1B of the vaccination rollout, but it's not exhaustive. Medical practitioners can exercise professional judgement when considering if a patient fits into these categories.

Will over 50-year-olds eventually be able to choose Pfizer when there is enough?

According to the same health spokesperson, specific vaccines will be administered "based on availability and clinical guidance on appropriate vaccines for people".

How can we be so behind when the rest of the world is jabbing in thousands?

Australia has vaccinated more than one million people, and Scott Morrison argues that the rollout is on par with the rest of the world.

But some countries did get a head start when they granted emergency use of COVID-19 vaccines, in circumstances where they were grappling with significant outbreaks. Australia waited for the Therapeutic Goods Administration to complete its usual approval process, with the government saying it wouldn’t cut corners.

Australia later hit a snag when the European Union blocked a shipment of the AstraZeneca vaccine, arguing the producer had to first make good on its promised deliveries to the bloc.

The prime minister earlier this month said 3.1 million expected doses had not been supplied from overseas.

But despite the slower-than-expected start to the vaccination program, the rollout was expected to kick up a gear as domestic supply of the AstraZeneca vaccine got underway from late March.

With most Australians previously expected to receive the AstraZeneca shot, the updated advice is a significant blow.

With reporting by AFP and AAP.